General Planning | FAQs
Q |​ Why should I prepare for my care in later life?
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Preparing for your care in later life makes it more likely for your care goals and preferences to be honored during an emergency or serious illness. While you can’t plan for everything that might happen, you can make sure that others know what matters most to you about your care. You can even designate certain trusted people to make medical decisions for you if you become unable. These measures may also prevent people you do not want involved in your care from making medical decisions for you.
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It is very important to choose and document a healthcare proxy, especially if you would like someone outside of your biological family or legal marriage (if applicable) to make healthcare decisions for you if you get sick and are unable to communicate your wishes. When you choose and document your healthcare proxy on your state's legal form, it is also very important to talk with the person you chose about what is most important to you about your care. Consider completing an advance directive to help you and your healthcare proxy think about, talk about, and document decisions about your care.
See the Advance Directives and Healthcare Proxy tabs for more information.
Q |​ When should I start taking steps to prepare for my care?
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Adults of any age with the capacity to make their own medical decisions can take steps to prepare for their care. It is recommended to start preparing as soon as early adulthood and make updates as your care goals and preferences change over time. It is important to start the process before you experience a serious illness or before a surgery, including gender-affirming surgery, because making decisions about your care can be more difficult when you’re not well. You can always update your goals and preferences, even during treatment for a serious illness.
Q |​ How do I start taking steps to prepare for my care?
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To start preparing for your care through a process called advance care planning, use the following steps as a guide:
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Think about what matters to you about your future healthcare. For example, you might ask yourself, “Is it important to me to continue gender-affirming medical treatments if I have a serious illness?”
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Talk with trusted people in your support system about your wishes.
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Choose a trusted person to serve as your healthcare proxy (see Healthcare Proxy section).
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Complete an advance directive. Access forms by state→ or from the Five Wishes®→.
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Share your advance directive with your medical provider and your healthcare proxy.
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Keep the conversation going! Wishes change over time, so sharing updates with your support system on a regular basis will help them stay informed about what matters to you about your care.
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For a trans-friendly advance care planning resource, check out the Transforming Choices Starter Guide and Planning for Lifelong Care→.
For general information about advance care planning, check out these resources from the National Institute on Aging:
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Q |​ How do I talk to my doctor about planning for my future medical care?
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You can ask your provider during a primary care appointment to discuss your options for advance care planning and what makes sense for your current state of health. For example, a person with a serious illness may decide to sign a Do Not Resuscitate (DNR) order if they do not want to have CPR when their heart stops. Before you talk to your healthcare provider, take some time to think through your goals and preferences for your medical care and talk it over with people you trust. The resources below can help you get ready to talk to your doctor and to fill out the forms you choose to document your goals and preferences:
Transforming Choices Healthcare Decisions Starter Guide
What Matters to Me Workbook→ by the Conversation Project and Ariadne Labs
Q |​ What is important to know about planning for my healthcare when I retire?
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When you retire, you will likely have to change your insurance provider or enroll in Medicare, and you may be on a fixed income. Depending on your insurance provider, you may have to change to a different doctor. Consider the following tips:
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Use a health savings account, if you have one, to cover medical expenses tax- and penalty-free.
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Enroll in Medicare at the right time to avoid penalties.
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Enroll in long-term care insurance in your 50s or early 60s to cover the cost of long-term care if you need it later in life.
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Check the terms of any new insurance plans you are considering to find out whether your doctor is in network.
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Q |​ If I decide to move to another state, what should I know about accessing healthcare there?
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When moving to another state, it is important to consider the following when accessing healthcare:
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State laws that protect or restrict coverage for gender-affirming care. Check out this resource from the Movement Advancement Project→ detailing states with “shield laws” that protect gender-affirming care.
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Availability of affirming healthcare providers. Check out the LGBTQ+ Healthcare Directory→ and Outlist→ to start searching for providers by state.
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Community organizations that support LGBTQIA+ health. Search for local and regional organizations that provide healthcare and other support services for LGBTQIA+ people in the state where you’re moving.
If you need relocation assistance, see this list of support organizations from Trans Lifeline→ (Note. Listings may not be up to date).
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Q |​ If I decide to move to another country, what should I know about accessing healthcare there?
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Accessing healthcare abroad may be very different from accessing healthcare in the US. Here are some tips to keep in mind:
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Research the health insurance systems of your destination to help you determine insurance enrollment options and requirements (for example, if you are going to a country with national healthcare, find out if coverage is available for non-citizens).
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Research the healthcare systems of your destination to help you determine if they cover the transition-related care you need, including surgeries and hormones, and whether those are available publicly (through the government) and/or privately.
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Find out your current insurance coverage for healthcare services abroad. Medicare does not cover medical care outside of the US.
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Plan ahead to make sure you have access to prescription medications in the new country.
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Bring your prescriptions filled and in the original bottles so that you have them during your move. Remember any additional items you may need, such as syringes, needles, alcohol wipes, etc.
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Collect your medical records and bring a doctor’s note explaining your healthcare needs.
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Get vaccinated to prevent infection when moving to certain countries.
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Talk to your doctor about how travel might affect health risks from medical conditions you have.
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Plan how you will communicate with healthcare providers when you need medical care if English is not the primary language of your destination.
Tips for trans people considering leaving the US for another country may be found at Trans World Express→.
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