Medicare Advanced Directive Requirements

An advance directive is a written legal document that communicates the heath care wishes of the patient even when they are incapacitated. There are two types -- the Living Will and a Power of Attorney for Health Care. Living Wills are care directives specifically stating what measures the patient wants taken if incapacitated. In a Power of Attorney for Health Care, the patient appoints a person to make those decisions.

Federal Law

• The Patient Self-Determination Act of 1990 requires that certain health facilities receiving Medicare or Medicaid funds provide their patients with information about advance directives. This includes hospitals, nursing care facilities, hospices, home health agencies and managed health care plans. They only have to provide the information for the state in which they are located. Failure to do so will cause them to lose their funding.

State Law

• Advance directives are regulated by the state in which the patient resides and can vary by state. A state's department of health services would have the information about requirements. This means you may have to check that your documents meet state requirements if you move to another state.

Mental Capacity

• Advance directives cover not only end--stage, but also terminal illness and persistent unconsciousness. Creating these documents is like creating a will. The patient must be of sound mind.

Witness & Notarize

• In most states, advance directives have to be witnessed and signed by two people. Some states such as Texas require the documents be notarized. The American Bar Association suggests that witnesses be people who will not benefit from the patient. Witnesses are expected to know the person well enough to vouch for their competency.

Paperwork

• There are generic forms available for advance directives. A priest has created a form, using church doctrine, especially for Catholics. Many states have forms on their health department websites. The forms are meant to be a guide and can be added to or altered.

Directives

• The law does not require people to have advanced directives to get Medicare or Medicaid benefits; it encourages it for the sake of the patient and their family. Advance directives last as long as you want them, and can be changed as many times as you wish. If you have one and become incapacitated, the latest directive takes effect.