A medical emergency can create two urgent questions: Who can get information about your care? And who can make decisions if you cannot?
A HIPAA Authorization and an Advance Medical Directive answer different questions. One gives someone permission to receive protected health information. The other can name the person who makes health-care decisions for you and may record your treatment wishes.
Having just one can leave a gap. Here’s what each document does, and why both matter.
The short answer
- HIPAA Authorization: Lets the person you name receive specified medical information. By itself, it does not give them authority to make treatment decisions.
- Advance Medical Directive: Can name a health-care agent to make decisions if you cannot. It may also record your treatment preferences.
- Durable financial power of attorney: Usually covers financial and property matters. It does not automatically give your agent access to medical records or authority over your care.
The names and legal details vary by state. The goal is the same: give the right person the right authority when you need help.
What does a HIPAA Authorization do?
HIPAA is a federal privacy law that protects certain health information. A HIPAA Authorization is your written permission for a person or organization to receive information covered by that law.
You can name a spouse, adult child, parent, friend, or another trusted person. Depending on the document, you may be able to set limits on who can receive information, what information they can receive, and how long the permission lasts.
A HIPAA Authorization can help your named person:
- Speak with your doctors or other providers.
- Request or receive medical records covered by the authorization.
- Help coordinate care by getting information you have allowed providers to share.
It does not, by itself, let that person consent to surgery, choose treatment, or make other health-care decisions for you. It gives permission to access information, not decision-making power.
HIPAA also does not always require a signed authorization before a provider can speak with family. In some situations, a provider may share relevant information with someone involved in your care if you agree or do not object. If you cannot make your wishes known, the provider may use professional judgment. But that is not a dependable substitute for naming the person you want to receive information and documenting your permission.
What does an Advance Medical Directive do?
An Advance Medical Directive can name a health-care agent. The person you want to make medical decisions if you cannot make or communicate them yourself. It may also include instructions about the care you want.
The document’s name and format differ across Virginia, Maryland, West Virginia, and DC. Some forms combine an agent appointment with treatment instructions; others handle these topics differently. Read your document carefully to see what it actually covers.
An Advance Medical Directive can help:
- Identify who should speak for you when you cannot.
- Give your agent authority to make health-care decisions within the document’s scope and applicable law.
- Communicate your wishes about treatment and care.
- Reduce uncertainty and avoid conflict among family members.
A directive does not mean your agent takes over while you can make your own decisions. The agent’s authority depends on the document and state law, including when it becomes effective.
Why your agent may still need HIPAA access
Your health-care agent may need information to understand your condition and make an informed decision. Federal HIPAA guidance generally treats a person with legal authority to make health-care decisions for you as your personal representative for relevant information, subject to certain exceptions.
But the timing and scope of that authority matter. If your Advance Medical Directive becomes effective only after you are unable to make decisions, your agent may not have that authority before then. The document’s language and your state’s law also matter. Some directives specifically authorize an agent to access medical records; others may not say so clearly.
A separate HIPAA Authorization can make your permission clear and allow access when you want it, even before your agent’s decision-making authority takes effect. It can also help avoid confusion when a provider is trying to determine what a document authorizes.
The safest approach is to make sure your documents work together: your directive names the person who can act for your care, and your HIPAA Authorization states who may receive your information.
A financial power of attorney is different
A durable power of attorney is commonly used to let an agent handle financial or property matters if you cannot. That may include paying bills, managing accounts, or dealing with real estate, depending on the document.
Do not assume that a financial power of attorney lets your agent access your medical records. A financial POA that only covers money and property does not automatically make the agent your health-care representative under HIPAA.
A power of attorney could matter for medical access if it is legally effective and actually gives the agent authority to make health-care decisions. But that is different from a document limited to financial matters. Check the language rather than relying on the title.
For more on the role of a financial POA, see our guide to what a power of attorney does.
Put the documents together
Ask these questions as you review your plan:
- Who do you want to receive your medical information? Name the person clearly in a HIPAA Authorization.
- Who should make decisions if you cannot? Name that person in an Advance Medical Directive.
- When should each authority apply? Check whether access or decision-making begins immediately or only after a stated condition.
- Have you named a backup? A second choice can help if your first-choice agent is unavailable.
- Do your documents match your state and your wishes? Signing and document requirements can vary by jurisdiction.
Tell your chosen people where the documents are and give them copies. Consider sharing the relevant documents with your health-care providers, too. A document no one can find may not help during a crisis.
A separate issue after death
HIPAA access for a living person and authority to administer someone’s estate after death are different issues. Small-estate rules may help determine who can handle certain probate matters, but they do not replace a living person’s HIPAA Authorization or Advance Medical Directive.
For context, Maryland's small-estate threshold is $50,000, or $100,000 if the surviving spouse is the sole heir or legatee. Virginia's small-estate affidavit procedure generally covers a personal estate of up to $75,000, with a separate provision for a single asset valued at $35,000 or less, subject to statutory conditions. See the Maryland Register of Wills small-estate information and Virginia's Small Estate Act.
Both belong in a complete plan
A will or trust addresses what happens to property after death. It does not, by itself, name the person who should make your health-care decisions or give someone permission to access your medical records while you are alive.
That is why Estate Plan HQ includes both an Advance Medical Directive and a HIPAA Authorization in its will-based and trust-based plans. Each fills a different role. Together, they help your chosen people get the information and authority they may need.
Our plans are personally drafted and reviewed by a licensed attorney, with flat-rate pricing and no in-person meeting required. Learn about our will-based and trust-based planning options.
The bottom line
A HIPAA Authorization lets someone receive information. An Advance Medical Directive can appoint someone to make health-care decisions if you cannot. A financial power of attorney usually handles money and property, not medical care.
Do not assume one document covers all three jobs. Make sure your plan names the right people, grants the right authority, and fits the laws of your state.
For more on the role of a directive, read Advance Medical Directives Explained. For official federal guidance, see HHS on health-care powers of attorney and HIPAA access and personal representatives.
This article provides general information, not legal advice. Requirements and document language vary by state.