Can I Use My Health Care Documents in Other States?
Do you winter in the south, spend summers in the north, or travel extensively for business? If you spend a significant amount of time in more than one state, you’ll want to take the time to make sure your health care documents -- living will, advance directive, or medical power of attorney -- will be valid wherever you are.
Most States Will Accept Your Health Care Documents
Usually, documents directing health care remain valid when you cross state lines. Most states will accept a health care directive that is legally valid in the state where it was made.
For example, if you make health care documents in Massachusetts but you spend summers in Arizona, your documents will be honored because Arizona law states that a health care directive is valid in Arizona if it was valid where and when it was made, as long as it doesn’t violate any criminal laws (a well made health care directive won’t).
Some states, however, accept other states’ health care documents only to the extent they comply with their own laws. And a few states say nothing about reciprocity, making the outcome unclear.
The table at the end of this article lists the reciprocity laws for each state.
How Federal Law Protects You -- And How It Doesn’t
The U.S. Constitution gives you the right to direct your own health care, and no state may take that right away from you. This means your basic wishes for medical treatment -- for instance, whether you want to be placed on a respirator or receive feeding tubes if you are in a permanent coma -- must be honored from one state to the next, no matter the particulars state law. Still, you may want to investigate to be sure your documents will easily cross state lines. Confusion or delays could interfere with your ability to get the kind of care you want.
In addition, the constitutional right to make your own medical decisions doesn’t apply in the same way to a medical power of attorney, the document in which you name a health care representative or “agent” to make medical decisions for you, if you cannot do so yourself. While every state has a law that allows you to name a health care representative, states may place limits on what your representative can do for you. For example, one state may allow your agent to admit you to a nursing home, while another would not permit that unless your document very specifically gave that power to your agent. Provisions like these may never affect you, but it’s best to know whether they exist.
Don’t Make Health Care Directives for More Than One State
It’s almost never a good idea to make a separate set of health care documents for each state where you spend time. Health care forms often differ widely from state to state, making it difficult to prepare documents with identical provisions. And if your health care instructions don’t completely agree, signing one document could revoke a document you made earlier -- even if you signed it only an hour before.
Steps to Ensure Your Wishes Are Followed
Here are four things you can do to ensure your health care wishes will be followed when you travel from one state to another.
1. Do what you can to learn whether your documents will pass muster in each of the states where you spend significant time. You can start by looking up the law, using the chart below. You might also want to make a phone call to a patient representative at a hospital where you might be likely to receive treatment in another state. Tell them you’ve made documents in Massachusetts and ask whether they would have any trouble accepting them. If so, ask what they recommend that you do, keeping in mind the warning about making multiple documents, above.
2. Be sure that the signature requirements for your home state’s documents -- that is, witnesses and/or notarization -- comply with the requirements of the other states. (See Do I Need to Have My Health Care Documents Witnessed or Notarized?) If you want to cover the bases in every state, have your documents signed by two disinterested adult witnesses and get them notarized, too.
3. Remember to bring your documents with you when you travel. Your health care directives won’t do you any good at all if no one knows they exist. Make a wallet card stating that you have made health care documents and keep it with you. If you have a second home, keep copies of your documents there. Choose a safe place to store them and be sure others know where to find them if necessary.
4. If after taking the first three steps, you still feel concerned that your health care wishes won’t be honored in all the states where you spend time, ask an experienced estate planning lawyer for guidance. (See How Do I Find a Good Lawyer in Massachusetts?)
Reciprocity Laws: State by State
The following list of state laws is a work in progress. It can help you find not only Massachusetts's rules about honoring health care documents, but the laws of other states where you live and travel as well.