How do I get Medicare to talk with me about my parent?
Medicare protects your parent's privacy, so it shares personal health information with you only if your parent says it's OK. There are two ways:
- On the phone. Your parent can give verbal permission while you are both on the call with 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048).
- In writing. Your parent can sign the Authorization to Disclose Personal Health Information form (CMS-10106), available in English and Spanish. Once Medicare processes it, you can call on your parent's behalf without them on the line.
This form only lets Medicare share information with you. It doesn't make you your parent's representative for appeals, and it doesn't let you make health care or money decisions. If your parent has a Medicare Advantage or Part D plan, call Member Services on the plan card and ask what the plan needs before it will talk with you. State Health Plan retirees should ask the Plan the same question.
How can I handle an appeal or claim for my parent?
To file an appeal, a claim or a complaint for your parent, your parent should name you on Medicare's Appointment of Representative form, CMS-1696. As the appointed representative, you can make requests and receive notices on your parent's behalf. Keep a copy, and send one with each appeal.
If a hospital says your parent is ready to go home and you disagree, or skilled nursing or home health care is ending too soon, call North Carolina's Medicare quality improvement organization, Acentra Health, at 1-888-317-0751 (TTY 711) right away. If a nursing home or adult care home tells your parent to move out, that's a different appeal, to the NC Medicaid Hearing Office. See Medicare appeals in North Carolina.
Who can manage my parent's Social Security money?
If your parent can no longer manage Social Security or SSI benefits, Social Security can appoint a representative payee, a person or organization that receives the benefits and uses them for your parent's needs.
- A power of attorney isn't enough. Social Security says a power of attorney or a joint bank account doesn't give you authority to manage someone else's benefits.
- How to apply. Contact Social Security. You fill out Form SSA-11 and show proof of identity, usually in an interview. Find the nearest North Carolina office with the Social Security office locator.
- Your duties. A payee must use the money for your parent's current needs, save what isn't needed, keep records and report to Social Security when asked.
- Plan ahead. With Advance Designation, your parent can name up to three people Social Security should consider as payee if one is ever needed.
Social Security: 1-800-772-1213 (TTY 1-800-325-0778).
How do North Carolina advance directives work?
North Carolina has two main health care documents, and each has a statutory form in the General Statutes. Many people sign both.
| Health care power of attorney | Living will (advance directive for a natural death) | |
|---|---|---|
| North Carolina law | G.S. 32A-15 to 32A-27; statutory form in G.S. 32A-25.1 | G.S. 90-320 to 90-324; statutory form in G.S. 90-321(d1) |
| What it does | Names a health care agent to make health care decisions when your parent can't make or communicate them | Tells doctors to withhold or stop life-prolonging measures in conditions your parent chooses: an incurable condition that will soon cause death, permanent unconsciousness, or advanced dementia or another irreversible loss of cognitive ability |
| Who can sign | Anyone 18 or older who can make and communicate health care decisions | A person of sound mind (both witnesses must believe the signer is) |
| How it's signed | Before two qualified witnesses, and acknowledged before a notary public | Before two qualified witnesses, and proved before a notary public or a clerk of superior court |
| When it takes effect | When the physician your parent names (or the attending physician) determines in writing that your parent lacks capacity | When the attending physician determines your parent has a condition named in the document, and a second physician confirms it |
Who can't be a witness. For both documents, a witness can't be related within the third degree to your parent or your parent's spouse, can't expect to inherit from your parent, can't have a claim against the estate, and can't be the attending physician, a licensed health care provider employed by that physician, or a paid employee of a hospital where your parent is a patient or a nursing home or adult care home where your parent lives. The notary may be an employee of those places.
Who can be the agent. Any competent person 18 or older who isn't paid to provide health care to your parent (G.S. 32A-18). Your parent can revoke the document at any time while able to communicate.
Money and guardianship are separate. A financial power of attorney falls under North Carolina's Uniform Power of Attorney Act (G.S. Chapter 32C), which has its own statutory form (G.S. 32C-3-301). If your parent can no longer decide and has no valid documents, the clerk of superior court in the county handles guardianship (G.S. 35A-1203). Give copies of every document to your parent's doctors and hospital, and keep one in your caregiver folder. For complex situations, talk with a North Carolina attorney.
Where can a North Carolina caregiver find help and a break?
Area agencies on aging
North Carolina's 16 area agencies on aging connect older adults and caregivers with local services such as in-home aides, meals and transportation for people 60 and older. Find yours on the NCDHHS map (PDF) or see how to find your area agency on aging.
Family Caregiver Support Program
For unpaid caregivers 18 and older caring for someone 60 or older, or someone of any age with Alzheimer's disease or a related disorder. Services vary by area: information, help getting services, counseling, support groups and training, short-term respite and limited supplemental services. It doesn't pay caregivers for continuous care.
Project C.A.R.E. and Lifespan Respite
Project C.A.R.E. offers dementia care consultation, caregiver education and, when funds allow, self-directed respite through regional offices. The NC Lifespan Respite Program reimburses unpaid caregivers for some respite each year; a local organization must refer you, and applications open only when funds are available.
CAP/DA and PACE
If your parent qualifies for NC Medicaid and needs a nursing-home level of care, the CAP/DA waiver (18 and older, through NC Medicaid Direct) can pay for in-home aide, adult day health and respite, with a consumer-directed option; a statewide waitlist has been used since February 2024. North Carolina has 11 PACE organizations for people 55 and older who need that level of care.
If your parent lives in a nursing home or adult care home and you have concerns about care, contact the regional long-term care ombudsman, or file a complaint with the Division of Health Service Regulation at 1-800-624-3004. If you think an older or disabled adult is being exploited, abused or neglected, call Adult Protective Services at the county Department of Social Services.
What can I do day to day?
- Set up a Medicare.gov account with your parent. You can both see Original Medicare claims soon after they're processed.
- Review statements every month. Look for services or supplies your parent didn't get, and report them to 1-800-MEDICARE. See Medicare fraud in North Carolina.
- Check for help with costs. See Medicare Savings Programs (MQB) in North Carolina, Extra Help and NC Medicaid and Medicare. The county DSS takes applications.
- Mark Open Enrollment on the calendar. From October 15 to December 7, check whether your parent's doctors and drugs are still covered for next year. If your parent's plan is ending, see North Carolina plans ending in 2027.
- Plan for storms. Keep a list of your parent's drugs, equipment suppliers and plan phone numbers in a go-bag. See hurricanes, floods and Medicare.
- Keep a caregiver folder. Include your parent's Medicare and plan cards, drug list, doctors, signed permission forms and advance directives.
Help reviewing your parent's plan
A licensed insurance agent who works with Benefits Life can join a call with you and your parent and explain Medicare Advantage, Medigap and Part D plans from the companies they work with, at no cost to you. Your parent decides; you can help ask the questions. You can request a call from a licensed insurance agent, or see plans for your parent's ZIP code.
Sources
- Medicare.gov — Contact Medicare (Authorization to Disclose Personal Health Information, CMS-10106)
- CMS — Form CMS-1696, Appointment of Representative
- Acentra Health BFCC-QIO — How to file an appeal
- Social Security — Frequently asked questions for representative payees
- N.C.G.S. 32A-16 — Health care power of attorney: definitions (qualified witness)
- N.C.G.S. 32A-20 — Effectiveness and revocation
- N.C.G.S. 32A-25.1 — Statutory form health care power of attorney
- N.C.G.S. 90-321 — Right to a natural death (living will)
- N.C.G.S. 32C-3-301 — Statutory form power of attorney
- N.C.G.S. 35A-1203 — Guardianship: authority of the clerk
- NCDHHS — Family Caregiver Support Program
- NCDHHS — Project C.A.R.E.
- NCDHHS — NC Lifespan Respite Program
- NC Medicaid — Community Alternatives Program for Disabled Adults (CAP/DA)
- NC Medicaid — PACE
- NCDHHS — Adult Protective Services
Frequently asked questions
Can I give someone permission to talk to Medicare for me?
Yes. You can give verbal permission while you and that person are both on the phone with 1-800-MEDICARE, or sign Medicare's Authorization to Disclose Personal Health Information form (CMS-10106), in English or Spanish. It lets Medicare share your information with that person; it doesn't let them make decisions for you.
Can I file a Medicare appeal for my parent?
Yes, if your parent names you as their representative on Medicare's Appointment of Representative form, CMS-1696. For hospital discharge and other fast appeals in North Carolina, the quality improvement organization is Acentra Health, 1-888-317-0751 (TTY 711).
Who can witness a North Carolina health care power of attorney?
Two qualified witnesses who aren't related to your parent or your parent's spouse within the third degree, wouldn't inherit from your parent, have no claim against the estate, and aren't the attending physician or a paid employee of the physician, a hospital where your parent is a patient or a nursing home or adult care home where your parent lives. A notary public must also acknowledge it.
Does a power of attorney let me manage my parent's Social Security?
No. Social Security says a power of attorney or a joint bank account doesn't give you authority to manage someone's benefits. Social Security must appoint you as representative payee, usually after an interview using Form SSA-11.
Where can a North Carolina caregiver get a break?
Start with your area agency on aging, which runs the Family Caregiver Support Program for people caring for someone 60 or older or someone with Alzheimer's disease or a related disorder. NCDHHS also runs Project C.A.R.E. for dementia caregivers and the NC Lifespan Respite Program, which reimburses some respite costs when funds are available.
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