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Counseling Agreement

Some benefits counselors use an agreement signed by the Medicare beneficiary and/or family member being counseled and the counselor to assure that beneficiaries and family members or friends who are counseled understand that:

• Beneficiaries make the decisions about enrollment for benefits or into health plans
• Counselors offer guidance and assistance, but do not make decisions for beneficiaries.

Here are some versions of counseling agreements that were used in 2006.

• Liability Statement General (25Kb PDF file)
• Liability Form General (29Kb PDF file)