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Advance Directives and Other Legal Documents

All states have laws that allow individuals to make future healthcare treatment decisions, in the event we are unable to make or communicate our own decisions later. This enables our family and doctors to understand the type of medical care we want or do not want. State laws also allow us to appoint a person to make future healthcare treatment decisions for us if we are unable to make them for ourselves. The documents related to these laws are called “advance directives.” Learn more about these legal documents:

Advance Directive Notice
AZ Blue has partnered with Five Wishes, which is a tool that may be helpful when thinking about documenting your healthcare choices. Find more information on the videos linked below:

Five Wishes Preview video
Five Wishes Waiting Room video

Appointment of Representative (AOR) Instructions

AOR Form – English
AOR Form – Español

Confidential Information Release (CIR) Form - English
Confidential Information Release (CIR) Form - Español
Confidential Information Release for HIV related - English
Confidential Information Release For HIV related - Español 

AZ Blue is committed to complying with these state laws and with the federal law regarding the distribution of advance directive information to our members upon enrollment. We cannot refuse care or discriminate against you based on whether or not you have completed an advance directive. We educate our staff about advance directive rights and procedures and offer community education on these rights. AZ Blue documents whether or not members have advance directives in a prominent part of their current medical records. Learn more in Chapter 8, “Your rights and responsibilities,” in your plan Evidence of Coverage (EOC).

    Blue Cross® Blue Shield® of Arizona (AZ Blue) is contracted with Medicare to offer HMO Medicare Advantage plans. Enrollment in AZ Blue plans depends on contract renewal.

    You are eligible to enroll in a AZ Blue Medicare Supplement plan if you are age 65 or older, entitled to Medicare Part A, and enrolled in Medicare Part B, and you live in the plan service area. You must continue to pay your Medicare Part B premiums (and Part A, if applicable), if not otherwise paid for by Medicaid or another third party. During the first six months when you are age 65 and also enrolled in Medicare Parts A & B you cannot be denied a Medicare Supplement plan when you apply for one, regardless of health status.

    Health Choice Pathway HMO D-SNP is a Health Plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in Health Choice Pathway HMO D-SNP depends on contract renewal. Health Choice Pathway Member Services can be reached at 1-800-656-8991, TTY: 711, 8 a.m. to 8 p.m., 7 days a week.
    Member Services can be reached at 480-937-0409 (in Arizona) or at our toll-free phone number at 1-800-446-8331 (TTY users should call 711). Hours are 8 a.m. to 8 p.m., Monday through Friday from April 1 to September 30; and 7 days a week from October 1 to March 31. Member Services also has free language interpreter services available for non-English speakers.

    OptumRx® is an independent company providing prescription mail order services.

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    Last Updated 01/01/2025