How to Get Permission to Talk to Medicare for a Parent (Form CMS-10106)

To let 1-800-MEDICARE talk to you about a parent's claims and health information, your parent fills out and signs the "Authorization to Disclose Personal Health Information" form, CMS-10106. They can submit it online through their secure Medicare.gov account, or mail it to the address on the form. If you need to handle a Medicare appeal for your parent, that's a different form: the "Appointment of Representative," CMS-1696.

Why do I need a form to talk to Medicare for my parent?

Privacy law. The CMS-10106 form says that by law, your parent must give 1-800-MEDICARE permission in writing before Medicare can share information with someone other than them.

Medicare.gov describes the form's purpose as "giving Medicare permission to talk to someone you choose about your claims and health records, if you can't."

What is form CMS-10106?

CMS-10106 is the "1-800-Medicare Authorization to Disclose Personal Health Information" form. As of October 2026, the Centers for Medicare & Medicaid Services (CMS) form page lists:

• Revision date: March 1, 2026
• Office of Management and Budget (OMB) number: 0938-0930
• OMB expiration date: March 31, 2029
• Versions: English and Spanish

Download it from the CMS form page or Medicare.gov's "Other Forms" page, or have your parent fill it out online in their Medicare.gov account.

What does the form ask for?

The form asks your parent to:

1. Give their information: name, Medicare Number, date of birth, and address.
2. Choose what Medicare can share: all of their personal health information, or only limited information they select. New York residents complete an extra section about certain sensitive information.
3. Choose how long the permission lasts.
4. Name the person or people Medicare can talk to (you, and anyone else they choose), or an organization.
5. Sign and date it.

Fill in every section. Missing details can slow things down.

How do we submit it?

The CMS-10106 form gives two options:

• Online (faster): Your parent logs in to their secure Medicare.gov account and submits the authorization there.
• By mail: Send the completed, signed form to: 1-800-MEDICARE Written Authorization Dept. PO Box 1270 Lawrence, KS 66044

Keep a copy for your files. Mail can take time to process, so if you need to call soon, the online option is the quicker one.

Can my parent take the permission back?

Yes. Medicare's form explains that your parent can revoke the permission in writing at any time, except for anything Medicare already did based on it.

Does CMS-10106 let me file appeals or make decisions?

No. CMS-10106 lets Medicare share information with you. It doesn't make you your parent's representative for appeals.

To act for your parent in an Original Medicare appeal, Medicare.gov says to include a copy of the "Appointment of Representative" form (CMS-1696) or another written document with the required elements. Your parent and you both sign it.

Does this form cover my parent's Medicare Advantage or drug plan?

The CMS-10106 form gives permission to 1-800-MEDICARE. Your parent's Medicare Advantage plan, drug plan, or Medigap insurer is a separate company with its own authorization form. Call the member services number on each card and ask for their "authorization to release information" or similar form.

What about doctors and hospitals?

Doctors' offices and hospitals have their own rules and forms. Under the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule, the U.S. Department of Health and Human Services (HHS) says a person with legal authority to make health care decisions for an adult, such as a health care power of attorney or a court-appointed guardian, is treated as that adult's "personal representative" for their health information. Ask each billing office what they need on file.

What if my parent can't sign?

If your parent can't sign the form, you'll generally need legal authority to act for them. The HHS guidance above lists health care power of attorney and court-appointed guardians as examples. For a parent who has died, CMS-10106 says it can also be used to get information if you have legal authority, like executor papers; include a copy of that documentation.

An elder law attorney can explain the options in your state.

What should I say when I call 1-800-MEDICARE?

Once the authorization is processed, call 1-800-MEDICARE (1-800-633-4227) and say:

"Hi, I'm calling about my parent, [name]. They've submitted an authorization form (CMS-10106) naming me. Their Medicare Number is [number]. I have a question about a claim from [provider] on [date]."

Have the Medicare Summary Notice in front of you.

Frequently asked questions

What is the current Medicare authorization form number?

CMS-10106, "1-800-Medicare Authorization to Disclose Personal Health Information." The CMS form page lists a March 2026 revision.

How long does the authorization last?

Your parent chooses how long it lasts on the form. They can revoke it in writing at any time.

Is CMS-10106 the same as power of attorney?

No. It only lets 1-800-MEDICARE share information with the person named. It doesn't give legal authority to make decisions.

Do I need CMS-1696 too?

Only if you'll be handling a Medicare appeal on your parent's behalf.

Can someone help us fill it out?

Yes. Your parent's State Health Insurance Assistance Program (SHIP) offers free Medicare help. Find yours at shiphelp.org.

Want help once the paperwork is done?

Bill Review Coach is a monthly medical bill review service for seniors and their families. Once you can talk to Medicare for your parent, snap photos of their bills and notices each month, and we'll tell you in plain English what to check and what to say on the call. You make the calls and write the emails; we help you know what to say.