care tips Advanced Care Planning Updated 05/12

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1 Advanced Care Planning Updated 05/12

2 Advanced Care Planning Advanced Planning...1 Choosing a Health Care Representative...2 Designated Representative Form...4 Final Arrangements...5 Medicare Hospice Benefit...8 Palliative Care vs. Hospice...9 Updated 05/12

3 Advanced Planning If you became ill and were not able to make decisions, who would make medical decisions for you? What is an Advance Directive? An advance directive is a form which often includes a living will and a medical power of attorney. What is a Living Will? A living will or medical directive allows you to make your health care wishes known to doctors, family, and friends. What is a Medical Power of Attorney? A medical power of attorney or healthcare representative allows you to choose someone to make medical decisions for you if you are too ill to speak for yourself. Why Should I Have an Advance Directive? Having an advance directive is the best way to make sure you receive the health care you want at a time when you are not able to speak for yourself. It helps your family and doctors know what treatments you would or would not want. What If I Do Not Have an Advance Directive? If you do not have an advance directive, and you are too ill to make decisions, your doctor will talk with your family or next of kin. Who Do I Choose to Make My Decisions? Choose someone who knows you well and who you trust. He or she should know your wishes regarding medical care. He or she should be someone who is not afraid to ask your doctor questions. Where Do I Get an Advance Directive Form? Your local hospital State aging offi ce State bar association Most states require the form to be signed in front of a notary or 2 witnesses What Do I Do with the Form After I Complete It? Keep the original form Give copies to: Doctor Family The person you choose as your healthcare representative Where Can I Get More Information? For more information, talk with your doctor or lawyer. You may also contact Customer Service by calling the number on your insurance card for benefi t information or request a Hippa Designated Representative form. Reference: The content of this CareTip is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician with any questions you may have regarding a medical condition. Updated 05/12 1

4 Choosing a Health Care Representative If something happened and you were unable to make decisions, who would make decisions about your medical care? Who would decide where you should live? Who would make your day-to-day personal decisions in a way that refl ects your values and beliefs? What is a Healthcare Representative? A healthcare representative is someone who you designate to make healthcare decisions on your behalf if you lose the ability to do so on your own. Planning for your future is one of the best investments you can make for you and your family. It is a gift of love to everyone involved and reduces uncertainty during a time of crisis. Planning in advance is the best way to make sure you receive the health care you want. Choosing a Healthcare Representative Choose someone who knows you well and whom you trust Your representative should know your values and wishes regarding medical treatment Your representative should be someone who is not afraid to ask questions of the healthcare team. Talk With Your Healthcare Representative About Your Wishes Your representative needs to know how you feel about medical treatments especially life prolonging procedures. The following questions may help you to clarify your wishes: Do you want treatments which would prolong your life? Do you want to receive food or fl uid through a tube? Do you want to die naturally? Benefits of Having a Representative The representative knows you and understands your wishes about medical treatments. A representative has fl exibility. He or she can talk with your physicians about your changing medical condition and authorize treatment or have it withdrawn as circumstances change. Your representative can advocate for you. Updated 05/12 2

5 What If I Do Not Have a Healthcare Representative? If you are not able to make decisions, your doctor or nurse will talk to your family or next of kin. How Do I Appoint My Healthcare Representative? You can obtain a form from your local hospital or health department or Area Agency on Aging. Often, it is a section of an Advance Directive document. In some states, the form is called Medical Durable Power of Attorney. In most states, this form needs to be signed in the presence of witnesses or a notary. Keep the original form and give copies to your representative(s), family, and doctor. What Happens If I Change My Mind About My Healthcare Representative In The Future? If you decide that you would like to appoint a different Healthcare Representative, you should fi ll out another form and discard the previous form. Tell your doctor and loved ones about this change and make sure you keep the original document. Give copies to your new representative(s), family and doctors. Where Can I Get More Information? For more information talk with your doctor or nurse. You may also contact your Area Agency on Aging. Reference: The content of this CareTip is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician with any questions you may have regarding a medical condition. Updated 05/12 3

6 Designated Representative Form HIPAA What is a Member Designated Representative Form? Coventry cares about protecting your health care information. A federal law, the Health Insurance Portability and Accountability Act (HIPAA) protects the privacy of your health information. The Member Designated Representative Form authorizes a Coventry Health Care plan to release personal health information to the person or persons you name on the form. Do I need to complete a Member Designated Representative Form? No, you are not required to complete a Member Designated Representative Form. Why should I name a Member Designated Representative? If you are too ill to contact the insurance company regarding health care benefi ts etc, a Member Designated Representative can act on your behalf. The content of this CareTip is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician with any questions you may have regarding a medical condition. Updated 05/12 4

7 Final Arrangements Amidst the overwhelming sadness at the loss of a family member, there will be many decisions to be made. There are many tasks to complete to settle the person s estate. This information is intended to give you some basic information to guide you during this diffi cult time. Funeral Planning If your loved one did not make any plans prior to their death then you will need to make those preparations. One of the fi rst things to do is to plan the funeral service or memorial service. Funeral directors can be very helpful with the arrangements. It is a good idea to compare prices among funeral homes. The prices can vary greatly. There are many ways to honor the memory of your loved one. The choices are endless from traditional to very non-traditional. Traditional Funeral This is the most common type of funeral service. It is also the most expensive. There is usually a viewing, visitation or wake prior to the service. This may be followed by a procession to the cemetery. Direct Burial This is usually a less expensive funeral. There is usually no embalming, visitation or viewing. There may or may not be a service at the graveside. Cremation Cremation is an economical choice. There is the option of direct cremation without a viewing or visitation. There is also the option of having a viewing or visitation before the cremation. Caskets can be rented for a viewing. Body Donation A body may be donated to a medical school for research. The family may be required to pay for transportation to the school. The school typically pays for the cremation of the body. The remains are returned to the family. Funeral Costs Basic Services The fees for basic services of the funeral director include: Funeral planning Obtaining permits Death certifi cates Preparing the death notice Storing the body. In addition to the basic services fee, there are additional fees which may include but not limited to the following: Embalming Transferring body to funeral home Transferring body to the service or cemetery Fees to use the funeral home Updated 05/12 5

8 Limousine to transport family Casket Urns Grave Liner or Vault Internment (earth burial) Entombment (casket placed in a mausoleum) Headstones or markers Opening and closing of the grave Paying for funeral costs The costs of funerals can add up quickly. Some traditional funerals can cost well over $10,000. Social Security Social Security will pay a one time death benefi t of $255 to an eligible surviving spouse. For additional information contact SSA at Life Insurance Policy Many people utilize proceeds from a life insurance policy to help pay for funeral expenses. VA Benefits If your loved one was a veteran, they are eligible for burial benefi ts. For more information contact Veterans Affairs at Some People Purchase Burial Insurance Estate Matters to Address After the funeral, there are still matters to attend to. The estate includes all cash assets and property owned by your loved one at the time of death. Gather important documents Marriage license Social Security card Insurance card Medicare/Medicaid card Vehicle title Deeds to property Mortgages,bank,fi nancial accounts and credit card accounts Safety deposit contracts and key, outstanding bills Tax information Updated 05/12 6

9 Will The executor (also known as personal representative in some states), named in the will, will be responsible for paying debts and taxes owed. The executor will also distribute property according to the will. If your loved one did not complete a will, the property will be distributed according to state law. An attorney specializing in estate planning can be very helpful. Contact appropriate parties (Attorney, accountant, fi nancial planner) Contact former employers Ask about life insurance as well as any other benefi ts which you may be entitled to as the survivor. Obtain several death certifi cates If you use a funeral director, a limited number are usually provided and are usually covered in the basic services fee. Death certifi cates will be needed when dealing with: Social Security Administration: Veterans Administration, if your loved one was a veteran: You may need to close accounts, fi le claims for benefi ts, switch the policy to the surviving spouse, or change the name of the benefi ciaries. Bank or other fi nancial institutions You may need to close accounts or change the name on joint accounts or close safety deposit boxes. Notify credit card companies You may need to change the name on the account or close the account File a tax return You may need to fi le a fi nal return. Contact the IRS at for more information. Helpful Resources Funeral Consumers Alliance: National Funeral Directors Association: Your State Bar Association Your County Probate Offi ce The content of this CareTip is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician with any questions you may have regarding a medical condition. Updated 05/12 7

10 Medicare Hospice Benefit The Goal of Hospice is Comfort What is Hospice? Hospice is a way of caring for people who have a life limiting diagnosis. The Hospice team provides support service to the patient and their family. Who are members of the Hospice team? The patient is the most important member of the hospice team The patient s family or caregiver Medical Director Nurse Home Health Aide Social Worker Counselors such as a chaplain and/or a grief counselor Physical Therapist, Occupational Therapist or Speech Therapist Dietician Volunteer Some Hospices provide additional services such as music therapy or art therapy. Does Hospice provide medicine or medical equipment? Hospice will provide medicine to control symptoms such as pain. Hospice will provide some medical equipment such as a wheelchair or walker. Hospice will provide medical supplies such as bandages. What other services are available? Respite care if your family member or caregiver needs time away. Where can I receive Hospice service? Your own home A nursing home Hospice House Do I have to pay for Hospice? Medicare pays for most of the cost for Hospice. You may be asked to pay a small charge for medicine or for a respite stay. Who can receive Hospice care? Hospice is available to people who have a life limiting diagnosis. The patient chooses comfort care rather than aggressive treatment. Where can I get more information? Call Medicare at Call The National Hospice and Palliative Care Organization at Call your State Hospice Organization Reference: The content of this CareTip is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician with any questions you may have regarding a medical condition. Updated 05/12 8

11 Palliative Care vs. Hospice What is Palliative Care? Unlike hospice care, palliative care is for anyone with a serious illness regardless of life expectancy. The goal of palliative care is to relieve the pain, symptoms and stress of serious illness, whatever the diagnosis or prognosis. It is appropriate for people of any age and at any point in an illness. It can be delivered along with treatments that are meant to cure you. What is Hospice Hospice is a way of caring for people who have a life limiting diagnosis. The Hospice team provides support service to the patient and their family. Who Are the Members of the Hospice Team? The patient is the most important member of the hospice team The patient s family or caregiver Medical Director Nurse Home Health Aide Social Worker Counselors such as a chaplain and/or a grief counselor Physical Therapist, Occupational Therapist or Speech Therapist Dietician Volunteer Some Hospices provide additional services such as music therapy or art therapy While palliative care addresses patients with lifethreatening illnesses, anyone regardless of life expectancy can receive this type of care. Hospice, meanwhile, provides for patients who can no longer benefi t from regular medical treatment, per a doctor s determination, and are in the last stages of a terminal illness. Hospice and palliative care share the philosophy of maintaining and managing the patient s quality of life. Reference: The content of this CareTip is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician with any questions you may have regarding a medical condition. Updated 05/12 9