New Medicare Benefit – Helping You Make Your Wishes Known

Note: This article is courtesy of DocuBank®

Starting this year, Medicare is making it easier for people to have conversations about their medical wishes.  This is good news.  These conversations are important.  They help you think about what’s important to you and help you get the care that you want when it matters most.

With the benefit available, now is the time to talk with your lawyer, loved ones and doctor about your wishes, and make sure both have copies of your advance directives (if you do not already have these important documents drafted, schedule a time to meet with your estate planning attorney).

Below are answers to some common questions about this new Medicare benefit.

Q&A:  Medicare Benefit for Advance Care Planning

  1. How is Medicare making it easier to talk to my doctor about my wishes?
    Advance Care Planning (ACP) conversations are important and can be sometimes lengthy. It was hard for doctors to fit this conversation into the time frame of your regular office visit, which can feel very rushed as it is.  Medicare recognized this and decided to pay doctors separately to have these important discussions with their patients.  By paying additionally for Advance Care Planning conversations, Medicare is giving doctors the time to have this discussion with you.  Medicare pays physicians in half-hour increments for ACP.
  2. Are discussions about my wishes voluntary?
      You can bring up the subject, or your doctor can do so in the course of giving you appropriate care.  You always have the prerogative to accept or decline to have this conversation.
  3. What will a discussion about my wishes be like?
    ACP discussions are for explaining and discussing your wishes and your advance directive documents.  Since you already have advance directives, you and your doctor will discuss the choices you’ve made.  You can also ask your doctor questions and get clarification about medical terms or situations that might arise, and to make sure that the selections in your documents reflect your actual wishes.
  4. Should my doctor have a copy of my advance directives?
    To have this discussion, your doctor is likely to (and should) ask you for a copy of your advance directives.
  5. Does talking about ACP mean I eventually want to “pull the plug?”
    NO!  Not at all. Advance Care Planning is about figuring out and communicating your wishes — WHATEVER THEY MAY BE.  This could be a discussion about wanting everything done to extend life as long as possible in all medical situations.  Or it could be about wanting to be kept comfortable above all else in the case of a terminal illness.  Or it could be a myriad of scenarios/choices in between, depending on the circumstances.
  6. It is appropriate for my doctor to talk about my wishes when I’m healthy?
    YES! Advance Care Planning is not just for sick people. Your doctor may have an ACP discussion with you at your Medicare “Annual Wellness Visit.”  ACP discussions are recognized by the medical profession as a component of high quality care at many points in your life and health.  In fact, hospitals have been required for 25 years to ask patients if they have an advance directive.
  7. What else is included in an ACP discussion? Is ACP also about sharing whom I want to make decisions for me if I can’t?    This is at least as important as talking about your wishes. You can also talk about organ donation and other related matters.
  8. Is there a co-pay for ACP conversations with my doctor?
    There is no co-pay when these discussions occur during your Medicare Annual Wellness Visit.  There may be a co-pay at other times, depending on your Medicare plan.
  9. Must I always talk with my doctor for Medicare to pay for an ACP discussion?
    No, not necessarily.  You may also be able to talk with a nurse practitioner, physician assistant, or other staff person who is supervised by your doctor — if your the doctor’s office permits this.  Sometimes patients prefer to talk with these other health professionals, feeling that they are more compassionate or not as rushed.
  10. This is an uncomfortable conversation for me. Are there real benefits to forcing myself to do this?
    YES!  Research shows that patients and their loved ones benefit from having advance care planning discussions.  Studies have found that talking about choices for care – regardless of the specific care choices you make — increases patient and family satisfaction with their care.  It also has been shown to reduce the emotional burden and distress on caregivers.  The evidence bears out that talking about your wishes is a tremendous gift that you can give to yourself and to your loved ones.