End-of-Life Planning Decisions

How this engine works

You enter your own figures; the engine models two scenarios side by side and shows the twelve-month difference between them. The outputs are estimates built from your inputs and documented assumptions — not predictions, and not advice. Mood and stress are self-reported context that adjust the wording of the summary, nothing else. Inputs are processed in your browser. The full methodology, including what the engine does not claim, is on the Decision Center.

Step 2: Decision Forge — compare assumptions

Decision scenarios with reflection prompts

Each scenario in the tool above presents two options drawn from this event and models them side by side from the figures you entered. Before the comparison, the page names a cognitive-bias concept as an educational reflection prompt. It is a general prompt attached to the scenario rather than a finding about you: the page does not test whether the concept applies to your situation, and it does not indicate which option you should choose.

Self-reported context at decision time

The page does not create a psychological profile. Mood and stress may tailor wording and general next-step suggestions. They do not change the entered financial values or scenario math. They do not establish decision readiness. The named bias concept is a general reflection prompt; the page does not detect bias, assess decision capacity, diagnose a condition, or predict outcomes.

Four things that are settled before, not after

Most of what this page covers can be revised at any time, and revised again. These four cannot be repaired afterwards by anyone acting on your behalf, which is why they are set out on their own rather than left in the sequence above.

Three documents, and one of them is not what people think

All three are creatures of state law. There is no federal advance directive, no federal form and no national registry — only around nine states run registries, plus private vendors with no national coverage. If you move, or you are hospitalised in another state, the documents should be reviewed rather than assumed to travel.

The federal law people cite here does much less than its reputation suggests. It requires Medicare and Medicaid providers to give you written information about your rights under your state’s law, to keep written policies, to note in a prominent part of your record whether you have a directive, and not to discriminate based on whether you do. It creates no new substantive rights and does not require anyone to help you draft anything.

The beneficiary designation beats the will

A retirement account or life insurance policy passes to whoever is named on the beneficiary form, and the will generally does not change that. The Supreme Court settled the retirement-plan version of this in 2009: the plan administrator pays according to the plan documents, even where a divorce decree says otherwise.

Two qualifications keep this from being absolute. Twenty-six states apply revocation-on-divorce statutes to will substitutes — revocable trusts, pension accounts, life insurance — so in those states a divorce may automatically revoke an ex-spouse’s designation on a non-ERISA asset. And payable-on-death and transfer-on-death accounts work the same contractual way, passing outside the will entirely.

The practical instruction is unglamorous and it is the highest-value thing on this page: read every beneficiary form you have. Old employer plans, an account opened before a marriage, a policy bought through a former job. The form governs, and no amount of careful will-drafting reaches it.

Funeral costs, and who actually publishes that number

Federal rules give you specific rights when arranging a funeral, and they are more useful than most people realise.

• A general price list must be given to you to keep, on request, in person — before any discussion of arrangements.
• Prices must be quoted over the telephone on request.
• A casket price list and an outer burial container price list must be shown before the goods are.
• You may buy a casket elsewhere, and the funeral home may not charge a handling fee for it. For direct cremation it must offer an alternative container.
• You must receive an itemised statement of goods and services selected at the end of arrangements.
• No embalming fee may be charged without state-law requirement or your express authorisation.

On cost: no federal agency publishes a median funeral cost. The figure everyone quotes comes from a study by the funeral directors’ trade association — most recently 2023, giving $8,300 for a funeral with viewing and burial and $6,280 with cremation. Those numbers exclude the cemetery plot, the marker and cash advances such as flowers and obituaries, so they are not the cost of dying. A 2026 median funeral cost is not a figure anyone has published.

The estate tax sunset that did not happen

An enormous amount of material written in 2024 and 2025 warns that the estate tax exclusion falls to roughly $7 million in 2026. That reversion was repealed. The 2026 basic exclusion amount is $15,000,000 per person, permanent and indexed. The annual gift exclusion is $19,000.

This matters more than a corrected number, because the sunset narrative pushed people toward irreversible gifting decisions to beat a deadline that no longer exists. If you accelerated gifts on that advice, the premise is gone even though the gifts are not.

Worth knowing if you check this yourself: the tax authority’s own estate and gift tax FAQ page has been stale on exactly this point, still describing a reversion to a pre-2018 level. The revenue procedure and the statute are the sources of record; consumer FAQ pages are not.

On portability — carrying your unused exclusion to a surviving spouse — the election is made on a timely filed estate tax return, due nine months after death with a six-month extension. Where the estate had no filing requirement at all, simplified relief allows the election up to the fifth anniversary of the death, extended from two years in July 2022.

Electing hospice, and what it does and does not cover

Medicare hospice requires certification by two physicians — the hospice physician and your attending — that your prognosis is six months or less if the illness runs its normal course. Benefit periods run two 90-day periods and then unlimited 60-day periods, each recertified.

What it does not cover is the part that surprises families: curative treatment for the terminal illness, drugs intended to cure it, care from any provider not arranged by the hospice team, and room and board. Hospital, outpatient and ambulance care are excluded unless arranged by hospice or unrelated to the terminal condition. Costs are small — up to $5 per prescription for outpatient symptom drugs, and 5 percent coinsurance for inpatient respite.

Electing hospice is reversible. You may stop at any time, which restores Medicare coverage of the benefits you waived, and you may elect hospice again later for any period you qualify for. Families sometimes delay the decision believing it is final; it is not.

A document nobody can find does nothing

The most common failure in end-of-life planning is not the absence of documents. It is documents that exist and cannot be produced at the moment they are needed — typically at two in the morning, in an emergency department, by someone who is not thinking clearly.

Three practical rules follow. Tell the person you named that you named them, and make sure they are willing; a proxy who learns of the role during a crisis is being asked to make decisions with no preparation. Give them a copy, and give one to your physician for the medical record. And do not store the only copy in a safe deposit box: in many states a box is sealed on death and requires a court process to open, which is precisely the delay these documents exist to prevent.

Where the documents are is itself information worth writing down somewhere ordinary — a note in the household files, a line in a shared document. The goal is that someone under stress can find them in two minutes without needing to guess.

The inventory that is not a legal document

Alongside the will and the directives, the thing that most reduces the burden on whoever handles your affairs is a plain list. None of it is legally operative, and all of it saves weeks.

1. Accounts and where they are — banks, brokerages, retirement plans from former employers, pensions, life insurance, and any account at an institution nobody else in the household uses.
2. Recurring obligations — subscriptions, autopayments, storage units, a safe deposit box and where its key is. These continue billing long after a death and are tedious to unwind.
3. Digital access — through a password manager’s emergency-access feature and the legacy-contact settings on the major accounts, not through a list of passwords. Those settings override a will, so they are the effective instrument.
4. Who to notify — employer, professional bodies, insurers, and the people who would not otherwise hear.
5. Where the documents live — the will and who holds the original, the directives, the deed, the titles, recent tax returns.

One thing to keep off the list and out of the will: passwords and account numbers. A will admitted to probate becomes a public court record in most states, so anything written into it can be read by anyone who asks for the file. Put the credentials in a password manager and the instruction to look there in the will.

Digital assets

The law most often cited here is a model act drafted by a private body, with no force until a state enacts it. Nearly every state has, but it is not federal law and the details vary.

Where adopted, it sets a three-tier priority that is worth knowing because the top tier is the one you control directly: the provider’s own online tool — a legacy contact, an inactive account manager — overrides everything, including your will. Below that comes your will, trust or power of attorney. Below that, the provider’s terms of service. So an afternoon spent setting legacy contacts in the accounts that matter does more than a clause in a will.