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(b) Representative

A representative may assist the A/R in the application and redetermination process and in other matters related to the A/R’s MA eligibility. Only one designated representative at a time may be recognized as authorized to act on the A/R’s behalf. Designation of a representative is indicated in writing on the MA application form or a letter submitted to the Department or its designee.

An A/R who is at least 18 years old and mentally competent to provide information required by the Department is not required to have a representative, but may choose to designate a representative to provide assistance or act on the A/R’s behalf in matters related to MA eligibility. A pregnant woman of any age is not required to have a representative and may sign the application and attend the interview on her own behalf, even if she is younger than 18 years old. A child younger than 18 years old (unmarried and not pregnant), or an individual who is not mentally competent to provide required information. Must have a representative designated writing to act on the individuals’ behalf in matters related to MA eligibility. A representative may be one of the following individual who is at least 18 years old:

o An individual who is related to the A/R by birth or marriage; o The A/R’s legally recognized guardian or representative with power-of- attorney; o The caregiver with whom an A/R younger than 18 years old lives, if the child does not live with the child’s parent or other caregiver relative; o An individual designated by the A/R if the A/R is at least 18 years old; o A provider’s representative/hospital/institution o The A/R’s legal counsel o A governmental representative who is not involved with determining the A/R’s MA eligibility (e.g. social services social worker) o Anyone that can provide the required information o The representative must be 21 years of age to sign the application for someone under 21.