TennCare Authorized Representative: How to File Form HCFA for a Parent

You call TennCare to check on your parent's Medicare Savings Program application and the caseworker won't tell you anything. Not the status, not what documents are missing, not whether the case was approved or denied. It isn't rudeness — TennCare is legally prohibited from sharing case details with anyone who isn't an authorized representative on record.

Why You Need Form HCFA

TennCare uses its own authorization process, separate from anything filed with Social Security or Medicare. Even if you have:

• A Social Security representative payee designation (Form SSA-11)
• An SSA appointed representative (Form SSA-1696)
• A Medicare authorization on file

None of those carry over to TennCare. The state requires its own Authorization of Individual Representative Form (Form HCFA) before a family member can access case information or receive eligibility notices.

You can still submit an application on your parent's behalf — the Authorized Representative section is Step 1 on the standard TennCare application. But if you filed the application without completing that section, or if your authorization has expired, you won't have authorized access to case details or notices.

What the Form Requires

The authorization form asks for:

• Your parent's name, date of birth, and Social Security number
• Your name, relationship, and contact information
• The scope of authority — whether you can receive notices, submit documents, and speak with caseworkers on your parent's behalf
• The duration: 5 months, 1 year, or ongoing
• Your parent's signature

Your parent must explicitly grant consent. If they are unable to sign, contact TennCare Connect to confirm who may sign and what supporting documentation is required.

How to Submit

The completed form can be submitted through the same channels as any TennCare document:

• Online through TennCare Connect at tenncareconnect.tn.gov (upload as a document attachment)
• Fax to 1-855-315-0669
• Mail to TennCare Connect, P.O. Box 305240, Nashville, TN 37230-5240
• In person at a county Department of Human Services office

Until TennCare processes the form, you won't have representative access — so submit it as early as possible, ideally alongside the MSP application itself.

Common Mistakes

Choosing a short duration. If you select the 5-month authorization while your parent's MSP case could take 20 to 40 days to process plus a 12-month renewal cycle, the authorization may expire before the first renewal. Unless there's a specific reason to limit the timeframe, "ongoing" prevents the lockout from recurring.

Not submitting with the initial application. Completing the Authorized Representative section on the application form is one path. Filing Form HCFA separately is the other. If you do both, that's fine — they're complementary, not conflicting. But doing neither means you won't be able to follow up on the case at all.

Assuming SSA or Medicare authorization transfers. It doesn't. TennCare, Social Security, and Medicare are three separate agencies with three separate authorization frameworks. Each requires its own paperwork.

If You're Managing From Out of State

Adult children applying for a parent's Medicare Savings Program from another state — Atlanta, Charlotte, Dallas — are particularly dependent on representative access. Without it, you can't see whether TennCare issued an Information Request Notice asking for bank statements, and your parent may not understand the notice or know how to respond within the 10-to-15-day deadline.

The Tennessee Medicare Savings Programs & Extra Help Guide covers representative authorization alongside the full application workflow, including how to handle the TennCare Connect portal, what documents to upload, and how to track the case through approval.

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