How to Appoint a Personal Representative for Your Anthem Medicare Plan

Last Updated : 09/09/20183 min read

From time to time, you may want someone to help you manage your Anthem Medicare plan benefits, or help you file an appeal, grievance, or complaint. Fortunately, there is a process you can follow to appoint a personal representative who can act on your behalf with your Anthem Medicare Advantage plan or Anthem Medicare Part D Prescription Drug plan.

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What is an Anthem Medicare plan personal representative?

A personal representative is someone you can authorize to discuss your health care treatment concerns and Anthem Medicare plan coverage, who can speak on your behalf with representatives from Anthem. This person should be someone who understands your wishes and whom you trust to act in your best interests. An Anthem Medicare personal representative can be:

  • Your spouse, child, sibling, or other family member
  • Your doctor or other health-care provider
  • A counselor or social worker
  • A lawyer or advocate
  • A clergy member
  • A trusted friend

When do I need a personal representative with my Anthem Medicare Advantage or Anthem Medicare Prescription Drug Plan?

In some cases, your health-care provider can contact Anthem Medicare on your behalf without written authorization to be your personal representative:

  • Your doctor can request a coverage decision or appeal about your medical care under an Anthem Medicare Advantage plan.
  • Your doctor or other prescriber can request obtain prior authorization for a prescription drug, request a coverage decision or exception, and file an appeal about prescription drug coverage under your stand-alone Anthem MedicarePart D Prescription Drug Plan.
  • If you have authorized someone with durable power of attorney under the laws in your state, or if the state has designated a legal representative to act on your behalf, you don’t need to file a personal representative form with Anthem Medicare. You only need to submit a copy of that authorization to your Anthem MedicareAdvantage or stand-alone Anthem Medicare Part D Prescription Drug Plan.

If anyone other than your legal representative, doctor or other health-care provider is acting on your behalf, you must file a written personal representative authorization form.

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How do I appoint a personal representative for my Anthem Medicare plan?

The easiest way to appoint a personal representative for your Anthem Medicare plan is to download and complete this form and mail or fax it to Anthem Medicare Customer Service. You can also write a letter yourself including the following information:

  • Your name and the name of your personal representative.
  • Your Anthem Medicare plan ID and your personal identification number.
  • A statement giving your permission for the representative to act on your behalf.
  • A statement indicating the representative is willing to act on your behalf.
  • Both your signature and your representative’s signature and the date you signed the letter.

If you have any questions about the process and need to contact Anthem Medicare Customer service, or if you need a mailing address or fax number to submit your form, you can find contact information from Anthem Medicare customer service (see link above).

If you’d like information about Anthem Medicare Advantage plans or Anthem Medicare Prescription Drug Plans, click the Find Plans button on this page and view the Medicare plan plans offered in your area.

Anthem Blue Cross and Blue Shield serves Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), and Wisconsin.

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