Filial Responsibility [Why You Could Be Held Responsible for Your Parent’s Medical Bills]

Written by: Steven Gibbs | Last Updated on: October 31, 2024
Fact Checked by Jason Herring and Barry Brooksby (licensed insurance experts)

Insurance and Estates, a strategic life insurance provider composed of life insurance professionals, is committed to integrity in our editorial standards and transparency in how we receive compensation from our insurance partners.

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If your parents are still living, this article should serve as a wake up call when it comes to your parent’s financial plans and your personal financial responsibility for your parents, i.e. your financial filial responsibility.

The average cost of care in a nursing home currently ranges between $5,000 and $9,000 a month ($60,000 – $100,000 a year). This is for chronic or “skilled nursing care” due to a chronic condition such as Alzheimer’s Disease.

Even if long term chronic care is not an issue, emergency procedures and hospital stays can easily generate medical bills in the tens and even hundred of thousands of dollars.

The question given these large numbers, and the ongoing problem of rising healthcare costs is, if a court awards a judgment for unpaid medical bills, can you as the adult child be held responsible?

If you’re like many adult children, your first response may be something like ”that’s absurd!”

Filial Responsibility Laws

However, if you live an any one of a number of states that have filial support laws, your responsibility, and consequent neglect, could lead to civil or criminal penalties, which means you could be held legally responsible and required to pay your parents medical bills, nursing home costs, fined and face potential jail time.

Is this currently happening? A little.

Do we expect it to happen more into the future? You bet.

With rising long-term care costs and boomers now retiring in droves, states will look to elderly parent’s family members to help cover costs and unpaid bills the states do not want to pay.

And it has already occurred a few years back in Pennsylvania to the tune of over $90,000 judgment against the appellant to pay for his mom’s skilled nursing home care bill.

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Filial Responsibility States

Currently, 30 filial responsibility states (Alaska, Arkansas, California, Connecticut, Delaware, Georgia, Idaho, Indiana, Iowa, Kentucky, Louisiana, Maryland, Massachusetts, Mississippi, Montana, Nevada, New Hampshire, New Jersey, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, Utah, Vermont, Virginia, and West Virginia) have passed statutes that cover “filial” responsibility laws.

Under filial responsibility laws adult children may be required, and held liable, to pay for a parent’s medical bills if certain circumstances exist which are broadly summarized as follows:

  1. Parent is receiving financial support from state government
  2. Parent has accumulated a nursing home or medical bill in the state in which the filial responsibility law exists and cannot pay
  3. Parent is classified as “indigent” meaning that their expenses exceed social security benefits
  4. Parent does NOT qualify for Medicaid
  5. Caregiver has reason to believe that adult child can pay the bill and chooses to sue him/her

Depending upon your state’s filial responsibility laws, if a court in one of these filial responsibility states orders that a judgment may be enforced against the adult child, any number of unfortunate legal remedies, such as liens, wage garnishments, and even potential jail time can be imposed.

Exceptions to Filial Support Laws

The good and bad news is that judges have “discretion” when enforcing these filial responsibility laws, and it comes down to a factual inquiry in a court of law.

In filial support hearings, the adult child would need to demonstrate that he/she does NOT have adequate funds due to other responsibilities such as student loans, cost of living, medical bills, etc.

It may also be effective if the adult child can show abandonment or other reasons for lack of ongoing relationship with their elderly parents. But proving abandonment is a tall task and requires that the adult child prove various elements, including that the parent abandonment occurred while the adult child was a minor.

And in a filial support hearing before the court, you might be able to offset some of your financial obligation by showing mitigating circumstances that would make it immoral for you to have to pay full support, such as demonstrating prior bad acts by your parents.

The bottom line is you may be responsible for your parents long-term care expenses, such as unpaid medical bills and nursing home costs. And without a plan in place, you are setting yourself up for a potentially catastrophic financial tsunami in the future.

Key Takeaway: Plan Today

An important “takeaway” regarding filial support obligations is that adult children, particularly in these filial responsibility states, should be as concerned with a parent’s long-term care (LTC) planning as the parents themselves.

LTC planning is part of having a coherent estate plan, and should involve input from a number of professionals such as an estate and elder law attorney, a tax advisor and an insurance expert focusing on long-term care insurance (LTCI) options.

There are various options for long term medical care planning such as:

  1. Standalone long-term care insurance
  2. Life Insurance Riders
  3. Long-Term Care Annuity
  4. Pre-Medicaid Planning
  5. Asset Protection Planning

All of the above should be considered as essential aspects of your family wealth protection plan because long term medical care costs are a very calculable risk. If certain steps are taken in advance, needless stress and financial fallout can be limited and potentially avoided.

Standalone Long-Term Care Insurance (LTCI)

Traditionally, the best long term care insurance has been standalone policies, since they provide the greatest flexibility at the lowest price.

Long-term care insurance claims require that you be diagnosed as a “chronically ill individual”, which basically means you are unable to perform 2 of 6 activities of daily living or have a severe cognitive impairment, such as Alzheimer’s Disease.

LTCI provides a reimbursement for qualified expenses, such as in-home care, nursing facilities, adult day care, home modifications and assisted living facilities.

Many of these services can run in excess of hundreds of thousands of dollars, making long-term care insurance costs look attractive in comparison.

For more on this topic, please see “What is long-term care insurance” and “Long-term care insurance pros and cons“.

Life Insurance Riders

Another option to consider is life insurance long term care rider. These policies are combination long-term care life insurance contracts that provide you with many benefits, such as a guaranteed lump sum death benefit, guaranteed long-term care benefit, cash value growth and potential return of premium.

These hybrid life insurance long-term care policies are a good alternative for those who don’t like the “use it or lose it” feature of traditional LTCI.

Long-Term Care Annuity

Asset based long-term care insurance comes in different forms. One way people pay for long-term care insurance is with an annuity.

A Long-Term Care Annuity is a single premium annuity that allows you to withdraw from your annuity’s accumulated value to pay your LTC expenses.

And if you don’t use your accumulated value, it can go to your spouse upon your death.

Another benefit of single premium long-term care annuities is you do not have to worry about your premium on your LTC policy increasing.

Pre-Medicaid Planning

Having a plan in place regarding medicaid will put you ahead of the majority of Americans who put little to no thought into this subject.

Thanks to the Deficit Reduction Act of 2005, qualifying for Medicaid long-term care coverage is tough. One Pre Medicaid Planning step is familiarizing yourself on your specific State’s Long-Term Care Partnership Program is a great step to take to understand how LTCI can actually protect your assets if you are forced into a Medicaid “spend down”.

Asset Protection Planning

Proper asset protection planning requires not only a plan but the ability to execute. Staying aware of tax laws, such as the current federal estate tax exemption limit, are vital to any proper estate and asset protection plan.

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22 comments

  • genae george
    genae george

    I have taken notice that all the questions asked of the attorney’s on this site were diverted. I am wondering why this site exists if no questions can ever be answered. Appears to be a waste of time. My suggestion to those who have received no answers to their questions would be to do your own research on the filial laws in your state and keep googling. Attorneys have no more access to the state laws than you do. After doing research call an attorney and ask them as many questions as you can get out of them for free. If they have free consultations that is a plus, just do your research , write down some good questions prior to meeting and definitely take notes.
    Wishing you courage and resolve on journey
    .

    • Insurance&Estates
      A
      Insurance&Estates

      Am not sure what you mean by diverted? Yes, this site actually exists and we post content for educational purposes only. When folks need actual legal advice from an attorney who is licensed in their area, then we are obligated to recommend that they seek that advice accordingly. Blog posts are not the proper place for legal advice in ANY event. People need to get a consultation from a legal expert.

      I hope this makes sense.

      Best, Steve Gibbs, Esq. Licensed in FL and CA:)

  • John

    If the parent lives in a state with filial responsibility laws but the adult child lives in a state which does not, which jurisdiction takes precedent?

    • Insurance&Estates
      A
      Insurance&Estates

      Fair question, this would be something to ask an elder law attorney in your parent’s state of residency.

      Best, Steve Gibbs for I&E

  • Eva Vanvleet
    Eva Vanvleet

    WA DEEMED MY MOTHER UNABLE TO SELF CARE AND PUT HER IN LONG TERM CARE. I LIVE IN ORE BUT SHE IS AZ RES, VISITING.THEY Want me to pick her up and sign total responsibility. She’s went through a couple million gambling over last15 years. She’s broke and I’m disabled and husband works. I’m being shamed and bullied by medical staff. What are my rights. My mother has been abusive and 10 years of therapy notes.

    • Insurance&Estates
      A
      Insurance&Estates

      Hello Eva,

      It seems like you need an elder abuse attorney in your area and this isn’t our expertise. Best, I&E

  • Phillip Homesly
    Phillip Homesly

    Hello,My disabled friends father passed away,was well to do yet did not account for him well in his will.My friend is totally disabled and on SSI (not based on work history). Father had 2 million dollars yet only left 100k in will ,and rest to cousins..
    Is a contest clause in will but deceased father had mental issues..
    Can my friend contest the will based on “Filial Responsibility” in state of Pennsylvania?
    My friend is his named son on birth certificate..Thanks..

    • Insurance&Estates
      A
      Insurance&Estates

      Hello Phillip, this is something you would need to contact a PA estate litigation attorney about.

      Best, Steve Gibbs for I&E

  • Alex F

    My parents live in VA, and I live in CO. CO is not a filial state, but VA is. Am I still responsible for them? My dad physically abused us as kids and I have no intention of taking care of his sadistic ass

    • Insurance&Estates
      A
      Insurance&Estates

      Hello Alex, I suggest you check with an elder law attorney in VA to get a better idea of your potential liability.

      Best, Steve Gibbs, for I&E

  • IMC

    My dad had dementia. He went into the hospital and theyrefused to release him because they said it was unsafe. He was in rehab for 6 months. His insurance ran out Sept 17th and he was approved for medicaid in October but because of their rules he could not be released until Dec 1st. Since then the have sent me inconsistent bills with the amount owed continuously changing. Recently I checked my credit and noticed a debt collection for the rehab facility. I disputed it and they said its valid. I called the rehab and they said because I am his POA and signed the admission form I am responsible for the debt. How am I being held responsible for his debt. He was the resident, how can the put it on me.

    • Insurance&Estates
      A
      Insurance&Estates

      Hello and thanks for commenting. We recommend that you seek immediate assistance from an expert (i.e. elder law/Medicaid attorney) in your area. These are state specific issues and you’ll need strategic legal guidance.

      Best, Steve Gibbs for I&E

  • Duke

    Hello, my dad is in a nursing home in Virginia and nearing the end of his life. The nursing home did not apply for Medicaid until after my dad had been in the facility for almost a year and then they finally applied. He is currently receiving Medicaid and has been for almost two years. Due to the fact he’s nearing the end of his life, I want hospice to look after him and the nursing facility he’s in doesn’t allow hospice.
    In the meantime, a large bill had built up of over $40k due to them not applying in a timely manner. Now that bill has reduced down to $35k because Medicaid is paying a little of it every month. If I transfer him to a hospice facility or he should pass away before this $35 is paid will I be responsible. It is truly their fault his app wasn’t submitted and once it was he did qualify, but I don’t think it’s fair they’d try to make me pay it. Also, the business office manager has told me verbally I wouldn’t be responsible but she refuses to give me anything in writing.
    Thanks for any help,

    • Insurance&Estates
      A
      Insurance&Estates

      Hello and thanks for commenting. Although we write some educational articles on these topics, we cannot offer legal advice. It looks like, from your facts that you may need to consult with an experienced Medicaid planning (elder law) attorney in your home state and local area.

      Best,

      Steve Gibbs for I&E

  • Bea Marino
    Bea Marino

    If an adult child is on disability and parent has left the person an inheritance so they can support themselves after the parent dies, if the parent has to go into a nursing home, will the adult child have to turn over their inheritance to pay for the nursing home bills? At this point, they are living in a fidial responsibility state (KY). Can anything be done to protect the inheritance funds for the disabled adult child? Thank you.

    • Insurance&Estates
      A
      Insurance&Estates

      Hello Bea, thank you for commenting. I highly recommend that you connect with an experienced special needs/Medicaid planning attorney in KY as this is outside the scope of our focus and expertise.

      Best,

      Steve Gibbs for I&E

  • laura m
    laura m

    What about final coroner expenses? The coroner is demanding payment from the decedent’s daughter. She cannot pay the final expenses. She has had no contact with the decedent for 26 years and he never paid court ordered child support when she was a minor.

    • Insurance&Estates
      A
      Insurance&Estates

      Hello Laura, thank your for reading and your comment. Great question, liability of family members for any cost is not automatic and would likely vary depending upon your state laws, so that’s a good place to start.

      Best, I&E

  • Clint

    Hi,

    My Mom visited us for a holiday in Massachusetts from India and had taken visitors travel insurance for her stay here. During her stay she had a fall and we had taken her to emergency and after they checked her they wanted her to undergo hip replacement surgery. Once the surgery was over they moved her to Rehab for 40 days. The insurance policy was for 50000usd, however would like to know how much am I liable to pay if the cost of surgery and rehab exceeds 50000usd.

    Thanks

    Clint

  • April Nunez
    April Nunez

    What about a daughter in laws perspective? For example, we have been paying my in-laws phone bill for 3 years, & not by my choice either, it was supposed to be a stepping stone till they got on their feet. Instead, they turned it into a yacht & expect it, are financially destroyed due to personal life choices, & drug seeking behavior. Husband is torn because they’re his parents & this happened his whole life with them. He tells me, ” so if I cut off their phone, how am I going to talk to Mom?” I responded, ” they can use your brother & his wife’s phone in the room down the hall I suppose. It’s not like they’d be cut off, they could still call.” I have a big heart I do, but I’ve been used in my last marriage & I see it coming from a mile away thanks to ex in laws. I don’t know what to do anymore, & how can we be exempt from this law?

    • Insurance&Estates
      A
      Insurance&Estates

      Hello April, we appreciate you sharing your story and we empathize with your frustration. I think the attempt by government to hold adult children responsible for a parent’s obligations is a problematic legal approach, and whether it is enforced or applicable depends on your state laws. Best advice is to stay proactive in assisting parents with solutions for covering for their own care and doing their own proper planning. There are many ways to do this as touched on in our various articles and we can connect you with a long term care and/or elder law professional in your area when you’re ready. Best to you. Sincerely, IandE team.

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