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Provider Manual

Advanced Directive Policy

Last Updated on August 28, 2018

Overview

The State of Wisconsin permits individuals 18 years of age or older and of sound mind to complete an advance directive expressing their preferences for future health care treatment. An advance directive allows a member to direct a physician in their end-of-life decisions and/or to name someone to make health care  decisions on their behalf should the member be unable to make such decisions for himself or herself. Security Health Plan educates Medicare Advantage members concerning advance directives upon enrollment and in the Care Management Program. Medicare Advantage members are encouraged to complete an advance directive and are offered a copy of the Wisconsin “Power of Attorney for Health Care” and “Living Will (Declaration to Physicians)” forms, as requested by members. The brochure, “Advance Directives, Making Your Health Care Decisions,” is provided upon enrollment and informs of three advance directive type options:

  • Power of Attorney for Health Care
  • Living Will (Declaration to Physicians)
  • Do Not Resuscitate Order and Bracelet (requires physician involvement)

Medicare Advantage members are encouraged to submit a copy of their advance directive to their personal provider and local hospital. Members are also encouraged to discuss their advance directive with their health care providers.

Power of Attorney for Health Care

The Power of Attorney for Health Care form allows the member to designate two people to make health care decisions if the member becomes unable to do so. The health care agents make decisions based upon the expressed directives provided by the member. The agent’s authority takes effect only after the member is determined by two physicians to be incapacitated.

Living Will (Declaration to Physicians)

The Living Will form allows Medicare Advantage members to make choices about which if any, life-sustaining procedures that can occur when in a terminal or persistent vegetative state. It allows the member to express these specific choices to physicians without choosing others to do so on the member’s behalf.

Do Not Resuscitate (DNR) Order and Bracelet

A physician may order a DNR bracelet at the request of a member who wishes not to be revived if heart or breathing activity stops. This order applies to emergency medical services personnel when responding to emergency calls. Only qualified persons are eligible for this order. Conditions that qualify a person for a bracelet include those with a terminal condition or those with a medical condition so severe that resuscitation would be unsuccessful. The bracelet is worn at all times and can be revoked by the person wearing it at any time.

Per Wisconsin state law, Security Health Plan informs Medicare Advantage members of their right to make health care decisions and the right to complete an advance directive expressing their preferences for future health care treatment. Security Health Plan follows a member’s request in an advance directive unless otherwise provided by law and its providers are not required to provide care that conflicts with an advance directive. Security Health Plan allows a member’s legal health care representative(s) to manage care or treatment decisions when the member is incapacitated due to physical or mental limitations and unable to do so, per state law. Additionally, Security Health Plan requires contracted health care providers to discuss health care decision making with members and maintain medical record documentation of the presence of an advance directive.