Do I or the family have the medical say if we live separately and he is confined in a hospital out of state?

Who is I? Is I the spouse? If he is out of state, that state's laws apply, not Illinois. But under Illinois law the spouse would hold that power and right. You presume that the family has told the medical professionals that he is married. Do not presume. If you want the say, you must take affirmative steps to exercise that right.

Naturally, the best way for everyone to deal with this situation was to have a Power of Attorney created before they were in this position. However, when there is no power of attorney, there can be a lot of conflict with what happens. If a guardian needs to be appointed at this point, it would be a court proceeding. You may recall the case of Teri Schaivo in Florida. The spouse and parents fought for years in court over who was able to make the decision as to whether to end life support. Your best bet would be to talk with someone at the hospital to see what their procedures permit and to an attorney in the state where he is in the hospital.

Without specific authority granted by the patient, HPPA rules do not allow medical providers to share confidential medical information. A power of attorney for health care (POA) is required to grant authority to make medical decisions. Without a POA or other specific authority you can merely suggest action and no medical provider need to speak to you, though some do seek input from family.