Navigating Medicare Clients with a Power of Attorney
When working as a Medicare agent, you’ll occasionally encounter clients who have a Power of Attorney (POA) in place. This often happens when a beneficiary is unable to make healthcare or financial decisions on their own due to age, illness, injury, or cognitive decline. In this post, we will discuss best practices when writing clients with a POA. Knowing how to handle these situations correctly is critical, not only for compliance, but to protect your client’s best interests and your professional integrity.
Understand the Type of POA in Place
Not all powers of attorney are the same. The POA document may grant authority over:
- Healthcare decisions only – The designated person can make medical choices but may not be authorized to enroll or disenroll the client from Medicare plans.
- Financial matters only – The person can manage finances, including paying premiums, but may not have authority over healthcare decisions.
- Durable Power of Attorney – Remains valid if the client becomes incapacitated and may include healthcare and/or financial authority, depending on the document.
It is important to request and review a copy of the POA before proceeding. Make sure it specifically covers the actions that will take place; choosing coverage, signing enrollment forms or authorizing plan changes.
Verify Legal Authority Before Taking Action
Carriers and CMS have strict rules about working with someone other than the Medicare beneficiary. Each plan carrier may require:
- A copy of the POA on file
- A completed Authorized Representative form
- Verification that the POA is active and valid
Do not rely on verbal claims alone—documentation is key. Acting without proper proof can create compliance issues for you and enrollment problems for your client.
Ready to join the team at Crowe; click here for online contracting.
Communicate Clearly and Respectfully
When a POA is in place, you may need to adjust your communication style:
- Speak directly to the authorized individual about plan options, but keep the beneficiary engaged if they are able to participate.
- Avoid discussing personal health or financial information with anyone not listed on the POA or other authorized documents.
- Be patient; these situations often involve extra steps and emotions.
Document Every Interaction
For your protection and for compliance purposes:
- Keep a record of all communications with both the beneficiary and the POA.
- Note when and how you received POA documentation.
- Record all decisions made and who made them.
Watch a YouTube video on what you need to know before a Medicare sale
Stay Compliant with CMS and Carrier Guidelines
Remember: CMS rules still apply, even if you’re working through a POA. Follow the same protocols for:
- Scope of Appointment (SOA) forms
- Plan comparisons and benefit explanations
- Enrollment timelines and eligibility checks
The Bottom Line
Handling clients with a Power of Attorney requires patience, diligence, and a solid understanding of legal authority. By verifying documentation, following compliance procedures, and maintaining respectful communication, you can protect your client’s interests while safeguarding your own professional standing.