Every adult, starting at age 18, should have four documents: a health care proxy, a Health Insurance Portability and Accountability Act (HIPAA) authorization, a durable power of attorney, and a will. Without them, family members may be unable to get medical information or act for you without going to court for guardianship or conservatorship.
Estate planning is often pictured as something for the wealthy or the elderly. But there is a core set of documents that every adult should have, starting at age eighteen, regardless of how much they own. They are not about passing on wealth; they are about who speaks for you and acts for you if you cannot. This article covers those foundational documents, with special attention to HIPAA, the one most people have never heard of until it is too late.
Why Can't Family Members Get an Adult's Medical Information?
HIPAA is the federal medical-privacy law. It does important work, but it has a consequence families rarely anticipate: once your child turns eighteen, or for any adult, doctors and hospitals are generally prohibited from sharing medical information with family members without the patient's authorization. A parent can be standing in the hospital, unable to get a straight answer about their own adult child's condition, because no HIPAA authorization is on file.
A HIPAA authorization fixes this. It is a simple document naming the people who are allowed to receive your medical information. For parents of college-age children, it is essential, and it is exactly why an off-to-college document package matters.
What Are the Four Documents Every Adult Should Have?
1. Health Care Proxy. This names the person who can make medical decisions for you if you become unable to make them yourself. Without it, your family may have to go to court to be appointed before they can direct your care, a slow, expensive process at the worst possible time. See our guide on healthcare proxies and advance directives.
2. HIPAA Authorization. As above, this lets your named people actually receive the medical information they need to help you. It pairs naturally with the health care proxy.
3. Durable Power of Attorney. This names someone to manage your finances, paying bills, handling accounts, dealing with insurance, if you are incapacitated. Without it, even a spouse may lack authority over accounts in your sole name. See our guide on the durable power of attorney.
4. A Will. Even a young adult with modest assets benefits from a basic will, and for anyone with children, it is the only way to name a guardian.
What happens without them: If you are incapacitated with none of these in place, your loved ones cannot simply step in. They must petition a court for guardianship (over your person) and conservatorship (over your finances), a public, costly, time-consuming process, to gain the authority these documents would have granted instantly and privately. The documents are, in effect, how you keep these decisions out of court and in the hands of people you trust.
Who Needs These Documents, and When?
The honest answer is everyone, the day they turn eighteen. Three groups should treat it as urgent:
- Young adults and college students, the HIPAA and health care proxy gap is real the moment they turn eighteen and leave home.
- Every adult of any age, incapacity from accident or illness does not wait for old age.
- Seniors, where these documents are the front line of elder-law and long-term-care planning.
The Good News
These four documents are foundational, affordable, and quick to put in place, and they spare your family the single most stressful scenario in estate planning: needing to act for you, and being legally unable to. If you have been meaning to "get your affairs in order," this is where everyone should start.