Typically, a Medicare beneficiary is the only individual who may make a valid request for enrollment into (or disenroll from) a Medicare Advantage plan. However, another individual could be the legal representative or another person to execute an enrollment request. CMS will recognize State laws that authorize certain persons to make such requests on behalf of a Medicare beneficiary.
Under State law, a person with a court-appointed legal guardianship, or a person with durable power of attorney, or an individual authorized to make decisions under State surrogate consent laws, would have the authority to act for the Medicare beneficiary in this capacity.
Instructions on how to appoint a representative including a link to the downloadable version of the CMS Appointment of Representative Form (CMS Form-1696).Link to CMS FORMSLink to Pre-enrollment Check ListLink to Enrollment Form