Advance Care Planning & Medicare

In each case, it is fully covered by Medicare Part B medical insurance. You have no out-of-pocket costs.

There is no limit on the number of times you can seek advance care planning under these two conditions. Your doctor or other qualified medical professional must document any changes to your health status as well as to your wishes for end-of-life care.

Advance care planning happens during a face-to-face meeting with your doctor or other qualified health care professional. These sessions allow you to make end-of-life health care decisions while you are coherent and capable.

During this meeting, the two of you discuss how you want your health care handled if you are ever unable to make decisions about your health care.

If you are already incapacitated, Medicare will cover this face-to-face discussion between your doctor and your surrogates. Surrogates are family members or others who have been entrusted to make health care decisions for you.

Advance care planning consists only of informing you of your options and answering your questions. But you may also discuss legal options called advance directives.

You can obtain an advance directive through your healthcare provider as part of your Medicare wellness visit or other medical necessity. You can also seek an advance directive through other routes that may not be covered by Medicare.

Advance directives are documents that let you name someone to speak for you regarding your health care wishes if you are incapacitated. Alternatively, an advance directive may define your wishes based on your personal preferences and values.

These directives serve as a guideline for your medical team in determining the treatment and type of care you wish to have. In addition, they can ease the unnecessary stress and grief your family or other caregivers may be dealing with at the time.

Advance directives remain in effect until you regain the ability to speak for yourself.