Most Americans Get This Wrong About Medical Debt After Death—Don’t Be One of Them

Losing a loved one is hard enough, but bereaved people may face a double slam when the medical bills arrive.

Partners of recently deceased loved ones have nearly twice as much medical debt as other individuals, according to a 2024 report from the Consumer Financial Protection Bureau (CFPB). Surviving spouses have an average of $28,749 in unpaid medical debt, compared to $15,785 for the rest of the population.

These people face a morass of challenges during a time of grief, but there are some protections and options when it comes to paying medical debt. Some may not even be obligated to pay it at all.

Your Estate Pays First, But Families Aren’t Always Off the Hook

A deceased person’s estate is “usually” responsible for their medical bills, according to the CFPB. Settling an estate involves using the deceased’s assets to pay their outstanding debts. Anything left goes to the heirs and beneficiaries.

“Under federal law, family members generally aren’t personally liable for a deceased loved one’s medical debt,” explains Laura Cowan, an estate planning attorney and founder of 2-Hour Lifestyle Lawyer. “Medical bills become part of the decedent’s estate and are paid out of estate assets during probate. If there isn’t enough in the estate to cover the debts, they often go unpaid.”

If the debts exceed the assets, state laws determine who gets paid first. Some creditors, including medical providers, may not receive payment at all.

“Medical debt is treated like any other creditor claim,” says Matthew Wiley, principal attorney at Wiley Law, LLC. “It’s paid out of the estate if assets are available, according to a legal priority system: funeral costs, probate expenses, medical debt from a last illness, taxes, and then general debts, in that order. If the estate can’t cover it all, the estate is considered insolvent, and creditors often go unpaid.”

When Spouses and Cosigners Become Responsible for Medical Bills

However, there are situations where a spouse or other family member might be held responsible for a deceased person’s expenses. Here are some ways you can end up on the hook:

Cosigned Debts

Survivors generally aren’t responsible for paying their spouses’ medical debts at the federal level unless they’ve legally agreed to do so. Hospitals and care providers usually require patients to sign an agreement to pay any costs that their insurance doesn’t cover.

But they can ask a family member or spouse to sign paperwork, agreeing to pay for their relatives’ treatment. If you do sign, you can be held liable for any unpaid medical expenses.

Community Property Law

Nine U.S. states consider marital assets to be community property, meaning that spouses equally own all assets and income acquired during the marriage. This means that spouses are also responsible for one another’s debts and medical expenses. However, the surviving spouse may only be responsible for half the total debt.

The community property states are: Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Texas, Washington, and Wisconsin.

Filial Responsibility Law

Filial responsibility obligates adult children to cover some of their parents’ financial needs if they’re unable to do so themselves. Twenty-nine states have filial responsibility laws on their books, but they’re not actively enforced in all of them. These states include:

• Alaska
• Arkansas
• California
• Connecticut
• Delaware
• Georgia
• Idaho
• Indiana
• Iowa
• Kentucky
• Louisiana
• Massachusetts
• Mississippi
• Montana
• Nevada
• New Jersey
• New Hampshire
• North Carolina
• North Dakota
• Ohio
• Oregon
• Pennsylvania
• Rhode Island
• South Dakota
• Tennessee
• Utah
• Vermont
• Virginia
• West Virginia

The Arkansas statute covers only mental health services, however, and Nevada enforces its law only if the adult child has contractually entered into a written agreement to do so.

Necessaries Statutes

A necessaries statute is the flip side to filial responsibility: It applies to parents and spouses rather than offspring. These laws state that you may be financially responsible for the necessary expenses of a child or spouse if they are unable to pay.

How Debt Collectors Target Grieving Families

Unscrupulous debt collectors sometimes target surviving spouses to demand repayment for medical debt. Doing so may violate the Fair Debt Collection Practices Act, and the CFPB has proposed removing medical bills from credit reports to end this practice.

Debt collectors are legally permitted to discuss a decedent’s medical debts with two parties: the executor of the deceased’s estate and their surviving spouse. While it is not illegal to request payment from a spouse, a debt collector cannot say that a spouse is responsible for the debt if they aren’t.

“Many collectors push legal boundaries,” Wiley says, “especially when survivors are emotional.”

Under this type of pressure, it helps to know your rights. Under the Fair Debt Collection Practices Act (FDCPA), debt collectors must stop calling after you tell them you have an attorney. You also have the right to dispute the debt or tell debt collectors when and how to contact you.

“You’re under no obligation to speak to them or agree to anything,” Wiley adds. “In almost all situations, you should hang up the phone and not sign anything without talking to a lawyer.”

Know Your Rights As a Family Member

Those admission forms at the hospital may not just be for medical decisions. They can also include an agreement to pay for the patient’s medical bills if they’re not physically able to sign the form themselves.

“Hospitals and care providers may ask grieving family members to sign admissions forms or ‘responsibility clauses,’” according to Wiley. “Don’t do it unless you want to become personally liable.”

If you’re the patient’s power of attorney, you can indicate that you are acting in that role alongside your signature. “Always sign as ‘Jane Doe, POA for John Doe,’” Wiley recommends, “never just your name.”

Debt collectors must provide details about the debt in question within five days of contacting you. If you don’t hear from them, they may be scamming or attempting to manipulate you. You can also request contact information and then send them a written order to stop calling you. They’re then legally obligated to cease.

“Families have the right to request written verification of the debt,” Cowan advises. “They should consult an attorney or the probate court before paying anything.”

When a debt collector crosses the line, you can report them to the CFPB or your state’s attorney general.

The Bottom Line

If you do receive bills after the death of a loved one, you don’t need to handle it alone. There are many low-cost and free legal clinics if you’re unable to pay an attorney. The first step is to figure out if you’re actually on the hook.

While there are some circumstances where you are obliged to pay for a loved one’s debts, there’s no need to give in to emotional pressure. Always ask for written verification of any debts, and consult a lawyer if you have any doubts.