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Fill Out an AOR Form With Your Loved One

There are two ways members can grant a loved one permission to talk to Tufts Health Plan about their benefits:

Call us

Members can give us a call and identify the person they want to be able to call on their behalf. This is known as a “HIPAA authorization.” It’s important for members to select someone they trust who can discuss their benefits in case of an emergency. This type of authorization doesn’t expire but it does have limitations. It only allows someone to call and discuss coverage -not make changes or decisions about the member’s plan. To allow someone to make decisions about their plan, members need to fill out an Appointment of Personal Representative form which is detailed below.

Members should fill out the Appointment of Personal Representative Form

Filling out a Tufts Health Plan Appointment of Personal Representative Form (PDF) gives someone permission to call Tufts Health Plan on a member’s behalf AND gives that person the ability to make decisions related to a member’s coverage. Once we have this form on file, the person the member has identified can call us and discuss pharmacy and benefit information. This form also allows the person the member selects to make decisions about their plan such as changing their Primary Care Physician (PCP) or filing an appeal. The authorization is good for one year unless the member specifies an earlier expiration date. We contact members who have forms that are about to expire after a year.

Appointment of Personal Representative Form (PDF)

If you have any questions, call Customer Relations

1-800-701-9000 (TTY: 711) 7 days a week, 8 a.m. – 8 p.m. (From April 1 – September 30, representatives are available Monday - Friday, 8 a.m. – 8 p.m.) After hours and on holidays, please leave a message and a representative will return your call the next business day.