A Guide to Advance Care Planning and Medicare Coverage
While it can be difficult to think about, advance care planning is an important part of your healthcare plan. The process of advance care planning ensures that your family, caregivers, and healthcare providers understand your wishes. This is essential in the event that you can’t communicate medical wishes yourself due to an illness or injury.
Medicare makes it easier to prioritize advance care planning since your coverage includes care planning services at no cost to you. Read on to learn how Medicare covers advanced care planning.
Key takeaways:
Advance care planning involves discussion and documentation of your medical decisions to be used in the event that you can’t communicate them yourself.
Medicare covers advance care planning during your annual Wellness visit at no cost to you.
What is advance care planning?
Sometimes, a health condition or injury can impair someone’s ability to make medical decisions. In these cases, it’s helpful to have an advance care directive in place so healthcare providers and caregivers understand a person’s values, goals, and preferences regarding healthcare decisions—including end-of-life care. There are a few components to advance care planning, though the process can vary:
Completing an advance directive: An advance directive is a legal document that specifies your preferences for medical treatment and healthcare decisions in case you are unable to communicate your wishes.
Choosing a power of attorney or healthcare proxy: Also known as a healthcare proxy, a power of attorney is a document that discusses who you would want to make medical decisions on your behalf. This person is typically a trusted family member or friend who knows you well enough to express and execute your preferences.
Other documents: Other documents and discussions for advance care planning may include a living will, DNR (Do Not Resuscitate) Order, and Medical Orders for Life-Sustaining Treatment (MOLST). These documents include information on other decisions related to medical treatments and palliative care.
When do you need advance care planning?
Advance care planning is a way for you to have control over your health in the event that you can’t speak for yourself. These services are especially important If you know that you may be in a position where you can’t make medical decisions in the future. Here are some examples of when you may need advance care planning:
You have a terminal illness
You have a chronic condition
You’re an older adult
You have Alzheimer’s or other forms of dementia
You want to plan in case of an accident
Even if you’re healthy, having an advance care plan in place can provide peace of mind for family members and yourself in the event of an emergency.
Does Medicare cover advance care planning?
Yes, Medicare covers advance care planning. The service is completely voluntary and offered at no cost to you as part of your yearly “Wellness” visit. However, if you seek advance care planning during medical treatment or any time outside of the Wellness visit, you’ll pay 20% of the cost of the service once your Part B deductible is met.
Medicare also covers comfort care and palliative care for those who qualify.
What to expect for advance care planning during your annual Medicare Wellness visit
Among other preventive and planning services, your Medicare Wellness visit includes advance care planning. Your doctor may recommend that you take advantage of advance care planning services if you have dementia or a chronic condition like heart or lung disease.
If you opt for the service, you and your doctor will likely:
Discuss your values, goals, and preferences for medical care
Discuss your designation for a healthcare proxy or power of attorney
Provide you with educational and counseling resources related to advance care planning
Help you understand the legal documentation process
Understanding your Medicare coverage
Medicare beneficiaries may not be aware that advance care planning resources are covered by their insurance. Talking to a Chapter Medicare Advisor can help you understand your Medicare coverage, so you can maximize your value and make the most of your coverage. Call us at 855-900-2427 or schedule a time to chat for a free, personalized consultation.