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Social Security representative payee vs Medicare authorized person - separate processes?

I'm trying to help my mom with her benefits but I'm confused about the representative payee process. I just became her rep payee for Social Security after her stroke last month, but does that automatically make me her authorized person for Medicare too? Or do I need to set that up separately with Medicare? The field office wasn't clear when I called, and I've been getting conflicting info online. Some sites say it's all under SSA, others say Medicare requires additional paperwork. Anyone navigate this successfully?

Ethan Davis

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They're different. When I became rep payee for my dad, I still had to fill out separate paperwork to handle his Medicare stuff. Had to use form CMS-1696 I think. Being a rep payee for SS doesn't automatically give u authority for Medicare decisions.

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Aisha Abdullah

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Ugh that's what I was afraid of. Did you submit the Medicare form to the same office or somewhere else?

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Yuki Tanaka

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Social Security representative payee and Medicare authorized representative are two separate designations that require different processes. As a representative payee, you're authorized to receive and manage your mother's Social Security benefits, but this doesn't automatically extend to Medicare. For Medicare, you'll need to complete Form CMS-1696 (Appointment of Representative) which authorizes you to act on her behalf for Medicare matters. Additionally, if you need to handle her Medicare Part D (prescription drug) decisions, some plans require their own authorization forms. The Medicare authorization gives you ability to: - Enroll/disenroll in Medicare plans - File appeals for denied services - Access her Medicare information - Communicate with Medicare on her behalf

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Aisha Abdullah

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Thank you for explaining this so clearly! I'll download that CMS-1696 form. Is there a time limit for how long the Medicare authorization lasts? The rep payee status continues until SSA reviews it, but I'm not sure about the Medicare side.

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Carmen Ortiz

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My sister is rep paye for our mom. She just went to SS office with the paperwork they gave her and then Medicare knew automatically. No seprate forms!!! So confused why everyone saying differnt things.

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Yuki Tanaka

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There are actually a few situations where it might appear automatic, but technically they're still separate. If your sister completed an MSP (Medicare Savings Program) application or if your mother has both Medicare and Medicaid, sometimes the authorizations can be processed together. But for most situations, separate authorizations are required for Medicare-specific decisions.

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MidnightRider

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I went through this NIGHTMARE last year with my aunt. Being a rep payee for Social Security is one process. Then for Medicare you need the CMS-1696 form. BUT THEN I found out there's ANOTHER form if you want to access the Medicare.gov account online!!! And ANOTHER form if she has a Medicare Advantage plan! I spent WEEKS getting this sorted out and kept getting bounced between offices. None of the customer service people seem to understand their own systems!!! It's absolutely ridiculous how complicated they make this!!!

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Andre Laurent

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Same experience here. Was told 3 different things by 3 different people at SSA. So frustrating!

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Hey there! I actually work with seniors and help them navigate these systems. There's often confusion about this topic. To clarify: 1. Rep payee (Social Security) - Allows you to receive/manage SS benefits 2. Authorized representative (Medicare) - Allows you to handle Medicare issues 3. Medicare account designee - Allows online account access They're separate systems with separate authorizations. For the Medicare side, you'll need to submit Form CMS-1696, but if your mom has a Medicare Advantage plan or Part D plan, those insurance companies might require their own authorization forms too. If you're having trouble reaching representatives at Medicare to get this sorted, I've personally seen clients have good experiences with Claimyr (claimyr.com). They help you connect with agents quickly without the ridiculous hold times. There's a demo of how it works here: https://youtu.be/Z-BRbJw3puU

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Aisha Abdullah

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Thank you, that breakdown is really helpful! I'll definitely check out Claimyr - I've been trying to reach Medicare for 3 days and keep getting disconnected after 40+ minutes on hold. At this point I'll try anything to get this sorted out faster.

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There's a lot of incorrect information here. Let me clarify the official policy: Being a representative payee for Social Security benefits does NOT automatically make you authorized to act on someone's behalf for Medicare matters. These are completely separate programs with separate authorization requirements, even though Medicare is administered by the Social Security Administration. For Medicare authorization, you need form CMS-1696. This allows you to handle things like appeals, enrollment decisions, and communicating with Medicare. This authorization can be ongoing or for a specific timeframe. For online Medicare account access, there's yet another process through Medicare.gov's account settings where the beneficiary can grant access (if they're able), or you can request access directly. If your mother has a Medicare Advantage plan or Part D plan, those private insurers may have their own authorization requirements too. Source: I worked at SSA for 12 years before retiring.

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MidnightRider

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THIS!!! Wish someone had given me this clear explanation from the beginning instead of the runaround I got from every office I called! Would have saved me so much time and frustration.

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Aisha Abdullah

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Update: I finally got this sorted out! For anyone who finds this thread later - here's what worked: 1. Rep payee for Social Security is completely separate from Medicare authorization 2. Got the CMS-1696 form from Medicare.gov, filled it out, and mailed it to my mom's Medicare Advantage plan 3. Had to fill out a separate form for her Part D prescription plan 4. Used Claimyr to finally reach a Medicare rep who added me as an authorized person on her Medicare.gov account Frustrating process but finally done! Thanks everyone for the help and guidance.

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Ethan Davis

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they should really make this easier, my grandmother needed help and i had to do all this paperwork too. glad u got it fixed!

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