What a POLST does
In Oregon, POLST is set in law by the Oregon POLST Registry Act (ORS 127.663 to 127.684). The statute defines a POLST as a physician order for life-sustaining treatment signed by a physician, naturopathic physician, nurse practitioner or physician assistant. Because it's a medical order, emergency medical services and hospitals act on it right away, unlike a wish written in a letter.
The Oregon POLST Program says a POLST is for people with serious progressive illness, such as advanced heart or lung disease or cancer that has spread, and for frail older adults who may not want every available treatment. It's not meant for healthy adults.
POLST or advance directive?
| POLST | Advance directive | |
|---|---|---|
| Who signs | Your clinician, after talking with you | You, with two witnesses or a notary |
| Who it's for | Serious illness or frailty | Any adult |
| What it does | Medical orders followed now | Names a health care representative and states your wishes |
| Where it's kept | Oregon POLST Registry | With you, your representative and your doctor |
Many people have both. See How do I make an advance directive in Oregon?
The Oregon POLST Registry
The registry is an Oregon Health Authority program that OHSU's Department of Emergency Medicine has operated since 2009. Under ORS 127.666, a copy of every POLST, every revised POLST and any known revocation goes to the registry unless the patient opts out. Emergency crews can then check it when the paper form isn't at hand. The registry's number is 1-877-367-7657. Keep your original form where responders and family can find it.
How Medicare pays for the conversation
Medicare Part B covers voluntary advance care planning, which includes talking through a POLST:
- As part of your yearly Wellness visit or Welcome to Medicare visit: you pay nothing if your provider accepts assignment.
- At other visits: the Part B deductible ($283 in 2026) and 20% coinsurance apply.
Medicare Advantage plans cover the same service, with their own cost sharing. For coverage questions you can request a call from a licensed insurance agent. More in our POLST and Medicare guide.
Related questions
How do I make an advance directive in Oregon?
Oregon's form and witnesses.
Does Medicare cover hospice in Oregon?
Comfort care under Part A.
Can I use Death with Dignity while on hospice?
How the two fit together.
Sources
- Oregon POLST Program — About POLST
- OHSU — Oregon POLST Registry
- ORS 127.663 — Definitions (POLST Registry Act)
- ORS 127.666 — Oregon POLST Registry
- Medicare.gov — Advance care planning
More questions in this guide
- Can I use Death with Dignity while on hospice in Oregon?
- Does Medicare cover hospice care in Oregon?
- Does Medicare pay for Death with Dignity in Oregon?
- How do I make an advance directive in Oregon?
Part of the guide: End-of-Life Medicare in Oregon · All questions
Frequently asked questions
Is a POLST required?
No. The Oregon POLST Program says a POLST can never be required by a health care professional, care facility or health system.
Is a POLST the same as an advance directive?
No. An advance directive is your own legal document, best made while you're healthy, naming a health care representative and stating your wishes. A POLST is a medical order your clinician signs when you're seriously ill or frail.
Can I change or cancel my POLST?
Yes. Ask your clinician to complete a new form; revised forms and known revocations are sent to the registry.
What does Medicare charge for the POLST conversation?
Nothing if it's part of your yearly Wellness visit or Welcome to Medicare visit and your provider accepts assignment. At other visits, the Part B deductible and coinsurance apply.
Medicare in your Oregon county
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