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Advance Directive

Health Care Proxies and Living Wills: The Importance of Advance Directives

Although most of us realize the importance of creating legal documents like wills and advance directives, actually doing so seems to fall far down on our list of priorities. Unfortunately, failure to do so may result in someone you don’t trust making decisions on your behalf.

Medicare tries to make it a little easier by covering advance care planning under Medicare Part B. If your provider accepts assignment, you pay nothing for this service when conducted during your Yearly Wellness Visit. You may also talk to your health care provider about advance care outside of these visits. However, the Part B deductible and co-insurance apply.

What Are Advance Directives?

Simply put, advance directives are legal documents in which you state your wishes for the type of health care you want in the event you’re no longer able to communicate your wishes. Whether your physician deems your incapacitation is permanent or temporary, advance directives ensure you receive the type of care you prefer.

A doctor explains advance directives to a patient

Advance directives include living wills and health care proxies (also known as durable powers of attorney). When it comes to making medical decisions, it’s smart to have more than one directive to ensure your wishes are followed.

For example, if your living will states that you do not wish to be placed on life support, your providers hesitate to follow the directive, especially if the family member appointed by the state disputes it. But, if you also have a designated health care proxy, he or she can advocate for your wishes.

In addition to getting these forms from your physician, you can also work with an attorney who specializes in estate planning.

What Is a Living Will?

In a living will, you state the type of care you want so that, if you’re ever incapacitated, your loved ones and physician understand your wishes.

The document can be as simple as stating that you don’t want to be placed on life support to naming specific medications you do or do not wish to be given. You can also delineate your wishes for a variety of treatments and diagnoses. A living will allows you to be very clear about your preferences.

It is a good idea to share a copy of your living will with family. If you don’t name a health care proxy, that person may not have any say in your treatment (it depends on your state), but they can at least make sure the doctor knows your wishes.

Example of a Living Will
(Example of a Living Will)

What Is a Health Care Proxy?

A health care proxy is a legal document in which you name the person (your proxy) you choose to make medical decisions on your behalf. This is also known as a medical power of attorney.

You can name anyone you wish but it’s best to choose someone you trust to follow your wishes and who will stand up for them in the face of opposition from others.

Before naming your proxy in a legal document, speak to them about your views and preferences. You not only want to make sure they know what you want, you also want to make sure they’re willing to follow your wishes. For example, if you have conflicting religious beliefs, your preferred proxy may refuse. You may want to have a backup proxy, just in case.

In addition to discussing your wishes, give your health care proxy a copy of your living will.

What happens if I don’t name a health care proxy?

If you don’t name a proxy and you become incapacitated, the State will name one for you. As you can imagine, this is a time-consuming process and requires someone to petition the court first. The process varies by state, but many states choose a surrogate in this order:

  1. Spouse
  2. Parent
  3. Adult child
  4. Sibling

It can take months to iron these issues out in the courts. What’s more, the court may appoint someone you would never have trusted with these decisions.

Judge naming a proxy

What Is a DNR?

There is another advance directive called a do not resuscitate (DNR) order. This is not the same thing as a living will. As stated above, your living will gives detailed information about the types of treatments you want in a variety of circumstances. A DNR tells medical personnel that you do not wish to be resuscitated if you cease breathing or your heart stops beating.

People choose to draft a DNR due to fears about CPR, which does not have a high success rate and often results in injuries or brain damage (or both).

Why Should You Create an Advance Directive?

The point of an advance directive is the same point of a will or trust: making sure your wishes are known and honored when you’re no longer able to advocate for yourself. These directives also protect your loved ones. Without them, the state decides who’s responsible for your care. It can be a costly and time-consuming process. It may also lead to disputes when loved ones can’t agree on what’s best for you.

If you have questions about your Medicare coverage or plan options, please call us toll-free at 855-350-8101 to speak with a licensed agent.

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