Information to Gather Before You Call Medicare

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Nothing is more frustrating than waiting on hold for what seems like hours when you call Medicare. Worse yet is when you finally get someone on the phone, but you’re missing a key piece of information that prevents you from getting the answers you need.

Organize Important Information

Whether you’re calling about your own Medicare coverage or that of a loved one, have the following basic information on hand to ensure you’re prepared and able to get your questions answered in a timely manner.

  • Date of birth
  • Social Security number
  • Medicare ID/claim number (located on the Medicare card)
  • Effective dates for Medicare Part A and Part B (located on the Medicare card)
  • Information about current health care coverage, including policy, member and group ID numbers (e.g. long-term care insurance, insurance from a former or current employer or union)

Depending on the nature of your call, this additional information may be necessary:

  • Relevant information on current health conditions and/or prescription drugs
  • Veterans benefits information (if applicable)
  • Railroad Retirement Board information (if applicable)
  • Contact information for the beneficiary’s current long-term care facility (if applicable)
  • Bank account information and bank routing number (required to set up Medicare Easy Pay for automatic premium payments)
  • Medicaid/PACE information (if applicable)
  • Recent Medicare Summary Notices (MSNs), receipts and bills (if you’re inquiring about claims, coverage or filing an appeal)

Consider Using MyMedicare.gov

Medicare created an online platform called MyMedicare.gov that allows beneficiaries to manage their health information, claims, appeals and payments electronically. This resource prevents you from having to call Medicare every time you need a copy of a document or have a question. An added benefit of this platform is that important beneficiary information is organized in one easy-to-reference location for occasions when you do have to give Medicare a call.

Contacting Medicare on Behalf of Someone Else

If you’re calling Medicare regarding another person’s coverage, you’ll need to take some additional steps before you even pick up the phone. Medicare can only share a beneficiary’s personal health information with authorized entities. The beneficiary can grant you authorization verbally while you’re on the line with Medicare, online using their MyMedicare.gov account, or by mailing in a written form. The earlier authorization is granted, the easier it will be for you to help with their Medicare-related matters.

If your loved one becomes incapacitated and has not already authorized Medicare to speak with you, you’ll need to use your power of attorney (POA) to complete the authorization as their personal representative. If your loved one did not name you as POA prior to their incapacitation, you will have to go to court and petition for guardianship in order to access their medical and/or financial information and make decisions on their behalf. This is yet another example of why planning for the future is crucial for seniors and caregivers.

You can download the CMS-10106 Form for 1-800-MEDICARE Authorization to Disclose Personal Health Information here.

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