What are Filial Responsibility Laws?

Did you know that some states in the USA make it your legal responsibility to support your parents financially? This is called filial responsibility and over half the states have some form of these laws.

What are filial responsibility laws and how might they impact you?

What Are Filial Responsibility Laws?

“Filial responsibility” refers to the legal duty of an adult child to support their parents. Over half of US states have some form of filial responsibility laws on the books. If you parents can’t support themselves, then adult children may have a legal responsibility to do it.

The support that is required is for basic needs like housing, food, and medical care. The level of support can differ depending on the parents’ age and the adult child’s level of financial strength.

Filial Responsibility and Healthcare

Healthcare costs have been skyrocketing and grown between 3-6% per year to nearly $13,000 per person, well ahead of inflation.

This has made the medical care requirement of filial responsibility laws controversial.

Helping an elderly parent pay for their co-pay is very different than paying the 6-figure expenses that come with a nursing home stay. Many filial responsibility laws do not differentiate between medical care types which may leave adult children on the hook for major expenses.

If you live in a state with a filial responsibility law, healthcare providers may have the right to sue you if your parents accumulate large healthcare bills they can’t afford.

And with many healthcare companies struggling with profitability, these lawsuits could be a way they start to recoup expenses.

What States have Filial Responsibility laws?

There are currently 27 states that have some form of filial responsibility laws on their books.

The laws vary greatly between states. Some states have simple and broad laws that state a child who is able must support impoverished parents. Other laws may specify what coverage is required and stipulate it is only when the service is not provided by insurance.

There are states that require long-term care expenses to be covered by the adult children for a period of time. And still more states have age thresholds where the adult child is no longer responsible.

In short, you should look up the laws in your specific state of residence to see what your requirements are.

However, there are some common rules that are generally shared among all 27 states. You are likely legally responsible for a parent’s medical bill if:

• Your parent doesn’t qualify for Medicaid
• They are impoverished
• They can’t pay for their medical bills
• You have the financial means to pay for the bill and/or your parents transferred assets to you to avoid payment

If a healthcare provider decides to sue you in a filial responsibility state, you are likely going to be ordered to cover the bills.

Four Ways Filial Laws Impact You

There are 4 main ways that filial laws can impact you if you live in one of these states and have impoverished parents.

1) You can be sued to cover your parents’ bills

If your parents’ run up a large medical bill, there is an increased likelihood that a healthcare provider will take you to court. This is particularly true with long-term care bills or stays in custodial care facilities, which are very expensive. If your parent doesn’t have Medicaid or a long-term care insurance policy, these visits are largely out of pocket.

One very well known cases dealing with lawsuits around elder care isHCR vs Pittas 2012 where an elderly woman ran up nearly $100k in nursing home bills then fled the country. Her son was sued by HCR and found by the courts to be able to pay the bill. He was forced to cover the medical expenses.

2) Your finances could be examined for any transactions with your parents

Transferring assets from parents to children need to be done by experienced attorneys. “Fraudulent conveyance” is a legal term for any property transaction done to hide assets from creditors. Additionally, there are Medicaid asset transfer rules which, once broken, make your parents ineligible for Medicaid.

Any asset transfer can be examined by both healthcare providers and Medicaid. If they are found to be done to hide assets by a court, the assets aren’t safe.

A year after the Pittas case, the Four Seasons Healthcare Center sued Elden Linderkamp for his parent’s unpaid medical debt, over $100k worth. The court found Linderkamp responsible for the debt due to his parents selling a property to him for below market price. The healthcare center claimed it was a transaction intended to obscure assets from creditors.

These 2 cases firmly established the right of healthcare providers to seek retribution from adult children.

3) You can face criminal or civil penalties

If you get sued to settle your parents’ medical bills, you open yourself up to civil and criminal penalties.

Typical civil penalties for debt remedies are:

• Wage garnishment
• Bank account seizures
• Liens
• Credit score impacts

Additionally, some states have criminal statutes for not supporting parents’ debts. In North Carolina, refusal to pay off your parents’ debt is a Class 2 misdemeanor and can get you up to a 120-day jail sentence.

4) Additional legal headaches & expenses

Most filial responsibility laws are unclear how siblings and spouses share responsibility for parental medical debt. In the Pittas case, there were other family members in the state who could have paid the debt. But HCR chose to pursue Pittas alone.

If you are found responsible for your parents’ medical debt, you could have to sue your family to force them to pay a portion of the settlement.

This not only can create bad blood amongst family, but add to your legal expenses and headaches.

How can You avoid Filial Responsibility?

There are many stories of people who are estranged from their parents, had no say in their medical choices, and still had to settle their debts. There is little protection in filial responsibility states for you.

That doesn’t mean there is no steps you can take to try to avoid an unexpected large bill. You should:

1. Talk to your parents about their finances – This includes their plans for long-term care, medical plans, and Medicaid eligibility. If your parents are wealthy and have the means to pay their bills you are likely fine. And if your parents qualify for Medicaid, most of the costs will be covered. But if they fall in the middle, you need to be active in helping them manage the subject. Long-term care strategies include:
   • Long-term care insurance
   • Life insurance with a long-term care or accelerated death benefit rider
   • Permanent life insurance with a cash surrender value
   • Viatical settlement of life insurance
   • Home equity that can be cashed out.
2. Involve other family members – If you are in the danger zone of being responsible for your parents’ debts, you need to form a plan with your family. The plan should look to protect everyone’s assets while ensuring your parents are cared for.
3. Work with an elder care attorney – These specialize in end of life care and long-term care. The right attorney can help you come up with a strategy to manage your parents’ finances. The strategy will include estate planning and managing assets.
   • Note – one of the few ways to legally prevent creditors from getting assets is with life insurance.
4. Help your parents maneuver through available resources – If you parents qualify for Medicaid, it will ease the burden of long-term care. There are legal ways to lower parental income and disburse assets to help them qualify. Help your parents execute a Medicaid spend-down plan with the help of an elder care attorney or financial advisor.

Whatever you do, don’t wait until its too late and you are forced to cover unexpected parental medical expenses.

The Final Word

Medical and custodial care for your parents is complicated and in over half the country you have a financial interest in their choices.

Talk to your parents about their plans and finances. If they don’t have a plan, you should invest in good counsel to get a strategy in place. You don’t want to be surprised with a large medical expense due to avoiding the topic.

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