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Preparing for the later stages of life is never easy, but it is one of the most important steps you can take to protect yourself and your loved ones. For Iowans, understanding your options around estate planning, advance healthcare directives, long-term care insurance, and powers of attorney can give you peace of mind and help your family avoid unnecessary stress.

This guide will walk you through the essentials of planning for the future—covering everything from wills and trusts to durable powers of attorney and long-term care insurance—so you can make informed decisions and feel confident about next steps.

Why Planning Ahead Matters

None of us likes to think about death, disability, or losing independence, but the truth is that planning ahead gives you more control. By making decisions now, you can:

• Protect your assets and property.

• Ensure your healthcare and financial wishes are respected.

• Reduce stress and confusion for your family during difficult times.

• Potentially save money and avoid lengthy legal processes.

For Iowa residents, having the right documents in place can also help when navigating programs like Medicare or Medicaid, which have specific rules about financial eligibility and asset transfers.

Legal, Health, and Financial Protections

As you age, there are a few key documents and legal protections that everyone in Iowa should consider putting in place. You can find the forms referenced below on the Iowa Bar Association website.

Wills and Trusts

Will: A will is a legal document that states how your assets (like your home, bank accounts, or personal property) will be distributed after your death. Without a will, your estate will be divided according to Iowa law, which may not match your personal wishes.

In Iowa, a will must be in writing, signed by you, and witnessed by at least two people. While you can find do-it-yourself will templates online, it’s usually best to work with an Iowa attorney to make sure your will meets state requirements and truly reflects your wishes. After it’s signed, keep the original in a safe place (such as a fireproof box or safe deposit box) and let your executor know where it is.

Revocable (Living) Trust: A revocable trust allows you to manage and use your money and property during your lifetime and then pass it on to your beneficiaries when you die. One key benefit is that assets in a trust typically avoid the probate process, which can be time-consuming and costly.

Irrevocable Trust: With an irrevocable trust, once you place assets inside, you no longer directly control them. For Medicaid purposes, these assets may not be counted as yours if the trust was set up more than five years before you apply for long-term care coverage. This makes irrevocable trusts a common estate planning tool for people who want to protect property or savings for their heirs.

To create a trust in Iowa, you’ll need to work with an estate planning attorney who can help you decide whether a revocable or irrevocable trust is best for your situation. You’ll sign a trust document and then transfer assets (like your home or bank accounts) into the trust. Without this step, the trust doesn’t actually control anything.

Important for Iowans: Medicaid has a 5-year “look-back” rule. If you give away money or property within 5 years of applying, those transfers can affect your eligibility for benefits. Planning early is essential.

Durable Power of Attorney for Finances

A Durable Power of Attorney (DPOA) for Finances allows you to appoint a trusted person to manage your financial matters if you become unable to do so. This can include paying bills, managing bank accounts, selling property, or handling investments.

Without a DPOA, your family may need to go through the Iowa courts to gain authority to handle your finances—a process that is often stressful and time-consuming.

Iowa law provides a standard form for financial power of attorney that you can complete without an attorney, though legal guidance is recommended if your finances are complex. The form must be signed and either notarized or witnessed by two people.

Advance Directives and Healthcare Planning

Advance directives allow you to outline your wishes for medical treatment in case you are unable to speak for yourself. These are important for everyone—regardless of age or current health. Key documents include:

Living Will: States what medical treatments you would or would not want, such as CPR, ventilators, or tube feeding.

Iowa has a statutory “Declaration Relating to Use of Life-Sustaining Procedures” form that you can complete. It must be signed in front of two adult witnesses or a notary. Provide copies to your healthcare provider, your healthcare agent (if you name one), and keep one for your records.

Durable Power of Attorney for Healthcare (Healthcare Proxy): Appoints someone you trust to make medical decisions on your behalf.

You’ll complete Iowa’s standard healthcare power of attorney form, which must be signed in front of two witnesses or a notary. You can name a spouse, adult child, or other trusted person as your agent. Give copies to your agent, your doctor, and family members.

Great River Health offers help through trained volunteers who can guide you through filling it out. Once complete, give copies to your agent and keep the original in a safe but accessible place. Click here to learn more.

HIPAA Authorization: Lets your chosen person access your medical information and speak with doctors.

This form is usually included with healthcare power of attorney documents. You’ll list who is allowed to see your protected health information. Your healthcare provider may also have their own version of this form.

Do Not Resuscitate (DNR) Order: A medical order signed by your physician that instructs providers not to perform CPR if your heart or breathing stops.

In Iowa, a DNR is a physician-signed medical order (sometimes called an “Out-of-Hospital DNR”). Talk with your doctor if you are considering this option. Once issued, you’ll need to keep the document accessible—many people keep it posted in the home or carry a wallet card provided by the Iowa Department of Public Health.

Iowa Physician Orders for Scope of Treatment (IPOST): A medical order that turns your care preferences into actionable instructions for all healthcare settings. To complete one:

1. Talk with your physician, nurse practitioner, or physician's assistant about your preferences for CPR, level of intervention, and tube feeding.

1. The form requires signatures from both you (or your legal representative) and your healthcare provider.

1. Once completed:

1. Post it prominently (e.g., on your refrigerator) so emergency responders and caregivers can easily find it.

1. The form travels with you across settings—clinic, hospital, home, or nursing facility.

1. The form is revocable by physical marking (draw through it, write “VOID,” sign and date) and requires a new form if preferences change.

1. Importantly, IPOST does not replace advance directives or a DNR—it complements them by converting your wishes into formal medical orders

By having all of these documents in place, you’re able to take control of your healthcare and lift the burden from your loved ones during emotional times.

Considering Long-Term Care Insurance

One of the biggest questions many Iowans face is whether to purchase long-term care insurance.

What Is Long-Term Care Insurance?

Long-term care insurance is designed to pay for non-medical care, often called custodial care. This covers help with everyday activities such as:

• Bathing
• Dressing
• Eating
• Moving around your home

Unlike traditional health insurance, long-term care insurance can help pay for services in places like:

• Assisted living facilities
• Nursing homes
• Adult day centers
• In-home caregiving

You can purchase long-term care insurance through a licensed insurance agent. It’s best to shop around and compare policies, carefully looking at daily benefit amounts, how long benefits are paid, and what services are covered. The Iowa Insurance Division offers consumer resources to help you understand and evaluate policies. Consider meeting with a financial advisor to see how insurance fits into your broader retirement and estate planning.

What Medicare Covers (and Doesn’t)

Many people assume that Medicare will cover long-term care, but that is rarely the case. Medicare only pays for very limited skilled nursing or home health care under specific conditions, and it does not cover extended stays in nursing homes or most assisted living services. This means that without other coverage, the costs of long-term care often fall to individuals and their families.

Should You Consider Long-Term Care Insurance?

You and your family might consider a policy if:

• Your health background or family history makes long-term care more likely.
• You want to protect savings, property, or investments for your spouse, children, or heirs.
• You don’t have family members nearby who could provide care and would rely on paid services.

For many Iowans, a long-term care policy is worth considering as part of an overall financial and estate plan.

Navigating Medicare

Understanding Medicare can feel overwhelming, but you don’t have to figure it out alone. Great River Health offers free “Welcome to Medicare” seminars throughout the year to help you or your loved ones understand the many parts of Medicare and how they work together. During these sessions, you’ll learn about:

• Medicare Part A and Part B benefits
• Prescription drug coverage (Part D)
• Medicare Advantage plans
• Medicare supplement insurance (Medigap policies)
• How to recognize and prevent Medicare fraud, errors, and abuse

These seminars are open to the public and provide an excellent opportunity to ask questions before making important coverage decisions.

To find upcoming dates, simply search “Medicare” on our online events calendar or visit Medicare.gov for more information.

Senior Health Insurance Information Program (SHIIP)

Great River Health also partners with the Senior Health Insurance Information Program (SHIIP) to provide free, confidential, one-on-one counseling about Medicare and other health coverage options.

SHIIP was created in 1999 by the Iowa Insurance Division and is staffed by highly trained volunteers who provide unbiased information—never selling insurance or pushing a particular plan. Instead, they help seniors and their families understand:

• Medicare and supplemental insurance
• Medicare prescription drug coverage
• Long-term care insurance
• Other health insurance issues that impact seniors

In 2024 alone, Great River Health’s SHIIP volunteers helped over 2,000 people save more than $1 million in Medicare-related expenses.

You can schedule a SHIIP appointment online or by phone:

• Henry County Health Center: 319.385.6774
• Fort Madison, Keokuk, or West Burlington: 319.768.3342

Whether you’re new to Medicare or reviewing your current plan, SHIIP counselors are here to help you make informed, confident decisions about your health coverage.

Steps to Take Now

Planning for the future doesn’t need to happen all at once, but taking a few first steps can make a big difference:

• Talk with your family about your wishes and concerns.
• Meet with a financial advisor or elder law attorney to discuss trusts, wills, and long-term care planning.
• Complete your Durable Power of Attorney forms for both healthcare and finances.
• Put your advance directive in writing, so your loved ones and doctors know your wishes.
• Review your insurance options to see if long-term care coverage is a good fit.

How Great River Health Can Help

Thinking about death or long-term care is difficult, but planning ahead is one of the greatest gifts you can give yourself and your loved ones. By setting up wills or trusts, preparing durable powers of attorney, and considering long-term care insurance, you ensure that your wishes are honored, and your family is supported.

At Great River Health, we believe that preparing for the future is part of living well today. Our team and trained volunteers are here to help. Don’t wait until it’s too late—take the first step today.

Learn more about our services and get help filling out your Durable Power of Attorney forms by visiting Great River Health’s Advance Care Planning Resources.