End of Life Planning Checklist for Montana

End of Life Planning Checklist for Montana

National checklists miss the tools Montana specifically provides — the End-of-Life Registry, the $100,000 small estate affidavit threshold, Transfer on Death deeds for real property, and a POLST program that translates your wishes into enforceable medical orders. This checklist covers what Montana residents actually need, in the order they should do it.

Healthcare Documents

Complete your Montana Advance Directive. This single package includes two components: a Living Will (your treatment preferences) and a Durable Power of Attorney for Health Care (naming your decision-maker). Both must be signed by you and witnessed by two qualified adults who are not your healthcare agent.

Notarize the directive. The Living Will is valid with witnesses alone, but the Healthcare POA should be notarized for broad institutional acceptance. Notarize the entire package — it costs $5-$15 and prevents authenticity challenges.

Register with the Montana End-of-Life Registry. Mail your completed directive and the Consumer Registration Agreement to the Department of Justice, Office of Consumer Protection, PO Box 201410, Helena, MT 59620-1410. It is free. You will receive a wallet card that lets medical providers access your directive electronically from any Montana hospital.

Carry the wallet card. Place it in your wallet next to your driver's license and insurance card. EMTs and hospital staff are trained to check for medical identification during intake.

Discuss POLST with your physician. If you have a serious or life-limiting illness, your advance directive should be supplemented with Provider Orders for Life-Sustaining Treatment (POLST). This is a medical order — printed on official terra green paper — that translates your treatment preferences into instructions that EMTs, hospitals, and care facilities must follow. Your physician, APRN, or PA generates the POLST during a clinical conversation. Keep the original at home in a visible location.

Consider a Mental Health Advance Directive. If you have concerns about cognitive decline or dementia, Montana's Mental Health Care Advance Directive (MCA Title 53, Chapter 21, Part 13) lets you pre-consent to treatment decisions and include language that prevents revocation during periods of incapacity. This document must be notarized.

Asset Protection Documents

Execute a Transfer on Death (TOD) Deed for real property. Under MCA 72-6-415, a TOD deed lets you pass your home, ranch, or other real property directly to a named beneficiary outside of probate. The deed must be notarized and recorded with the County Clerk and Recorder in the county where the property is located. Recording fees: $20 for the first page, $10 each additional page.

Set up beneficiary designations for financial accounts. Bank accounts, retirement accounts, and investment accounts can include Payable on Death (POD) or Transfer on Death (TOD) designations that transfer directly to your beneficiary without probate. Contact each financial institution to add or update designations.

Add a beneficiary designation to vehicle titles. Montana allows beneficiary designations on vehicle titles through MVD Form MV13. The named beneficiary can transfer the title with just the death certificate and personal ID — no probate required.

Understand the small estate affidavit. If the total probate estate (assets without beneficiary designations or joint ownership) is $100,000 or less, your heirs can collect assets using a Small Estate Affidavit (Form 17.1) after a 30-day waiting period. No court filing required.

Consider Medicaid implications. Montana's Medicaid Estate Recovery Program can claim reimbursement for long-term care costs from assets that pass through formal probate. Using TOD deeds, beneficiary designations, and joint tenancy keeps assets out of probate and beyond recovery reach. If you anticipate needing Medicaid long-term care, consult an elder law attorney — Montana enforces a strict 60-month look-back period on asset transfers.

Personal and Financial Records

Create a Letter of Last Instructions. This is not a legal document — it is a practical reference for your family. Include: the location of your will, advance directive, and insurance policies; bank and investment account numbers; login credentials for online accounts; your Social Security number; your attorney's and accountant's contact information; funeral and burial preferences; and the names of people to notify.

Organize physical documents. Place your will, insurance policies, property deeds, vehicle titles, and financial records in one accessible location. Tell your healthcare agent and executor exactly where everything is.

Order certified death certificate copies in advance. Your family will need 8-12 certified copies for banks, insurance companies, and government agencies. The DPHHS Vital Statistics Bureau charges $16 per copy; county clerks may charge less (as low as $7 in some Montana counties). Ordering in bulk after death is more efficient.

Communication

Have the conversation. Documents alone are not enough. Talk to your healthcare agent about your values, not just your treatment preferences. Explain why you have made the choices you have. A written directive gives your agent legal authority; a conversation gives them the confidence to use it.

Inform your family. Let immediate family members know that your advance directive exists, where it is stored, and who your healthcare agent is. This prevents the "I had no idea" emergency that creates conflict.

Notify your physician. Give your primary care provider a copy of your advance directive and ask them to confirm it is in your medical record. Do the same with any specialists you see regularly.

Review Schedule

Review your advance directive every three to five years, and immediately after any major life change — marriage, divorce, death of a spouse, new diagnosis, or relocation to Montana from another state. Update the End-of-Life Registry whenever you revoke or replace a directive.

The Montana Advance Directive & Living Will Kit provides the statutory forms, witness checklist, registry submission guide, and companion asset protection instructions to work through this checklist efficiently.

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