Medical Debts in New York After Death

Medical Debts in New York After Death

When a family member dies after a long illness, especially one that required very expensive medical treatments, the unpaid medical bills that remain can be enormous. Who is legally responsible for the medical debts that a decedent leaves behind?

Many people in New York think that they are legally required to pay the medical debts of their deceased family member. This blog post explains the law in the state of New York governing who is obligated to pay the decedent’s medical creditors and what the creditors must prove to collect on the decedent’s debt from survivors.

Primary Financial Responsibility Is in the Decedent’s Estate

Unless someone else signed documents accepting financial responsibility to pay for the medical bills generated by the decedent’s treatments during their illness (as we’ll discuss below), the decedent’s own estate assets are the sole source from which to pay those debts.

The decedent’s estate is made up of all the assets (personal property and real estate) that the decedent owned at the time of their death.  The assets get inventoried and accounted for through the probate process. It’s common for a person’s wills to contain language stating that their just debts and funeral expenses should be paid before any inheritance is distributed. Likewise, in the case of a decedent who died intestate (without a will), the court orders the payment of legitimate debts that the decedent had at death before the heirs at law receive any shares of the estate.

If the estate has insufficient assets to pay the outstanding medical debts, then nothing in the estate would remain to be distributed to those named in the will, or, if the decedent died intestate, to the heirs at law.

Medical Debts in New York After Death
Unless someone else signed documents accepting financial responsibility to pay for the medical bills generated by the decedent’s treatments during their illness the decedent’s own estate assets are the sole source from which to pay those debts.

Assets Transferred Outside of Decedent’s Probate Estate Are Not Reachable by Creditors

Other property or assets that the decedent held as a joint tenant or that they assigned or transferred  into a trust are not typically included in their probate estate. The assets held by a trust are not deemed to be owned by the decedent but are managed, controlled, and technically owned by the trustee to be administered for the benefit or the designated person or cause identified in the trust agreement or instrument

Joint bank accounts and other jointly held property pass to the surviving joint account holder by law the instant the first account holder dies. Likewise, the decedent’s life insurance benefit payments to named beneficiary(ies) do not become estate assets unless no named beneficiary is then living.

Medicaid Reimbursement After the Death of the Recipient

Medicaid reimbursement rules and regulations in New York can be complex and any obligations to repay Medicaid for the benefits received by the decedent before their death will depend on the facts of each case. While creating some types of trusts may well preserve the Medicaid recipient’s eligibility for benefits, and enable them to enjoy certain benefits from the trust’s assets and income, reimbursing Medicaid in New York State is generally only required from assets that remain in a self-funded (first-person) trust or a pooled special-needs or supplemental needs trust (SNT).

The trusts and estates lawyers at Ely J. Rosenzveig & Associates devote a large portion of their practice to creating legal instruments that position their clients’ property and financial assets in a way that best protects their accumulated wealth from creditors.

Do Adult Children Need to Pay for Their Parents’ Medical Bills?

No, unless you signed documents agreeing to guarantee payment or to otherwise accept financial responsibility for your parents’ medical debts/bills. This includes bills or debts incurred for nursing home or assisted living facility services.

If you were involved in getting your parent admitted into an eldercare facility, the facility’s administrator might well have requested or even required you, or someone in the family other than your parent to guarantee payment in advance of and as a condition to admission.

No person should sign any documents or enter into any agreements with nursing homes, assisted living facilities, or other similar elder care entities or institutions unless you have an experienced elder law attorney review the documents and discuss them with you in detail. Not only do they often bind the person signing to large payments, they also can contain important waivers of valuable rights and agreements to be bound by arbitration instead of having recourse to the courts, if an issue arises that cannot be resolved directly between the parties

Does a Husband or Wife Need to Pay for Their Spouse’s Remaining Medical Bills?

New York State law recognizes and applies the “doctrine of necessaries” (or necessities) which holds that marriage is a special relationship legally obliging each spouse in a marriage to provide the other with the necessities of life, i.e., food, shelter, and medical care.

This mutual expectation to support one another means that the law in New York does allow the decedent’s creditors who provided necessary services to them before their death to seek reimbursement from the surviving spouse, but only when the creditor can prove that the following  factors are present:

  1. The necessities were actually delivered and there was a cost associated with them:
  2. The necessities (goods and/or services) provided were necessary for the wellbeing and/or health of the recipient spouse;
  3. The debtor and non-debtor spouse were married at the time the necessities were provided;
  4. The debt is specifically and explicitly itemized, and remains outstanding; and
  5. The non-debtor spouse has the ability to pay.

Parents Are Liable to Pay Medical Debts of Minor Children

Perhaps it seems unnecessary to say, but the doctrine of necessaries also applies in the case of parents whose minor children receive necessary medical or nursing care before their death.

The Law Office of Ely J. Rosenzveig & Associates can help you and your family wade through the maze of complicated rules and regulations concerning liability for a decedent’s debts, and make the best and most cost-effective decision possible for all concerned.  

We are experienced elder law, special needs, and trusts & estates attorneys who are at the frontlines and on the cutting edge in the fields of Medicaid, asset protection planning, estate and trust planning & administration, probate litigation, and debt obligations after death. We are committed to tailoring our counsel, as best we can, to your wants and needs, are we always available to consult with you and your family.


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Contact Ely J. Rosenzveig & Associates
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Ariel S. Rosenzveig
Ariel Rosenzveig

Ariel S. Rosenzveig received his Juris Doctor from the Benjamin N. Cardozo School of Law in May, 2011, and has been practicing law with the firm since August, 2011. During his summers while in law school, Ariel interned with the United States Commodity Futures Trading Commission in New York and with the Securities & Futures Commission in Hong Kong, China.

While in law school, Ariel served on the staff of the Cardozo Public Law, Policy & Ethics Journal, volunteered with the Cardozo Advocates for Battered Women, and participated in the National Institute for Trial Advocacy’s Intensive Trial Advocacy Program. Prior to attending law school, Ariel worked as an arbitrage trader for a small proprietary trading firm on Wall Street. Ariel graduated summa cum laude from Yeshiva University in 2006.

Ariel is licensed to practice law in the states of New York and New Jersey, and is a member of the New York State Bar Association (NYSBA), NYSBA’s Elder Law section, and the National Academy of Elder Law Attorneys (NAELA). In June, 2015, Ariel successfully completed a certificate program in mediation through the Program on Negotiation at Harvard Law School.