Medical power of attorney in Montana: how it works, how to sign
The short answer
In Montana, a durable health care power of attorney names someone to make medical decisions when you can't. The law asks only for a writing with wording showing it survives incapacity. If you name nobody, Montana turns to your spouse, adult children, parents, siblings, a trusted decisionmaker, then a close friend.
The question under every medical power of attorney is a simple one. If you can't speak for yourself, who talks to the doctor?
Montana calls the document a "durable health care power of attorney." This page covers how to make one, how Montana's living will works, and who decides if you name nobody. It is part of our guides to estate planning by state. For the basics of the role, see what a medical power of attorney is.
How do I make a health care power of attorney in Montana?
Montana keeps this short. You need a writing that names your agent and says the power continues if you become disabled or incapacitated (MCA 72-5-501).
The statute gives sample wording: "This health care power of attorney is not affected by subsequent disability or incapacity of the principal or lapse of time." You can instead say it "becomes effective upon the disability or incapacity of the principal." Words that show the same intent also work.
That's it. Montana's statute sets no witness requirement and no notary requirement for this document, and it has no official form. Many people still sign before a notary or a witness, so nobody questions the paper later, but the law doesn't demand it.
This document is separate from your financial power of attorney. Montana's financial power of attorney law doesn't apply to health care decisions (MCA 72-31-303). Our Montana power of attorney guide covers the money side.
What can my agent decide?
Your agent makes the health care decisions you would make if you could. In day-to-day terms, that means talking with your doctors, reading your chart, and agreeing to or declining a test, a surgery or a new medicine in light of your wishes.
Your agent is a fiduciary: legally required to act in your interest and follow what you wrote.
Two Montana details are worth knowing:
- You can name a guardian in it. If a court ever needs to appoint a guardian, it follows your most recent nomination unless there is good cause not to (MCA 72-5-501).
- Say it plainly if you want your agent to decide about life support. If your health care power of attorney expressly authorizes decisions about withholding or withdrawing life-sustaining treatment, it also counts as a designation under Montana's living will law (MCA 50-9-103).
Do I need a living will too?
Many people sign both. A health care power of attorney names a person. A living will writes down your wishes, so that person isn't guessing.
Montana's living will is called a "declaration" under the Rights of the Terminally Ill Act. Any adult of sound mind may sign one directing that life-sustaining treatment be withheld or withdrawn. It can also name another adult to make those decisions (MCA 50-9-103).
The signing rules differ from the health care power of attorney:
- You sign it, or someone signs at your direction.
- Two witnesses must sign. A notary is not an alternative in Montana.
- The statute offers two optional forms: one with directions only, one that also names a person.
It applies when your doctor or advanced practice registered nurse finds a terminal condition: incurable or irreversible, and expected to cause death within a relatively short time (MCA 50-9-102).
Our post on health care power of attorney vs living will explains how the two work together, and treatment preferences helps you think through what to write.
Who decides if I haven't named anyone?
Montana now has a ranked list. It was added to the law in 2025, so older articles may say Montana has no such rule.
When your provider documents that you can't make decisions, the decision-maker comes from this list, in order (MCA 50-5-1311):
| Order | Who decides |
|---|---|
| 1 | A court-appointed guardian with medical authority |
| 2 | Your agent under a health care power of attorney, or a person named in your advance directive |
| 3 | Your spouse |
| 4 | An adult child |
| 5 | A parent |
| 6 | A brother or sister |
| 7 | A "trusted decisionmaker" you named in the hospital |
| 8 | A close friend with a deep understanding of your wishes |
| 9 | Another proxy appointed under the law, which can include a physician or advanced practice registered nurse |
So a close friend can serve, but only eighth, after every listed relative. The law also asks family and close friends to try to agree on who will decide (MCA 50-5-1303).
What is a trusted decisionmaker?
This is new in 2025. After you are admitted to a hospital, and while you can still decide, you can name a trusted decisionmaker just by telling a provider. A third person, such as another health professional, a friend or a family member, witnesses it (MCA 50-5-1310).
It is useful, but narrow. It lasts only until you sign an advance directive, name someone else, or go home from the hospital. And it still ranks below your spouse, children, parents and siblings.
A separate list for life support
One more wrinkle. For withholding or withdrawing life support from someone with a terminal condition and no living will, a different law sets a different order: spouse, adult children, parents, adult siblings, then the nearest other adult relative (MCA 50-9-106). There is no close friend on that list. The consent must be written and witnessed by two people.
If the person who really knows your wishes is a friend, a partner or a niece, naming them in a health care power of attorney moves them to the front of both lists. Our page on who decides for you walks through this, and the 50-state guide to default decision-makers compares other states.
Here is a typical case, a composite. Ellen is 73, widowed, and lives in Missoula. Her brother lives in Arizona and her son in Denver. Her neighbor Barb drives her to appointments and knows what she would want. Ellen names Barb as her health care agent and her son as backup, with clear wording about life support.
How do I choose my agent?
The practical questions matter most. Is the person willing? Can they get to the hospital? Will they follow your wishes even when they'd choose differently?
A short checklist:
- They know what you want, because you've told them.
- They can stay calm in a hospital hallway and ask questions.
- They live close enough, or can travel when needed.
- You've named a backup in case they can't.
Our post on how to choose a medical power of attorney has more questions to ask.
Some people would like a professional standing by, first or behind a friend. A Kinly membership includes a medical power of attorney written for your state, and Trella Trust Company can be named in the role, first or as the backup to someone you choose.
Once your health papers are done, our Montana probate guide covers what happens to your home and savings later.
Common questions
Does a medical power of attorney need to be notarized in Montana?
No. Montana's statute requires a writing naming your agent with wording that shows it survives incapacity. It sets no witness or notary requirement, though many people use a notary anyway.
Is there an official Montana medical power of attorney form?
No. Montana has no statutory form for the health care power of attorney. It does provide two optional forms for the living will, called a declaration.
How many witnesses does a Montana living will need?
Two. A Montana declaration must be signed by you, or at your direction, and witnessed by two people. A notary can't replace the witnesses.
Who makes medical decisions in Montana if there's no power of attorney?
A guardian or named agent comes first. Then your spouse, an adult child, a parent, a sibling, a trusted decisionmaker you named in the hospital, and then a close friend.
Can a close friend make medical decisions for me in Montana?
Yes, but only eighth in line, after all listed relatives, unless you name the friend as your health care agent. Naming them puts them first.
Sources
- MCA 72-5-501: Durable health care power of attorney (Montana Legislature)
- MCA 72-31-303: Applicability of the Uniform Power of Attorney Act (Montana Legislature)
- MCA 50-9-102: Definitions, Rights of the Terminally Ill Act (Montana Legislature)
- MCA 50-9-103: Declaration relating to use of life-sustaining treatment (Montana Legislature)
- MCA 50-9-106: Consent by others to withholding or withdrawal of treatment (Montana Legislature)
- MCA 50-5-1303: Notification to interested persons and selection of proxy decisionmaker (Montana Legislature)
- MCA 50-5-1310: Patient designation of trusted decisionmaker (Montana Legislature)
- MCA 50-5-1311: Hierarchy of decisionmaker selection (Montana Legislature)
This page is general information, not legal or financial advice. Laws vary by state.