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Medica Administrative Manual  >  Provider Responsibilities > Advance Directives

Advance Directives

An advance directive is a written document, made before a person suffers from an incapacitating illness or injury, in which an individual specifically makes choices about health care treatment or names someone to make those treatment decisions if the individual is unable
to make decisions.

The federal Patient Self-determination Act (PSDA) gives patients the legal right to make choices about their medical care in advance of incapacitating illness or injury through an advance directive.


PSDA impact on health care providers

Under the federal act, providers including HMOs, hospitals, skilled nursing facilities, hospices, home health agencies and others must provide written information to patients on state law about advance treatment directives, about patients’ rights to accept or refuse treatment, and about the providers’ own policies regarding advance directives.

Providers must inform their patients of their rights to make choices about their future medical care through an advance directive.

Providers must provide education on advance directives and note in a patient’s chart whether or not the patient has an advance directive. Providers cannot refuse to care for individuals because they do not have advance directives.


Impact on Medica

In the act, the definition of a provider includes HMOs. HMOs must inform members of state laws on advance directives.

To comply with this requirement, Medica includes information about advance directives in member packets. This information includes a member letter, a resource list regarding PSDA, and a question-and-answer guide.

By law, an individual’s health care coverage under Medica cannot be dependent upon having an advance directive.

For example, in Minnesota there are four types of advance directives:

  • Health care directive
  • Living will
  • Durable power of attorney/health care power of attorney
  • Nomination of a guardian as an advance directive

Providers cannot discriminate in treating or caring for a person and/or conservator/health care agent.

    • Mental health directives.

The health care directives may take the place of living wills and durable power of attorney/health care power of attorney.

Any competent person age 18 or older can make an advance directive.

An advance directive does not expire, but it should be reviewed periodically by the individual to make sure it continues to fit the individual’s needs and/or desires.


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