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My mom currently has stage 4 lung cancer.  Her prognosis is probably 1-3 years unless there is a miracle.  She is too ill to work anymore, so her sole income is Social Security.  She has Medicare Parts A and B, but missed the sign-up period to get supplemental insurance.  As it turns out, she has put her head in the sand for more than the past year, and I just opened up a years worth of mail to find bills from over 25 different medical providers.  She just spent 11 days in the hospital, so I know there are more coming.  I do plan to call a health insurance counselor to see what her options are, and I will help her apply for financial assistance with the hospitals. 
She has few/no assets.  Her house has a HELOC on it, and there are some past judgements that have probably been applied as liens.  We are looking at selling the house, but I think we would only net between $25-50K, and then she would still need someplace to live.  So I'll put that aside for now.  Assume she has no immediately seizable assets.  I am sorting through these hundreds of pieces of paper and making a spreadsheet and tying back to Medicare EOBs to make sure they are accurate.  Some of the bills are for relatively small amounts (remainder after Medicare paid).  Beyond a moral obligation, is there any point in paying these?  I can pay some of these (I know I am not legally required to), but the money should probably go first towards my mom's other living expenses.  The larger amounts such as hospital stays - what happens if she just doesn't pay?  Her credit is already shot.  I don't think anyone can take the house from her.  There's basically nothing in her bank account to garnish.  Any words of wisdom beyond pay your bills, deadbeat? 

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But you never see ads on TV asking for donations like they do for cancer or other diseases. Does that mean they already ... (more)

atikovi (Dec. 31, 2016 @ 4:45p) |

Unless your mother has a sizeable estate, you're wasting your money.

Chyvan (Dec. 31, 2016 @ 4:49p) |

When my dad passed we just sent a copy of his death certificate to each creditor and that was pretty much it.  He didn't... (more)

RedWolfe01 (Dec. 31, 2016 @ 5:24p) |

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I'm sorry I don't have any advice for you but wanted to express my condolences on coping with these very trying circumstances.

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Apply for MedicAID. They'll quite often go back an pay bills in the past 90 days. She sounds like she's dual eligible.

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Chyvan said:   Apply for MedicAID. They'll quite often go back an pay bills in the past 90 days. She sounds like she's dual eligible.
  Thanks, Chyvan.  That is on the list to do.  It's great to hear they will pay some back bills.  Now if only she hadn't sat on the bills for so long more of them would have been covered.

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Guywhogetsit said:   I'm sorry I don't have any advice for you but wanted to express my condolences on coping with these very trying circumstances.
  Thank you for the kind words. 

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So sorry to hear about your mom - I hope you had a good Christmas with her and your family together.

I have known lots of folks with metastatic cancer and bills are often the last thing on their mind. It is likely she will continue to receive treatment where needed, especially if she was recently admitted and had to go through the (hopefully functional) case manager/social work discharge planning process. I believe a good first step would be to contact her discharge planner and oncology social work team, who have had to deal with many unfortunate situations such as this one.

From your description, it appears she has no assets and is judgement proof. In cases like like this, the "pay your bills deadbeat" concept truly doesn't apply. The critical issue is whether she is tied into a health system which will continue to treat her.

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One thing I learned with my mother (who passed away in August from Stage 4 lung cancer with mets to brain), if your mom is amenable to going on hospice (without any treatments) Medicare will pay for everything 100%. Even her prescriptions. However it doesn't sound like you are there yet, since you say she has an estimated 1-3 years.

My mom's dx was different than yours though, because she never really got the stage 4 designation until about 6 months before she passed.

My eyes were really opened up about end of life care and how expensive (and not covered by insurance) it can be. Mom required some home health aides to come in at night (not covered by Medicare or supplemental insurance - they even had a long-term care policy that paid exactly -0-) and about 10 days of (non medical) nursing home care. Medicare/supplemental/long-term policy - none of them paid a dime of it. So sad, because they paid over $17,000 in premiums -- just for her -- for that long-term care policy.

Honestly, don't worry about the bills. It doesn't sound like she needs the additional stress of worrying about it. Just keep her comfortable and try and do the things she wants to do with the money. My mom liked to gamble, and dad took her to the gambling boats as much as he could. She never spent much but she would sit at the nickel slots for hours. She eventually got too weak to travel, so do it all as soon as possible!

Best wishes for a good outcome for your mom. A miracle is always a possibility!

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Not to threadcrap but just curious

What happens to the unpaid bills of a deceased cancer patient. Who supposed to pay those bills if this person was living alone?

Are these bills paid from the proceedings from the sale of a house??

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ferns48 said:   if your mom is amenable to going on hospice (without any treatments) Medicare will pay for everything 100%. Even her prescriptions. 
  Of course they will. Medicare reasons the patient will survive no more than 6 months without treatment and would rather pay 100% of those services than pay for 3 years of treatments. BTW new cancer drugs come out every few months and who knows, a cure might be around the corner.

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fleetwoodmac said:   Not to threadcrap but just curious

What happens to the unpaid bills of a deceased cancer patient. Who supposed to pay those bills if this person was living alone?

Are these bills paid from the proceedings from the sale of a house??


Any outstanding debts (medical or otherwise) get paid out of the deceased's estate. If there are not enough assets to cover the debts then they are never paid.

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rascott said:   
fleetwoodmac said:   Not to threadcrap but just curious

What happens to the unpaid bills of a deceased cancer patient. Who supposed to pay those bills if this person was living alone?

Are these bills paid from the proceedings from the sale of a house??


Any outstanding debts (medical or otherwise) get paid out of the deceased's estate. If there are not enough assets to cover the debts then they are never paid.

  In other words, everyone pays for these unpaid bills.

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delhel said:   
rascott said:   
fleetwoodmac said:   Not to threadcrap but just curious

What happens to the unpaid bills of a deceased cancer patient. Who supposed to pay those bills if this person was living alone?

Are these bills paid from the proceedings from the sale of a house??


Any outstanding debts (medical or otherwise) get paid out of the deceased's estate. If there are not enough assets to cover the debts then they are never paid.

  In other words, everyone pays for these unpaid bills.

  
Its a more extreme form of bankruptcy.  Normally by the time the liens and foreclosures get to court the relatives have carted off all the real valuables.

That is why I only transferred a life estate to my stepmother, when she passes it will revert back to me automatically and a lien won't attach.  (since she never paid anything into it I don't feel like I am looting the estate -- its just proper planning)  Making it a Life Estate means she can use her Homestead/over 65/disabled  exemptions to reduce the taxes -- which I am also paying anyway.

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ferns48 said:   One thing I learned with my mother (who passed away in August from Stage 4 lung cancer with mets to brain), if your mom is amenable to going on hospice (without any treatments) Medicare will pay for everything 100%. Even her prescriptions. However it doesn't sound like you are there yet, since you say she has an estimated 1-3 years.

My mom's dx was different than yours though, because she never really got the stage 4 designation until about 6 months before she passed.

My eyes were really opened up about end of life care and how expensive (and not covered by insurance) it can be. Mom required some home health aides to come in at night (not covered by Medicare or supplemental insurance - they even had a long-term care policy that paid exactly -0-) and about 10 days of (non medical) nursing home care. Medicare/supplemental/long-term policy - none of them paid a dime of it. So sad, because they paid over $17,000 in premiums -- just for her -- for that long-term care policy.

Honestly, don't worry about the bills. It doesn't sound like she needs the additional stress of worrying about it. Just keep her comfortable and try and do the things she wants to do with the money. My mom liked to gamble, and dad took her to the gambling boats as much as he could. She never spent much but she would sit at the nickel slots for hours. She eventually got too weak to travel, so do it all as soon as possible!

Best wishes for a good outcome for your mom. A miracle is always a possibility!

Nice post, ferns48.  Your advice is helpful, especially your thoughts (I bolded for emphasis above).

Most of us will face similar issues with our parents at some point.

 

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My mother passed away one year ago and was in a similar situation.  Due to medical bills, her liabilities exceeded her assets.  

We had an attorney handle her estate and with no will we had to go through probate.  The net proceeds after the sale of her home and car was less than $15k.  The proceeds were then distributed in this sequence:
1.  Court costs
2.  Attorney's fees
3.  Funeral costs (reasonable and customary)
4.  Medical bills
5.  Any other debts
(Only a percentage of her medical bills were paid)

I would definitely seek the advice of an estate attorney.

 

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Throw the bills in the garbage

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salzmane said:   My mother passed away one year ago and was in a similar situation.  Due to medical bills, her liabilities exceeded her assets.  

We had an attorney handle her estate and with no will we had to go through probate.  The net proceeds after the sale of her home and car was less than $15k.  The proceeds were then distributed in this sequence:
1.  Court costs
2.  Attorney's fees
3.  Funeral costs (reasonable and customary)
4.  Medical bills
5.  Any other debts
(Only a percentage of her medical bills were paid)

I would definitely seek the advice of an estate attorney.

 

  This is very helpful.  Thank you.  I am planning to find and consult with a PA estate attorney.  We need to get some paperwork done sooner rather than later. 

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ferns48 said:   
My eyes were really opened up about end of life care and how expensive


Someone once told me 50% of a person's lifetime medical cost occur in the last six months of life. Death is cheap. It's the treatment leading up to death that is exspensive.

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I always heard it as "Death is cheap. Fighting death is expensive, and it always wins eventually."

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ferns48 said:   One thing I learned with my mother (who passed away in August from Stage 4 lung cancer with mets to brain), if your mom is amenable to going on hospice (without any treatments) Medicare will pay for everything 100%. Even her prescriptions. However it doesn't sound like you are there yet, since you say she has an estimated 1-3 years.

My mom's dx was different than yours though, because she never really got the stage 4 designation until about 6 months before she passed.

My eyes were really opened up about end of life care and how expensive (and not covered by insurance) it can be. Mom required some home health aides to come in at night (not covered by Medicare or supplemental insurance - they even had a long-term care policy that paid exactly -0-) and about 10 days of (non medical) nursing home care. Medicare/supplemental/long-term policy - none of them paid a dime of it. So sad, because they paid over $17,000 in premiums -- just for her -- for that long-term care policy.

Honestly, don't worry about the bills. It doesn't sound like she needs the additional stress of worrying about it. Just keep her comfortable and try and do the things she wants to do with the money. My mom liked to gamble, and dad took her to the gambling boats as much as he could. She never spent much but she would sit at the nickel slots for hours. She eventually got too weak to travel, so do it all as soon as possible!

Best wishes for a good outcome for your mom. A miracle is always a possibility!
 

  My dad is nearing end of life right now...less than 3 months at the max likely.  He is in a rehab facility now and they are recommending hospice.  However, questions on the bolded above....1st states Medicare pays for everything, but then you state it pays for nothing.  He has requested to go home to pass away from the comfort there, but the facility is constantly monitoring his blood pressure/sugar levels as they are all over the place and without that he would pass away sooner rather than later.  My mom is trying her best to prolong his life (hard to let go after 48 years together) but she would need a home health aide several hours a day at the very least if for nothing else to let her go to the grocery store.  So, that would be an out of pocket expense?  From what she tells me, their medical insurance is covering ~85% of treatment now, and I too am shocked at the expense related to end of life care.

Finally, I have advised her to pay nothing until it's all over, but since they still have a joint household, will she be required to pay his medical expenses after the fact out of their joint assets (bank accounts, home equity, etc...)?

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If ageing was thought of more as a disease instead of an inevitable condition, research would increase and treatments or a cure might be possible down the road. Just don't expect government to take the lead.

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atikovi said:   If ageing was thought of more as a disease instead of an inevitable condition, research would increase and treatments or a cure might be possible down the road. Just don't expect government to take the lead.
  
You are kidding..  anti-aging is one of the MOST researched areas there is.  Lots of old rich people out there -- and even more who would like to transfer that money to themselves.  Ever since Alchemy and the Fountain of Youth.  

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But you never see ads on TV asking for donations like they do for cancer or other diseases. Does that mean they already found a cure but the old rich people are keeping it a secret?

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salzmane said:   We had an attorney handle her estate and with no will we had to go through probate.

I would definitely seek the advice of an estate attorney.


You got ripped off. You'd have had to go through probate even if there was a will. Many states have small estate procedures that you can do yourself. If the value of the debt exceeds the value of the assets, then you don't have to do anything. Let the creditors fight it out.

While you might want to pay for something you probably didn't need, don't tell other people to do it.

Modern said:   I am planning to find and consult with a PA estate attorney.

Unless your mother has a sizeable estate, you're wasting your money.

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Chyvan said:   
salzmane said:   We had an attorney handle her estate and with no will we had to go through probate.

I would definitely seek the advice of an estate attorney.


You got ripped off. You'd have had to go through probate even if there was a will. Many states have small estate procedures that you can do yourself. If the value of the debt exceeds the value of the assets, then you don't have to do anything. Let the creditors fight it out.

While you might want to pay for something you probably didn't need, don't tell other people to do it.

Modern said:   I am planning to find and consult with a PA estate attorney.

Unless your mother has a sizeable estate, you're wasting your money.

  
When my dad passed we just sent a copy of his death certificate to each creditor and that was pretty much it.  He didn't have any real estate or bank accounts, just physical stuff like a modestly valuable stamp collection.  

He had some paid off whole life plans, but they weren't enough to do more than pay for the uncovered burial costs.  They were also direct beneficiary plans.

Now if there is a paid for house then they might go after that, and the state will do so if you go on the state medicaid funded nursing home program.  (why I legally own my stepmothers house instead of her)

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