Most people assume naming a healthcare proxy settles the whole question of who's "in the loop" medically. It doesn't. A healthcare proxy only gains authority to make decisions once you're unable to make them yourself. It says nothing about who can simply access your information -- talk to your doctors, see test results, help coordinate care -- which is a completely separate legal question, governed by federal privacy law, not your proxy designation.
These are genuinely two different documents in most cases: your healthcare proxy, and a HIPAA authorization. And the list of people on each doesn't have to match.
"Deciding who makes decisions and deciding who gets to know what's happening are two separate lists. They can overlap completely, partially, or not at all."
Why the Two Lists Can Look Different
A proxy needs decision-making judgment
The person who makes decisions on your behalf should be someone you trust to weigh hard tradeoffs, possibly under pressure.
Access doesn't require that same judgment
Someone you'd want kept informed -- a sibling, a close friend -- doesn't need to be the decision-maker to still deserve real-time updates.
Access can matter even before incapacity
A HIPAA authorization can be used any time, even while you're fully capable, to let someone help coordinate appointments or ask about results on your behalf.
More people can be named than just one or two
Unlike a proxy (usually one primary, one backup), a HIPAA authorization can list several people at once, each with the same level of access.
None of this replaces the importance of choosing your proxy carefully. It just means that decision doesn't have to carry the full weight of "who gets to know what's going on" too.
It's common for a family to have one adult child named as healthcare proxy, while another sibling -- someone equally close, just not the one making decisions -- ends up shut out of basic updates simply because no one thought to add them to a separate access authorization. The exclusion usually isn't intentional. It's just a gap nobody thought to address directly.
A Reflection Before You Assume This Is Covered
Check off what's true for you right now. There's no scoring here — just a clearer read on where your thinking actually stands.
What Comes Next
Whether you've already thought through who should have access versus who should decide, or you're realizing those were never actually separate questions in your mind, instinct alone isn't quite enough to be sure everyone you'd want informed actually will be.
That's exactly what the Healthcare Proxy Workbook inside the Estate Prep Partners system helps with: thinking through access and decision-making as the two distinct questions they actually are.
Decide who's informed, not just who decides
The Healthcare Proxy Workbook helps you think through who should have access to your medical information -- separate from who makes the decisions.
Get started — $299 →