Medicare advance care planning, the talk with your doctor about the care you'd want if you ever couldn't speak for yourself, is free at your yearly Wellness visit. Putting that conversation off is completely understandable, and the reassuring part is that having it costs most people nothing. There is one wrinkle families do get billed by, so this guide explains what it covers, what it costs in 2026, and the one thing to ask your provider so the conversation stays free.
What the conversation actually looks like
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, and you can move at whatever pace feels right.
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 do different jobs. A living will spells out the treatments you would or wouldn't want, such as whether you'd want a ventilator or a feeding tube. A health care proxy, sometimes called a durable power of attorney for health care, names a person you trust to make decisions for you when you can't. Many people complete both: one says what you want, the other says who speaks for you. You don't have to complete either to have the conversation.
This is your plan, in your words. It exists so 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 Medicare advance care planning costs
For most people the cost here is the simplest part, and it is usually nothing. But the "free" promise has a condition, and the condition is exactly where families get an unexpected bill.
Medicare Part B covers advance care planning, and you pay $0 for it when it's done as part of your one-time Welcome to Medicare preventive visit or your yearly Wellness visit, as long as your provider accepts assignment. Both of those wellness visits are themselves $0 preventive services, with the Part B deductible waived.Centers for Medicare & Medicaid Services. (n.d.). Advance care planning coverage. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/advance-care-planning,Centers for Medicare & Medicaid Services. (n.d.). Preventive and screening services. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/preventive-screening-services
Here is the part that catches families off guard. That $0 price holds only when the conversation happens during the wellness visit and your provider bills it as part of that visit. If advance care planning is split into a separate follow-up appointment, or you raise it at a sick visit for something else, it's billed on its own, and the standard Part B cost-sharing applies: you pay the deductible if you haven't met it yet ($283 in 2026), then 20% of the Medicare-approved amount.Centers for Medicare & Medicaid Services. (n.d.). Advance care planning coverage. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/advance-care-planning,Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Jun 22, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
So the single most useful thing you can do is ask for the timing on purpose. Tell your provider you'd like to include advance care planning during your Annual Wellness Visit, so it's billed into that visit and stays free. Mechanically, Medicare waives the cost only when the planning is delivered on the same day as your Annual Wellness Visit and the provider codes it that way, and the waiver is available once a year. Knowing that ahead of time lets you choose the moment instead of being surprised by a charge later.Centers for Medicare & Medicaid Services. (n.d.). Advance care planning coverage. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/advance-care-planning
Here is the same rule at a glance.Centers for Medicare & Medicaid Services. (n.d.). Advance care planning coverage. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/advance-care-planning,Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Jun 22, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
| 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.Centers for Medicare & Medicaid Services. (n.d.). Advance care planning coverage. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/advance-care-planning
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. You can download your state's free advance directive forms from CaringInfo, a service of the National Hospice and Palliative Care Organization, or ask your state health department.
How to start Medicare advance care planning
You don't need to prepare anything to begin. The simplest path is to raise it at an appointment you already have coming up: at your next Annual Wellness Visit, tell your doctor you'd like to include advance care planning. Because it's covered at no cost during that visit, that one sentence is often all it takes.Centers for Medicare & Medicaid Services. (n.d.). Advance care planning coverage. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/advance-care-planning
If you want to put your wishes in writing, you can complete an advance directive on your own, before or after the visit, using the state-specific forms above. You may also hear about a POLST form, which is a separate medical order a doctor completes for someone who is already seriously ill. It's different from the advance directive you fill out yourself, and your provider can tell you whether one fits your situation. If you'd rather talk it through first, you can call 1-800-MEDICARE (1-800-633-4227) or read Medicare's own overview at medicare.gov.
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.Centers for Medicare & Medicaid Services. (n.d.). Advance care planning coverage. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/advance-care-planning
Frequently Asked Questions
Is advance care planning required?
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.Centers for Medicare & Medicaid Services. (n.d.). Advance care planning coverage. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/advance-care-planning
Do I have to complete an advance directive?
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.
Does Medicare Advantage cover advance care planning?
Yes. Medicare Advantage (Part C) plans must cover everything Original Medicare covers, including advance care planning and the yearly Wellness visit it can be folded into. Costs and rules can differ by plan, so if you're in a Medicare Advantage plan, ask your plan or provider how it's covered and whether your provider accepts the visit.Centers for Medicare & Medicaid Services. (n.d.). Compare Original Medicare & Medicare Advantage - Medicare.gov. medicare.gov. Retrieved Jun 23, 2026, from https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/your-coverage-options/compare-original-medicare-medicare-advantage
How do I bring it up so it stays free?
Tell your doctor at your Annual Wellness Visit that you'd like to include advance care planning. Asking for it during that visit is what keeps it billed at $0; raising it at a separate appointment can trigger the Part B deductible and 20% coinsurance.Centers for Medicare & Medicaid Services. (n.d.). Advance care planning coverage. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/advance-care-planning
Will my advance directive be kept on file with Medicare?
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.Centers for Medicare & Medicaid Services. (n.d.). Advance care planning coverage. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/advance-care-planning
Does it really cost nothing?
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 ($283 in 2026) and 20% coinsurance apply.Centers for Medicare & Medicaid Services. (n.d.). Advance care planning coverage. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/advance-care-planning,Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Jun 22, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
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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.