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Important Legal Information and Disclaimers

Blue Medicare HMO, Blue Medicare PPO, and Blue Medicare Rx (PDP) Members

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End-of-Life Care Planning

End-of-life care planning is both an important and sensitive subject. This page answers basic questions about end-of-life care planning. It's intended to help our members and their families know more about this subject as they make important decisions about the future.

Health Care Advance Directives

Health care advance directives, such as living wills or health care power of attorney, make a person's health care preferences both clear and legally binding. They outline personal wishes for medical treatment if you become seriously ill and are unable to make decisions for yourself.

North Carolina has three types of health care advance directives:

  1. Living wills.
  2. Health care power of attorney.
  3. Advance instruction for mental health treatment.

Completing an advance directive is strictly voluntary. You aren't required to complete any type of advance directive to receive medical care.

Also, your health insurance coverage or benefits won't be affected in any way if you decide not to complete a health care advance directive.

The Rules for Making an Advance Directive

In North Carolina, a living will, a health care power of attorney and an advance instruction for mental health treatment must be:

  1. Written.
  2. Signed by you while you're still able to make and communicate health care decisions
  3. Witnessed by two qualified adults.
  4. Notarized.

The forms required by the State of North Carolina can be obtained from the following places:

  • Doctor's office
  • Attorney's office
  • State or local office for the aging
  • A senior center, nursing home or hospice
  • A hospital or home health care agency

The North Carolina Secretary of State website also has forms you can download that meet all the rules for a formal advance directive.

If you have an advance directive from another state, keep in mind that state laws vary, so it's important for you to complete and sign advance directives that comply with your state laws. Some states do have laws that honor advance directives from another state. However, if you spend considerable time in another state, it's a good idea to fill out an advance directive form for that particular state.

Living Will

A living will is a legal document that tells others that you desire a natural death and what you want in relation to your medical care if you're:

  • Terminally ill
  • Permanently unconscious
  • You have a condition resulting in substantial cognitive loss such that you are unable to communicate your wishes

Having a living will can make it easier for your family to act on your behalf and make decisions about your care according to your wishes.

In a living will, you can specify what medical treatments you want and don't want, such as being on a ventilator or having a feeding tube.

A living will goes into effect only when your doctor and one other doctor determine that you meet one of the conditions specified in the living will. Your doctor can help you understand how a living will works.

Health Care Power of Attorney

A health care power of attorney is sometimes called a durable power of attorney for health care. It's a legal document that allows you to select a person to make health care decisions for you if you become unable to make or communicate them yourself. This person is called your "health care agent."

A health care power of attorney goes into effect when a doctor states in writing that you aren't able to make or to communicate your health care choices. If, due to moral or religious beliefs, you don't want a physician to make this determination, North Carolina law provides a process for a non-medical professional to do it.

You should choose an adult you trust to be your health care agent. Discuss your wishes with that person before you put it in writing. It's always helpful to discuss your wishes with your family, friends and your doctor or an eligible psychologist.

Advance Instruction for Mental Health Treatment

An advance instruction for mental health treatment is a legal document that tells doctors and mental health providers the mental health treatments you would or wouldn't want, if you later become unable to decide for yourself.

You can identify a person who is responsible for making your mental health decisions for you when the document goes into effect.

The advance instruction for mental health treatment can be separate from or combined with a health care power of attorney or a general power of attorney.

Once You Have a Health Care Advance Directive

Keep a copy of your health care advance directive in a safe place. Let family or friends know where it's kept. Give copies to your family, your doctor, your health care agent(s) and any close friends who might be asked about your medical care if you become unable to make your own decisions.

An advance directive doesn't expire. It remains in effect until you decide to change or cancel it. If you complete a new advance directive, the previous one is canceled. You should review your advance directive periodically to make sure it still reflects your wishes.

Additional Resources

BCBSNC is not responsible for the reliability or content of any linked website, and does not necessarily endorse the organizations or views expressed.

  • The State of North Carolina provides an online registry for advance directives and free forms for downloading. You can also call 1-919-807-2167 for more information.
  • Caring Connections is a program of the National Hospice and Palliative Care Organization (NHPCO) that provides free state advance directive forms you can download. You can also call 1-800-658-8898 or 1-877-658-8896 (multilingual line) for more information.
  • Aging with Dignity is a non-profit organization that provides the Five Wishes advance directive form. Five Wishes is legal in the State of North Carolina. There is a fee for ordering this form. You can also call 1-888-594-7437 for more information.



While BCBSNC has made reasonable efforts to present information contained in this site accurately, changes due to legal interpretation and/or changes in the law may not be reflected. The information provided should not be construed as providing legal advice. If legal advice or other professional assistance is required, professional services should be sought.

Important Legal Information and Disclaimers

The information on this page is current as of 10/1/2013.

Y0079_6246 CMS Approved 10212013