Privacy Notice and Appointing a Representative

Notice of Privacy Practices

Health New England knows how important it is to protect your privacy at all times and in all settings. Our Notice of Privacy Practices describes how Health New England may collect, use and disclose your protected health information, and your rights concerning your protected health information. Please review it carefully.

Health New England Notice of Privacy Practices 

Appointing a Representative

Many members ask us to disclose their protected health information to third parties for reasons not described in the Notice of Privacy Practices. For example, members often ask us to make their records available to a spouse or caregiver. Members may also wish someone to represent them when requesting prior authorization or filing an appeal or grievance.
If you would like to authorize someone else to call HNE and discuss your information, complete and mail an Authorization of Personal Representative form to the address below. (Please note: the authorization is valid only if signed.)

Authorization of Personal Representative Form

You may also use the CMS Appointment of Representative Form to appoint someone to represent you in requesting an initial organization or coverage determination or in filing a grievance or appeal. Mail completed forms to the above address.


You may revoke an authorization or end an appointment at any time by sending us a letter to the same address. Please include your name, address, member identification number and a telephone number where we can reach you. For assistance, please contact Member Services.


Health New England Medicare Advantage Plan
Enrollment Department
One Monarch Place 
Springfield, MA 01144-1500


Local Phone: (413) 787-0010
Toll-Free: (877) 443-3314
TTY: 711


H8578_2018_049 approved
 last updated on 9/30/2017