Thinking about a time when you might not be able to speak for yourself is hard, and putting it off is completely understandable. Medicare advance care planning gives you a calm, covered way to talk through the care you'd want, on your own terms, and at many wellness visits it costs you nothing. This guide explains what it is, what it costs in 2026, and how to begin when you're ready.
What advance care planning actually is
If the phrase sounds clinical, the reality is more human than that. Advance care planning is simply a conversation with your doctor or another qualified provider about the kind of care you would want in the future if you ever couldn't make decisions for yourself. Nothing more is required of you than talking.
That conversation may also include completing an advance directive, a document that records your wishes so the people around you know what you'd choose. The two most common forms are a living will, which spells out the treatments you would or wouldn't want, and a health care proxy, sometimes called a durable power of attorney for health care, which names a person you trust to make decisions on your behalf. You don't have to complete either one to have the conversation, and you can do it at whatever pace feels right.
This is your plan, in your words. It exists to make sure that if a hard moment ever comes, your family and your care team already know what matters to you, instead of having to guess.
What it costs
For many people, the cost is the part they expect to be complicated. Here it's usually the opposite.
Medicare Part B covers advance care planning, and the easiest way to have it cost you nothing is to fold it into a visit you're already entitled to. When the planning happens during your one-time Welcome to Medicare preventive visit or your annual Wellness visit, and your provider accepts assignment, you pay nothing for it.
If you raise it at a different appointment, woven into other medical treatment, the usual Part B cost-sharing applies: you'd pay the deductible if you haven't met it, then 20% of the Medicare-approved amount. Knowing that ahead of time lets you choose the moment, and many families simply ask to include the conversation at the next Wellness visit.
| Situation | What you pay |
|---|---|
| During your one-time Welcome to Medicare visit (provider accepts assignment) | $0 |
| During your yearly Wellness visit (provider accepts assignment) | $0 |
| As part of other medical treatment, outside a wellness visit | Part B deductible ($283), then 20% coinsurance |
Your advance directive stays with you
One worry that comes up often: people assume that once they complete an advance directive, it disappears into a government file they can't get back to. It doesn't work that way.
Your advance directive is not filed with Medicare. You keep it. The most useful thing you can do is share copies with the people who'd need them, your family, the person you've named as your proxy, and your providers, so it's on hand if it's ever needed. And nothing about it is permanent against your will. You can update or revoke it at any time, for any reason.
A practical note: advance directive rules and the specific forms vary by state. The document that's valid in one state may need adjusting if you move, so it's worth checking your own state's requirements, and revisiting your directive after any major change in your health or your life.
When to revisit it
Advance care planning isn't a one-time errand you check off. The wishes you'd record at 65 in good health may look different after a serious diagnosis, a hospitalization, or the loss of a spouse.
It's a kindness to yourself to revisit the conversation after any major health change, and to make sure the people who'd act on your behalf still have current copies. Because the yearly Wellness visit can include advance care planning at no cost, that annual appointment is a natural, low-pressure time to ask whether anything in your plan should change.
Frequently asked questions
No. It's entirely voluntary. Choosing to have the conversation, or to skip it, does not affect any of your other Medicare benefits in any way.
No. Advance care planning can be just a conversation. Completing a living will or naming a health care proxy is optional, and you can do it later or not at all.
No. Medicare doesn't keep it. You hold onto the document yourself and share copies with your family and providers, and you can change or cancel it whenever you want.
It's $0 when it's done as part of your Welcome to Medicare visit or your yearly Wellness visit and your provider accepts assignment. If it's done separately during other treatment, the Part B deductible and 20% coinsurance apply.
Learn More
- What Is Medicare? Parts A, B, C, and D explained
- Medicare preventive services and screenings
- What Medicare doesn't cover
Find personalized help planning ahead with Medicare at brevy.com.
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.