How to Become an Authorized Representative for Montana Medicaid and Medicare

You call Montana DPHHS to ask about your mother's Medicare Savings Program application, and the caseworker says they can't discuss the case with you. Privacy rules mean they're right — and until you file the correct form, you're locked out of every conversation about your parent's benefits.

The fix takes about fifteen minutes, but getting the wrong form or skipping a step can delay you by weeks.

The Form You Need: HCSD-102

Montana DPHHS uses the Authorized Representative Form (HCSD-102) to grant someone permission to act on a beneficiary's behalf. Once filed and accepted, you can:

• Submit applications through apply.mt.gov or by paper
• View notices and letters from the Office of Public Assistance
• Speak directly with caseworkers about the case
• Provide verification documents on your parent's behalf
• Request fair hearings if benefits are denied

Follow the current form's signature instructions. If your parent cannot sign, ask the Office of Public Assistance which signing method DPHHS accepts before submitting. The form names you specifically — DPHHS won't accept a blanket "my daughter handles my affairs" over the phone.

What Doesn't Automatically Work

Three documents that families assume will grant them access but don't:

1. General Power of Attorney — A POA gives you legal authority in many contexts, but Montana DPHHS state systems require Form HCSD-102 specifically. A POA alone won't let caseworkers discuss the case with you unless the HCSD-102 is also on file.

2. SSA Representative Payee status — Being named as your parent's Social Security representative payee doesn't carry over to state Medicaid agencies. SSA and DPHHS are separate systems.

3. Shared apply.mt.gov credentials — Sharing your parent's account password on the state portal violates DPHHS IT security policy. You need your own user account on apply.mt.gov, linked through the authorized representative designation.

How to File

Step 1: Download Form HCSD-102 from the DPHHS website or request a copy from your local Office of Public Assistance.

Step 2: Fill in both your information and your parent's. The form asks for names, addresses, dates of birth and the specific programs you're authorized to act on; select the medical-assistance program scope needed for Medicare Savings Programs and Medicaid as listed on the form.

Step 3: Complete the signature section using the method accepted by DPHHS. If your parent cannot sign, confirm the accepted method with the Office of Public Assistance before submitting.

Step 4: Submit the completed form through one of these channels:

• Upload through apply.mt.gov (attached to the application)
• Fax to DPHHS at 1-877-418-4533
• Mail to Human and Community Services Division, PO Box 202925, Helena, MT 59602-2925
• Bring it to your local OPA office in person

Step 5: Keep a copy. If a new caseworker says they don't have it on file, you'll want to be able to refax it immediately.

For Out-of-State Adult Children

If you live in Washington, Colorado or anywhere outside Montana and you're managing your parent's MSP application remotely, the HCSD-102 is non-negotiable. Without it, every call to the Public Assistance Helpline (1-888-706-1535) dead-ends at "we can't discuss that."

Submit the form with the application or as early as possible. Once DPHHS has it on file, you can view notices and speak with caseworkers. Request-for-information notices can have a 10-to-14-day deadline, so check for notices and respond by the deadline shown.

Once you're authorized, create your own apply.mt.gov account. You can track your parent's case, upload documents and check for notices without needing their login credentials.

Keeping Your Authorization Current

Check with DPHHS whether a fresh form is needed if:

• The beneficiary's case is closed and later reopened
• A new caseworker says the form is not on file
• The original form can't be located in the system

Keep a copy with your records so you can resubmit it if DPHHS requests one.

For the full process — authorized representative setup, application, income calculations, Extra Help and Big Sky Rx sequencing — our Montana Medicare Savings Programs Guide covers every step in order, including what to do when caseworkers can't find the form.

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