Advance care planning and medical decisions
Choosing a Health Care Agent and Discussing Your Wishes
How to pick a health care agent, name a backup, and talk through your wishes so the person who speaks for you does not have to guess.
A health care agent is a person you name to make care choices for you if you cannot speak for yourself. Some states call this person a proxy, a surrogate, or a representative. The job is big, and the choice is yours. This guide shows how to pick the right person, what to say to them, and how to put the choice in writing.
Key takeaways
- Pick a person who knows you well and will speak up for you.
- Name a backup person in case your first choice cannot act.
- Talk about your values first. Talk about treatments next.
- Put the name in your state form and give copies to the right people.
- Review the choice once a year and after big life changes.
What a health care agent does
Your agent steps in only when you cannot make or share your own choices. That can happen after a stroke, a bad fall, or a serious illness. Your agent talks with your doctors. Your agent reads your written wishes. Your agent then makes choices that match what you would want.
Your agent can agree to a treatment or say no to it. Your agent can choose a doctor or a care place. Your agent can see your medical records to help make a choice. The exact powers depend on your state law and on the form you sign.
An agent is not the same as a living will. A living will states the care you want in set cases. An agent can respond to cases no one saw coming. Many people have both. See our guide on advance directives and how to get started and our guide that compares a living will and a medical power of attorney.
Why the talk matters as much as the form
A form alone is not enough. In one study, loved ones guessed nearly one out of three end-of-life choices for a family member wrong (National Institute on Aging, checked 2026-11-08). That means a close person can love you and still guess wrong about your care.
A good talk fixes that risk. When your agent hears your values in your own words, they do not have to guess. They can tell a doctor what matters to you and why. That helps you get care that fits your wishes, and it can ease stress and guilt for your family later.
About 63 million adults in the United States gave care to an adult family member or friend in the past year (AARP and National Alliance for Caregiving, Caregiving in the US 2025). Many of them had to make hard choices with no clear guide. Your talk now gives your agent that guide.
How to pick the right person
Start with trust. Pick a person who will follow your wishes, even if they would choose in a different way for themselves. Then check these points.
A spouse or adult child is a common choice, but not the only one. A close friend can be a good agent. So can a sibling or a trusted neighbor. What counts most is trust and the will to speak for you.
Pick a backup agent too. Your first choice may be ill, out of town, or unable to act when you need help. Name a second person and tell both of them who is first and who is backup.
Some people should not be your agent. Your own doctor is often a poor choice, since the doctor treats you. A person who cannot handle stress may also be a poor fit. If no family member fits, ask your local Area Agency on Aging for ideas. You can reach the Eldercare Locator at 800-677-1116 (Administration for Community Living).
- The person is an adult who lives near you, or can get to you fast.
- The person can talk with doctors and ask hard questions.
- The person can stay calm in a crisis.
- The person knows your values and your faith, if faith matters to you.
- The person will talk with family members who may not agree.
- The person is willing to do the job. Ask first. Do not just name them.
Questions to answer together
Sit down with your agent when no one is in a rush. Use these questions to start.
There are no right answers. There are only your answers. Write down what you say so your agent can look back at it later. Our guide on updating, storing, and sharing your care-planning documents shows where copies should live.
- What does a good day look like for you?
- What abilities matter most to you?
- What do you fear most about being very sick?
- Would you want care that tries to extend life at all costs, or care that focuses on comfort?
- How do you feel about a breathing machine, tube feeding, or CPR?
- Where would you want to be cared for, at home or in a hospital?
- Who do you want near you at the end of life?
- What should your agent know about your faith or beliefs?
How to make it official
Each state has its own form to name a health care agent. The form may be called a durable power of attorney for health care or a health care proxy form. You can get your state form for free from your state attorney general, your Area Agency on Aging, or the Eldercare Locator at 800-677-1116.
Fill out the form with care. Sign it the way your state requires. Some states require witnesses. Some require a notary. Then give copies to your agent, your backup agent, your doctor, and your close family. Keep the original in a place your agent can reach fast. A locked box that no one can open does not help in a crisis.
You do not need a lawyer to fill out most state forms. A lawyer can help if your family case is complex or if you want advice on state rules.
Who covers what
- Medicare: Medicare Part B covers a talk about advance care planning as part of your Welcome to Medicare visit and your yearly Wellness visit. You pay nothing for that talk if your provider accepts assignment and the talk is part of that visit. If the talk is part of other treatment, the Part B deductible and coinsurance apply (Medicare.gov, checked 2026-11-08).
- Medicaid: Medicaid rules vary by state. Your state Medicaid office can say if a planning talk with a provider is covered in your state.
- Private pay: State forms are free from the sources above. If you hire a lawyer to help, you pay that fee yourself. Ask about the fee before you hire.
Sample Situation
Maria is 74 and lives alone. Her son lives ten minutes away. Her daughter lives in another state. Maria picks her son as her agent because he is close and calm in a crisis. She picks her daughter as backup. She then sits down with both of them on a video call. She tells them she wants care that keeps her comfortable if she cannot recover. She says she does not want a breathing machine if doctors say she will not wake up. She fills out her state form, signs it with two witnesses, and gives a copy to her son, her daughter, and her doctor. She keeps her own copy in a folder by her phone. Six months later she has a stroke and cannot speak. Her son shows the form at the hospital and tells the care team what Maria said she wanted. The team follows her wishes, and her daughter supports the choices because she heard them from Maria herself.
When to review your choice
Review your agent choice once a year. Review it after a move, a divorce, a death in the family, or a big change in health. If you pick a new agent, fill out a new form and give fresh copies to all the same people. Tell your old agent about the change.
Your next step
Naming an agent is one part of care planning. If you want to learn how care at the end of life is paid for and what choices you have, see our main section on hospice care. It shows who pays for what and how to ask for help near you.
Sources
Next step on Care and Living Guide
Hospice care — Learn what hospice covers and how to choose a hospice provider.