Posted by: David Forbes | December 23, 2009

Comparing 2010 Medicare Advantage Plans

Time is running out for Medicare Annual Enrollment period

The annual enrollment period ends on December 31st. Time is running out to choose a Medicare Advantage Plan or stand alone Part D prescription drug plan. If you have yet to submit an application, it’s not too late to start comparing Medicare Advantage Plans.

Even if you were happy with your 2009 Medicare Advantage Plan look at your options. The insurance companies that offer Medicare Advantage plans, offer a particular plan for one calendar year. They can change that plan or even discontinue that plan for the following year.

There were many plans in 2009 that will not be renewed for 2010. Many of these plans were private fee-for-service plans (PFFS). Funding cuts from Medicare to these insurance companies and network requirements for 2011 were the main reasons that many companies eliminated PFFS plans in some areas.

PPO and HMO plan options

With PFFS plans less prevalent for 2010, the main options are PPOs and HMOs. When comparing 2010 Medicare Advantage plans, you should take a look at these two options. Refer to your Medicare and You publication or visit the official Medicare website to search for plans in your area.

The benefit of these type of plans compared to a PFFS plan, is that you have a defined provider network. With a PFFS plan you are able to use any provider that accepts Medicare assignment and agrees to accept the plan’s payment terms and conditions. Although this may sound like the ideal situation, many providers will nor accept some PFFS plans and those that do can choose to accept you on a visit by visit basis except in the case of an emergency.

A Medicare HMO Advantage Plan requires you to have a primary care physician that co-ordinates your care with specialists and medical facilities. Cost sharing is often very reasonable for required co-pays and co-insurance.

A HMO plan also includes many non-Medicare covered benefits including, dental, vision and hearing services. It’s not uncommon for an HMO to include a gym membership and discounts on vitamins and medical related supplies.

You may also consider a PPO to increase your freedom of choice. AARP Medicare Complete offers a popular PPO plan in many parts of the country. With a PPO you still have a network of providers and you identify a primary care physician. Often you are able to change your primary care physician without the plan’s approval. You are also able to use providers that are out-of-network, but will have a lower cost if you use a network provider.

Be sure to check the network of providers if you plan to go out-of-network, as out of network charges may be significantly higher. This can be particularly true for out-of-network Hospital Stays.

Whether you are looking for a PFFS, PPO or HMO Medicare Advantage Plan, you still have time to start comparing 2010 Medicare Advantage Plans so that you can get the best plan for 2010.

Posted by: David Forbes | November 18, 2009

Comparing Medicare Advantage And Medigap

An Advantage Plan is not a Medicare supplement

This bears repeating because so many people refer to their Advantage plan as a supplemental plan. An Advantage Plan is not a Medicare supplement! Recall the definition of an Advantage Plan:

Medicare Advantage Plans are health plan options (like an HMO or PPO) approved by Medicare and offered by private companies. These plans are part of Medicare and are sometimes called “Part C” or “MA Plans.” Medicare pays a fixed amount for your care every month to the companies offering Medicare Advantage Plans. These companies must follow rules set by Medicare.

Official definition of a Medigap policy, also known as a Medicare supplement

A Medigap policy is health insurance sold by private insurance companies to fill gaps in Original Medicare coverage. Medigap policies don’t work with any other type of health insurance, including Medicare Advantage Plans, employer/union group coverage, Veterans Administration (VA) benefit ts, or TRICARE. Medigap policies help pay your share (coinsurance, co-payments, or deductibles) of the costs of Medicare-covered services. Some Medigap policies cover certain costs not covered by Original Medicare.
Keeping it simple: When you are enrolled in an Advantage plan, a private insurance company administers your Medicare. When you receive care you are showing your Advantage Plan membership card. Your Part D drug coverage may be included in your plan and you are subject to the rules governing your type of plan.
You may have a plan that doesn’t require a monthly premium or the premium may be nominal. You generally will have additional coverage beyond original Medicare such as dental, vision, hearing, etc.. You will share in the costs of your care through deductibles, co-payments and co-insurance. With an Advantage Plan, you will generally be accepted unless you have end-stage renal disease at the time of your application.

When you have a Medicare Supplement, you have original Medicare and have purchased a supplemental policy from a private insurance company to fill in the gaps that Medicare does not pay for covered services. When you receive care you will show your red, white, and blue Medicare card and your supplemental insurance card. If you purchase a supplement, you will need to also purchase a stand-alone Part D prescription drug plan. Some policies purchased prior to January 1, 2006 included drug coverage, but this is no longer the case.

A supplemental policy allows you to choose your providers just as though you had only original Medicare. Choose any provider that accepts Medicare assignment (some supplements have networks, known as Select plans). Plans are standardized and generally speaking you may have little or no out-of pocket expense. A supplement has certain open enrollment periods and guaranteed issue periods, but in other circumstances you may have to qualify medically.

Pay me now or pay me later

From a strictly financial point of view, you could say that buying a supplement resembles the pay me now scenario. Pay a fixed premium and have little or no exposure should you require care. The Advantage Plan is the pay me later option. You may have a small premium, but you are not laying out a larger premium payment that you may never have the reason to use. 

Both a Medicare supplement and an Advantage Plan are viable options to get the coverage you deserve. To learn more, please visit our Medicare Advantage Plans website to learn more about Advantage Plans.

Posted by: David Forbes | October 14, 2009

Medicare Part D Drug Plans Raise Costs For 2010

Cost of Medicare Part D going up for 2010

Expect to pay more for a Medicare Part D prescription drug plan in 2010. Insurance companies that offer Part D coverage are raising premiums. Many plans that did not have a deductible, are now requiring a calendar year deductible. In many cases, co-pays are also increasing.

Do your homework and take advantage of the Annual Enrollment Period (AEP), which starts, November 15 and continues through December 31st. The AEP is the opportunity for you to compare plans and make sure that you have the best plan for your circumstances. Completing an application during the AEP will ensure that your new coverage will go into effect on January 1st.

Medicare’s website updates plan information

Get all the facts about Medicare Part D Plans in your area. Go to the Medicare website and find plans in your area. The website has been updated to reflect information on 2010 Medicare Part D and Medicare Advantage Plans.

When comparing plans, its important to look beyond the monthly premium and also do some research on the plan’s formulary. The formulary is the list of drugs that are covered by the plan. Often times one company will place a drug in a higher cost tier than another company. If you can save a substantial amount of money on co-pays, it may be worth it to pay a little extra in plan premium.

If you budget is being stretched, this may be the time to have a conversation with your doctor to see if a generic drug is available to replace a brand name drug that will generally have a higher co-pay.

Additionally, if you are on maintenance medications, consider using the plan’s mail order pharmacy option. Many plans offer a 90 day supply for only two months co-pays.

If you are armed with a little knowledge and invest a little time in researching your options, you can still get a viable Part D drug plan and stay within a reasonable budget.

 

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Posted by: David Forbes | October 9, 2009

2010 Medicare Advantage Plans – Understand Your Options

2010 Medicare Advantage Plan options

When choosing a Medicare Advantage plan, it’s important to understand the different types of plans available and understand the plans rules before joining. Not all plan types may be available in your area. What’s right for one person, may not be right for you.

Medicare Advantage Plans include the following:

 

Preferred Provider Organization (PPO) Plans.
Health Maintenance Organization (HMO) Plans.

Private Fee-for-Service (PFFS) Plans.

Medical Savings Account (MSA) Plans.

Special Needs Plans (SNP).

All Medicare Advantage Plans provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. This means they must cover at least all of the services that Original Medicare covers. However, each Medicare Advantage Plan can charge different out-of-pocket costs. These are usually co-payments but can also be coinsurance and deductibles.

Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage, sometimes at an extra cost.

PPO Plans

These plans are popular because using the plan is fairly predictable. PPOs have network doctors and hospitals, but you can also use out-of-network providers for covered services, usually at a higher cost. You do not have to choose a specific provider and referrals are not required. PPOs are available either with Part D prescription coverage included or without Part D included.

Choosing a PPO may be right for you if you find the network adequate, but you would still like the flexibility to change providers or go outside of the network for covered services.

 

HMO Plans

Many choose this type of plan because cost sharing is often more favorable. HMOs generally require that you get your care and services from doctors and hospitals that are in network. Exceptions to this would be emergency care or out-of-network urgent care and dialysis services. Some plans offer a point of service that allows you to go out of network for a higher cost. Part D is generally included and choosing a doctor and getting referrals are often required, with the exception of some preventative testing.

In many major metropolitan areas a HMO may be your best choice, as networks are often inclusive and cost sharing generally low. On the other hand, if you travel extensively or live in a rural area where the network is smaller, you may want to choose a PPO.

 

PFFS Plans

On the surface, PFFS plans offer a great amount of freedom, but getting covered services can often be unpredictable. You are not required to use a network and can choose your own providers, but the plan decides how much they will pay doctors and hospitals and how much you will pay for services. This said, you can go to any Medicare approved doctor or hospital if they agree to treat you. Not all providers will accept the plan’s payment terms or agree to treat you. In fact, they can decide to treat you on a visit by visit basis, except in the case of an emergency.

In some rural areas, PFFS plans may be your only choice (though this is scheduled to change in 2011) because credible networks are difficult to put together by Advantage Plan carriers. Because of legislation to be effective in 2011, many carriers have ceased to offer PFFS plans in certain areas.

 

MSA Plans

Not as popular as other Advantage Plans, MSA Plans have two parts; a high deductible and a bank account. Medicare gives the plan a sum of money and a portion is deposited into the bank account. Because the sum is usually less than your deductible, you will have out-of-pocket costs until you reach your deductible. Money spent for covered services counts toward your deductible and once the deductible is met, the plan pays for your covered services for that year. Unused funds in your bank account roll over to the following year. MSA Plans do not include drug coverage and a stand alone plan will need to be purchased. You do not need a referral and can choose your own providers.

Choose a MSA Plan if you are extremely healthy and can cover the out-of-pocket expenses.

 

SNP Plans

Membership in these plans is generally limited to specific groups of people. A SNP may be right for you if you; eligible for both Medicare and Medicaid (dual enrolled), or you are a resident of certain types of institutions, (such as a nursing home), require nursing care at home or if you have one or more specific chronic health conditions such as congestive heart failure, diabetes, HIV/Aids, among others). Part D is always included and you generally need a referral and must use the providers in network except for emergency care and certain preventative services.

Consider a SNP if you meet the criteria for enrollment, as these plans are designed to best meet your needs.Armed with knowledge you can choose wisely

 

Summing it all up

Understanding the different types of plans available, and how they relate to your circumstances can go a long way towards a fulfilling experience in your Advantage Plan membership and usage

 

 

 

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Posted by: David Forbes | September 9, 2009

Medicare Advantage Plans – Are They A Sucker’s Bet?

Why choose a Medicare Advantage Plan?

If you are over 65 and not covered by employer or union group coverage you generally have three choices when it comes to your health coverage.

  1. Enroll in Medicare parts A and B and self insure for the hospital deductibles and the 20% of outpatient medical costs not covered by Medicare.
  2. Enroll in Medicare parts A and B and purchase Medigap coverage, also known as  Medicare Supplement insurance.
  3. Enroll in Medicare parts A and B and become a member of a Medicare Advantage plan.

I would not recommend the first option. You are exposing yourself to too much risk financially. You didn’t work hard and save for your retirement just to have it vanish because of unforseen medical expenses. I would personally recommend the second option if it is financially feasible and if you qualify medically. The best time to enroll in a Medicare Supplement policy is when you have an open enrollment period. Your open enrollment period starts on the first of the month that you turn 65 and lasts for six months. You are not subject to underwriting during this time. You can also enroll in a Medicare Supplement policy without being subject to underwriting during certain guaranteed enrollment periods.

When should you enroll in a Medicare Advantage plan?

You should consider a Medicare Advantage plan when you cannot afford the premiums for a Medicare Supplement policy. An Advantage plan can offer some valuable benefits and protections beyond original Medicare parts A and B.

  • Advantage plans often offer co-pays for certain services, i.e. emergency room and outpatient testing that will result in less expense than original Medicare.
  • Advantage plans may have the part D prescription drug plans included, allowing you to potentially save some money on part D premiums.
  • You will generally have a maximum annual out-of-pocket expense with an Advantage plan, which can potentially save you a financial hardship. This feature is a “stop loss” so you can limit your annual expenses.
  • These plans usually offer coverage for services not covered by original Medicare, such as, dental, vision, hearing and often gym memberships.

You should also consider an Advantage plan when you are not in an open or guaranteed enrollment period for a Medicare supplement policy and cannot pass the medical underwriting.

Which is better – Advantage plan or supplement?

The question is, which option is better for you? Whether you choose one over the other depends on your individual circumstances. For someone who is able to purchase a Medicare supplement and maintain the premiums, I would say that an Advantage plan would be a sucker’s bet. Why subject yourself to a network of providers, or worse yet, a private fee-for-service plan where the provider can choose to accept your coverage on a visit by visit basis? Another drawback of an Advantage plan is that insurance companies can change the plan design and costs on a year by year basis.

If you can’t purchase a Medicare supplement, then an Advantage plan is your better choice over original Medicare. You still have some protections and cost savings that you wouldn’t otherwise have. In the end, your choice is still a choice about insurance. You have to weigh the costs, and in the case of Medicare supplements, be aware of the underwriting qualifications.

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Posted by: David Forbes | August 30, 2009

2010 Medicare Advantage Plans – Expect Increased Costs

Expect to pay more for Medicare Advantage

Many insurance companies that offer Medicare Advantage Plans will most likely increase costs for their 2010 offerings. Carriers will see a 4.5% reduction in reimbursement rates from Medicare and this will have a significant effect on their ability to continue to offer a similar plan design as they offered for 2009 plans. The choice they will have to make with their private fee-for-service plans will be whether to raise monthly premiums or make the cost sharing greater for their members. Neither one of these choices is good news for Advantage Plan members.

The original idea behind an Advantage Plan was to offer the Medicare beneficiary, that was unable to afford the cost of a Medicare Supplement, the ability to get lower cost sharing for services at little or no monthly premium. In addition to a lower cost sharing structure, members were to receive additional benefits not normally covered by original Medicare. But if costs increase for 2010 plans, it hardly seems worth it to get extras like; vision, dental, hearing and gym memberships.

The right time to look at all Medicare options

The annual enrollment period (AEP) for Medicare Advantage starts November 15 and runs through December 31. You owe it to yourself to take a look at all the options that are available to you. Receiving your new member cards and info for 2010 Medicare Advantage from your 2009 Advantage Plan provider and putting them aside without further investigation, could be your worst move. Your annual enrollment period exists for a reason. Insurance companies can change plans on a year to year basis and you need to assess the new offering. In addition to assessing your current carriers’ new offering, you need to take a look at what else is available. Start by going to the Medicare website and looking at what other Advantage Plans are available in your area. If you want to stay with an Advantage Plan, another carrier may offer a better option for you.

The AEP is a good time to take a look at what Medicare Supplements are available. Medicare Supplement insurance or Medigap coverage consists of several standardized plans that to one degree or another, offer coverage for the gaps that original medicare does not cover. You may qualify for a guaranteed issue period, so you can purchase a supplement without being subject to medical underwriting. If you choose a Medicare supplement policy, you will also need to secure stand alone Part D prescription drug coverage as well. Unlike some Medicare Advantage Plans, supplements do not include Part D coverage.

With costs rising for Medicare Advantage Plans in 2010, this is the right time to assess all your options. You may find that the price disparity between an Advantage Plan and a supplement is not that great. If you qualify medically or are in a guaranteed issue period, you owe it to yourself to see if a supplement would meet your budget. If you are able to purchase a supplement policy, you will not be subject to the changes in your coverage each year. Having an affordable standardized plan can provide you with a little piece of mind.

 

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Posted by: David Forbes | August 21, 2009

Medicare Advantage Plans – The Good, The Bad, The Ugly

Medicare Advantage will be a hot topic in 2010

The winds of change are blowing in the Medicare Advantage arena. For some members, the change will be minimal, but for others the change will mean starting from scratch. Medicare Advantage plans have become popular with many beneficiaries as a way to save money by having co-pays for many services and getting additional benefits beyond original Medicare, such as vision, dental and hearing coverage. The allure is that you will not have to pay an insurance company for a Medicare Supplement policy and you will lessen your responsibility for the expenses that Medicare doesn’t cover. This may sound good on the surface but there can be downsides as well.

Here’s the good news

There are many people on Medicare that are in between.They are in between being able to afford a Medicare Supplement policy and having additional assistance from the State. A good example would be someone in the sandwich generation. There are Medicare beneficiaries that have a decent retirement income, but may have the expense of putting a child through college  while providing financial assistance or care for a parent. The Medicare Advantage option with a low premium or no premium may be the solution to saving some money on Medical services. There are also many under 65 Medicare beneficiaries that are unable to purchase a Medicare Supplement due to the way that individual States regulate insurance companies that offer them. Having a Medicare Advantage plan is a good thing if you have no other option. Another benefit of an Advantage plan, is that you generally have a maximum out of pocket expense that you are responsible for each year.

The Bad

The bad part of a Medicare Advantage plan can be what I call the smoke and mirrors aspect. I’m not implying that insurance companies or agents are intentionally misleading people, but plans can be confusing and misunderstood. One example is in the design of some plans. If you have original Medicare and you are hospitalized, you are responsible for a $1068 deductible for the first 60 days of inpatient care in 2009. Many Advantage plans will have a co-pay for the first 5 to 17 days (plans differ), and the co-pay may be in excess of $200 per day. That works if you are in the hospital for a couple days, but what if its a couple weeks? You are now paying more money for the hospital stay than you would under original Medicare. In addition, some plans have the same gaps in coverage for some services that Medicare has. For instance, many plans will still require you to be responsible for 20% of some out patient procedures. Potential plan members need to understand all aspects of the plan that they are considering.

The ugly truth

Plans limit your choice of providers. If you choose a HMO or PPO you generally know that when you enroll in such a plan. Many beneficiaries enroll in these plans because their medical providers are in network or because the plan design offers some benefits not otherwise available.

The Private Fee-For-service (PFFS) plans are another story. Your provider can choose to accept the plan on a visit by visit basis except in an emergency. Ouch! Also reimbursement rates for Medicare Advantage plans are being reduced for 2010 plans by 4.5%. This may force plans to increase prices or co-pays. Many PFFS plan are being eliminated in 2010. Some carriers have already indicated that they will not renew PFFS plans for 2010, leaving approximately 500,000 Advantage plan members to seek new coverage. These are the folks that are unfortunately starting from scratch. The silver lining is that they will have a guaranteed enrollment period for a Medicare Supplement policy should they opt for more stability.

Those that are losing their Medicare Advantage plan due to their carrier’s non-renewal for 2010, will have the option to enroll in a new plan for 2010 starting October 1st 2009. If a Medicare Supplement policy is out of reach and you can go with the flow (or swing with the punches!), you still have options in the Medicare Advantage market. You just need to know what you are getting into and expect that change will be constant.

 

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Posted by: David Forbes | August 14, 2009

Living Wills, Death Panels, Orwellian Bureaucrats – Oh My

Living wills – publicity is publicity

President Obama’s proposed health care reform has brought some attention to end-of-life wishes and the preparation of a living will. I’m not going to wade into the political debate about health care reform. I believe, that at least cognitively, I’ve tried on every pair of shoes in the store and decided to go barefoot as it relates to politics steeped in dogma and a misunderstanding of history. I just can’t buy into the wild arguments coming from any prospective. But I am pleased that the debate (putting it nicely) has partially brought the focus to end-of-life wishes and living wills. Planning for end-of-life situations by preparing a living will is good for many reasons, namely:

  • A living will allows you to control events even when you’re incapacitated.
  • A burden of uncertainty is lifted from your loved ones.
  • Your medical providers have a clear picture as it relates to a care plan.
  • You can preserve your estate by denying costly procedures that you may not want.

In the end, your political views will not matter, you are going to meet the same earthly fate as everyone else and a living will may prove to be prudent whether you are a proponent of health care reform or not.

Death panel or no death panel – get a living will

It’s time to put all this silliness aside and plan for the future. A living will is a little like insurance, you may never need it but if you do it can be a positive thing. This is a good opportunity to get a free printable living will and take a few minutes to complete the paperwork. Living wills can generally be prepared without the help or expense of an attorney, and depending on your State of residency, it may or may not need to be notarized.

Give some thought to who will act as your health care surrogate. Your surrogate is designated in your medical power of attorney and will act on your behalf if you are unable to do so. Make copies of your living will and make sure that your health care surrogate, family, close friends and your doctor have a copy. Keep the original in a safe place and keep in mind that any new living will that you may prepare in the future will supersede the previous document.

Finally, stay in touch with your health care surrogate and consider naming an alternate surrogate in the event that your primary surrogate is unable to act on your behalf. Preparing a living will has nothing to do with your political preference or the current health care reform debate. It has everything to do about you making sound decisions that can affect you and your loved ones.

Posted by: David Forbes | August 9, 2009

Funeral Costs: What You Need To Do Now

How will your bills and funeral expenses be paid?

Funerals are one of the most expensive purchases many people will ever make. A traditional funeral, including a casket and vault, costs about $6000, and extras like flowers and obituary notices can add thousands of dollars to the average funeral cost.  Many funerals run well over $10,000. To  make matters even worse, its estimated that millions of Americans have no life insurance to pay for the average funeral. Unfortunately, many people wait until they are either too old or not healthy enough to purchase traditional life insurance. The term insurance advertisements touting $500,000 of life insurance for a dollar a day don’t apply to the 75 year old with some pre-existing health problems.

Burial insurance is the answer

If your family could not afford to pay for your funeral without sacrificing their retirement or other savings, a burial insurance policy may be the answer. Burial insurance policies are typically simplified issue whole life policies at are available with death benefit amounts from $2,000 to $50,000.  Whole life insurance is permanent insurance that can build a cash value over time. Features of a burial insurance policy include:

  • No medical exams – just a few simple questions
  • Virtually guaranteed qualification
  • Coverage cannot be canceled because of age or health
  • Rates never increase
  • Lifetime benefit
  • Generally income tax-free death benefit

Getting a policy

Most companies will allow you to buy a burial insurance policy between the ages of 40 and 85. The rates are surprisingly affordable and you can apply for lower dollar amounts to fit most any budget. Some companies will allow an insurance agent to take your application over the phone, while others will require a signed application. I would recommend an insurance broker that represents more than one company so you can be be assured of getting the best rate. You can generally start the process online by providing a little information. After you find a company that offers burial insurance, an agent will follow up with you to make sure you qualify and to quote you some rates.

The proceeds from burial insurance can be used for any purpose, not just paying for a funeral. Another benefit of coverage is the ability to pay for any outstanding medical or hospital bills, or just leaving an inheritance. If your concerned about your own funeral costs or if you have a parent or loved one that needs to have a plan, purchasing burial insurance is a wise choice. None of us want to be a burden on our families and for a few dollars per month, we can have the peace of mind that we have a plan in place.

 

Posted by: David Forbes | August 6, 2009

Living Will Forms – Why They Need To Be State Specific

Your living will is a legal document

You’ve chosen to create a living will and maybe even found some free printable living will forms online. Now you need to make sure that the living will blank forms are State specific. A living will is a legal document, just as a State specific Last Will and Testament is a legal document. The last thing that you want is to have the validity of your living will challenged.

The purpose of a living will is to make your end-of-life wishes known in the event that you are unable to speak for yourself. Your health care surrogate is designated in your medical power of attorney and is responsible for communicating with your medical providers about your wishes. This should not be the time for someone to challenge your living will on legal grounds.

States have specific forms and requirements

The requirements for living will documents vary from State to State. Some States require a notary to witness your signature and others do not. Many States just require your living will to be witnesses by two people. The language varies from State to State. This is no time to just wing it and jot down some thoughts about want or don’t want when it comes to your end-of-life wishes. In addition to having State specific forms, you should also consider the following:

  • Make sure that your witnesses are of legal age
  • If a notary is required; don’t put if off 
  • Make sure your witnesses know what they are signing
  • Ensure that your health care surrogate thoroughly understands your wishes

 Finding the right resource

Do a search for “living will” on Google and it will return 1,720,000 results. You could review hundreds of sites and not find what you’re looking for; in this case, State Specific living will forms. I’ve visited hundreds of sites promising free living wills and have found that the living will may be free, but they are offering  generic forms or the living will forms are free, but the medical power of attorney forms are not. I recommend getting your free printable living will from a site set up by Live Oak Senior Advisors. You will find a request form on the home page asking for your first name and State of residency. Within seconds you will be downloading and printing completely free State specific living will blank forms. Now you can be assured that you have the correct living will forms.

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