Appointment of Representative

A member may appoint any individual (such as a relative, friend, advocate, an attorney, or any physician) to act as his or her representative and file an appeal on his or her behalf. To be appointed by a member, both the enrollee making the appointment and the representative accepting the appointment must sign, date, and complete a representative form.

Due in part to the incapacitated or legally incompetent status of a member, a representative is not required to produce a representative form. Instead, he or she must produce other appropriate legal papers supporting his or her status as the member’s authorized representative.

- Appointment of Representative Form -