If you’re like most Americans, handling the vast array of health care expenses is a major financial challenge. As those costs rise, so does anxiety.
A February 2024 KFF Health Tracking poll found that 74% of respondents were worried about how they would pay for unexpected medical bills and health care services for themselves and their families.
It’s one thing to cover your own and your children’s bills, but in some cases you may be paying for those of your parents.
Here’s when your parents’ care costs may be passed on to you, and how to prepare for those expenses even if you are not legally liable.
States With Filial Responsibility Laws
Filial responsibility laws were enacted to ensure that adult children will financially support their parents who can’t provide for themselves.
If your state has these statutes, technically it’s possible that you would be required to pay for some of your parents’ essential care needs when they are unable to do so.
The states that currently have filial responsibility statutes are:
— Alaska
— Arkansas
— California
— Connecticut
— Delaware
— Georgia
— Indiana
— Kentucky
— Louisiana
— Massachusetts
— Mississippi
— Nevada
— New Hampshire
— New Jersey
— North Carolina
— Ohio
— Oregon
— Pennsylvania
— Rhode Island
— South Dakota
— Tennessee
— Utah
— Vermont
— Virginia
— West Virginia
Each state has its own variation of the filial responsibility law. For example, California Family Code section 4400 reads, “Except as otherwise provided by law, an adult child shall, to the extent of the adult child’s ability, support a parent who is in need and unable to self-maintain by work.”
And in Nevada, per NRS 428.070, filial liability is mandated if there is a written agreement to pay for care, the child has control over and access to the parent’s assets or income and the child has sufficient financial ability to support the parent.
[Read: What to Do When Your Medical Bills Are Out of Control]
When You Might Be Responsible for Your Parents’ Bill
Even if the state has filial laws, they wouldn’t go into effect unless there are certain triggers. As outlined in Loyola Consumer Law Review, Losing Loved Ones and Your Livelihood: Re-Evaluating Filial Responsibility Laws, the parent must first be considered indigent. That means their income is so limited that it’s not adequate to provide for their personal maintenance and care.
There are other considerations in filial responsibility law, too.
If your parents received nursing home care and don’t have enough to pay the bill, you might be required to cover it when they receive care in a state that has a filial responsibility law and they didn’t qualify for Medicaid at the time.
The unpaid caregiver or facility would also have to sue you for the amount owed and you, as the adult child, would have to have the means to satisfy the amount due.
Filial Responsibility Law Enforcement Is Rare
Before you worry about forced payment, Sidney Curry, financial expert and co-founder of BC Holdings of Tennessee, LLC, says filial responsibility statutes sound alarming but are nothing to lose sleep over.
“I’ve never seen the law applied and I’ve been doing this for 23 years,” Curry says. “Only one state that I know of has a record of it being enforced and that’s Pennsylvania.”
In fact, Pennsylvania House of Representatives member Kristine C. Howard recently introduced the Stop Bankrupting Pennsylvanians Over Family Medical Bills Act. The proposed bill aims to prevent obliging “a person’s children, spouse, and parents to protect, care for, and support impoverished family members, thus holding family members financially responsible for medical expenses.”
“Also, most states have other laws that counter filial responsibility laws,” Curry says. “So, they may be on the books, but they aren’t enforced.”
Still, times may be changing.
“Most states with filial laws do not actively enforce them; however, particularly as costs increase, there are greater risks that they could be,” says Julia Cohen Sebastien, co-founder and CEO of Grayce, a technology-enabled caregiving platform for families.
“Further, some providers are more aggressive about seeking repayment from family, regardless of the law,” she adds.
[Related:Tips for Managing Medical Expenses]
Your Parents’ Medical Debt and Dealing with Collectors
Filial responsibility laws aside, you may start to receive calls from a debt collector regarding your parents’ medical debt if a bill goes unpaid.
In the event a doctor, hospital or other medical provider did not receive payment, they may charge the debt off and send it to a third-party collection agency. That company would then own the account. If your parents are unable to pay or have died, the collector may decide to turn to you.
Unless you co-signed or agreed to be a guarantor on your parent’s bills, however, you are not liable for the debt. The collector can’t sue you or add the account to your credit reports, no matter what they may claim.
Debt collectors can make a convincing case, Curry says, but if you’re not legally responsible for the bill, you don’t have to pay.
Moreover, the Fair Debt Collection Practices Act (FDCPA) gives you the right to not talk to third-party debt collectors. Once you tell the collector the debt is not yours and to stop contacting you, they are bound by the FDCPA to stop.
To offset any potential problems, though, avoid commingling finances with your parents.
“Don’t co-sign on debts, including loans, mortgages and credit cards,” Sebastien says. “Read all nursing home contracts, as many attempt to include sign off on family responsibility for unpaid bills. For any deceased loved ones, it is wise to follow all probate laws.”
She adds that for Medicaid, it’s best to ensure a parent’s eligibility status is not in dispute, and to check that they are clear on any look-back timeframes so that their asset status is not in violation of Medicaid thresholds in your state.
[Related:How to Minimize 4 Financial Management Disasters That Come With Aging]
Plan Ahead for Your Parents’ Medical Needs
“How do we sacrifice for our parents when they sacrificed for us?” Curry says.
“First we have a conversation with them! Be proactive. These can be hard and uncomfortable conversations but they are important. You need to talk about estate planning, wills and trusts, and power of attorney with medical directives,” he says.
If you foresee a time when your parents may need elder assistance, including at-home medical care and assisted living, consider long-term care insurance for them.
These insurance policies cover a wide variety of needs. Having a plan in place can give you peace of mind that your parents will receive professional health care without having to run through their savings and assets, or end up as a large financial obligation that neither of you can afford.
Whether or not you’re on the legal hook for your parents’ care, now or in the future, you may want to help them by saving extra cash.
“Make caring for your aging parents part of your emergency fund,” Curry says.
“That’s what it’s for, to help your family. You shouldn’t borrow for medical costs because that will set you back, so plan for them instead. We let our parents know that if there is a need, we will help. My mom was taking care of her dad until recently. It’s the moral thing to do,” he adds.
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This Is Why You Might Be Responsible For Paying Your Parents’ Medical Debts originally appeared on usnews.com
