Who May Complete the Enrollment
| Who May Complete the Enrollment? •A Medicare beneficiary is generally the only individual who may execute a valid request for enrollment in or disenrollment from an MA plan. However, state law may allow another individual to execute an enrollment or disenrollment request on behalf of the beneficiary. •CMS will allow a legal representative or another individual to execute an enrollment or disenrollment request on behalf of a beneficiary if authorized under state law. Depending on state law, this may include court-appointed legal guardians, individuals with a durable power of attorney for health care decisions, or individuals authorized to make health care decisions under state surrogate consent laws. •If there is uncertainty regarding whether another person may sign for a beneficiary, Agents should check with the Plan Sponsor. |
Who May Complete the Enrollment? Marketing Representative Participation •If a marketing representative assists in the completion of a paper enrollment form, the representative must indicate his/her name on the form. •Exceptions — The marketing representative does not need to include his/her name on the form: if a beneficiary requests an enrollment form be mailed to him/her and the name and mailing address are pre-filled.if the representative fills in the “office use only” block.if the representative corrects information on the enrollment form after verifying an individual’s information.  However, the representative must either add his/her initials and date next to the correction, or create a separate “correction” sheet, signed and dated by the individual making the correction, or an electronic record of a similar nature. This information should become a part of the enrollment file. •If the marketing representative pre-fills any other information, including the beneficiary’s phone number, they MUST include his/her name. •Marketing representatives must safeguard beneficiary information including enrollment forms. Significant penalties arise if beneficiary information is inappropriately released. |
