Medicaid Authorized Representative Maryland

Two Forms for Two Different Situations

Maryland's Medicaid system allows a family member to manage an aging parent's long-term care application, renewals, and correspondence through an authorized representative designation. But which form you use depends entirely on whether your parent can still make their own decisions.

Form OES 2004 (LTC) is the standard authorization form. Your parent signs it to designate you as their representative for all Medicaid-related matters. This works when the parent has mental capacity to understand what they are authorizing.

Form OES 015 (LTC) is the critical form most families do not know exists. Under COMAR 10.01.04.12, if a parent lacks capacity to appoint a representative and has no active power of attorney or court-appointed guardian, a family member acting in good faith can execute this form to represent the parent in the Medicaid application process.

Form OES 015 is one of the few mechanisms in Maryland that lets a family member act on behalf of an incapacitated parent without going through the court-supervised guardianship process. For families facing a parent who needs Medicaid-funded home care immediately, it can save months and thousands of dollars.

When to Use Form OES 2004

Use this form when your parent:

• Has mental capacity and can sign the designation
• Wants you to handle Medicaid paperwork on their behalf
• Is applying for long-term care Medicaid (Community First Choice, Community Options Waiver, or institutional Medicaid)

The parent signs the form, designating you by name. You then have authority to submit applications, respond to verification requests, attend eligibility interviews, file appeals, and receive all Medicaid correspondence on the parent's behalf.

When to Use Form OES 015

Use this form when your parent:

• Lacks mental capacity to sign Form OES 2004
• Does not have an existing durable power of attorney
• Does not have a court-appointed guardian
• Needs someone to apply for Medicaid on their behalf immediately

Under COMAR 10.01.04.12, you execute the form as a responsible family member. The form requires you to certify that the parent lacks capacity, that no POA or guardian exists, and that you are acting in good faith for the parent's benefit.

This is not a substitute for a power of attorney — it covers Medicaid matters only. You cannot use Form OES 015 to manage bank accounts, make medical decisions, or handle the parent's other financial affairs. For those, you still need either a POA (if capacity exists for a lucid-interval signing) or guardianship (if it does not).

What the Authorized Representative Can Do

Once designated, you can:

• Complete and submit the Medicaid application, including the extensive asset verification forms
• Provide financial documentation — bank statements, property deeds, pension letters — on the parent's behalf
• Respond to requests for additional information from the local Department of Social Services
• Attend eligibility interviews at the county DSS office
• File appeals if the application is denied
• Manage annual renewals and report changes in income or living situation

You are stepping into the parent's shoes for the Medicaid system only. Every other legal and financial decision remains outside the scope of this designation.

The Connection to Maryland Access Point

Most families first encounter the Medicaid authorized representative process after contacting Maryland Access Point (MAP) at 1-844-MAP-LINK. MAP provides free Options Counseling that screens the parent for Medicaid eligibility and helps determine which long-term care program — Community First Choice, the Community Options Waiver, or institutional Medicaid — fits the parent's situation.

The Options Counselor will ask whether you have legal authority to act on the parent's behalf. Having Form OES 2004 or OES 015 already completed and signed lets you move directly into the application process instead of pausing to sort out representation.

The Maryland Power of Attorney and Guardianship Kit covers both Medicaid representation forms with instructions for when each one applies, along with an asset preparation worksheet designed to organize the financial documentation the DSS requires with every application.

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