MARRIED COUPLES!!! Doctrine of Necessaries… What it is and why it matters to you!

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Not planning to protect money and real estate as a married couple can keep them vulnerable to lien recovery for long term care debts.

First, what is the doctrine of Necessaries? This doctrine
in North Carolina means that one spouse may be held responsible for the other
spouse’s medical bills. These medical bills can include hospital bills, doctor’s
bills and yes, nursing home care bills.

Why does the fact that a surviving spouse may be
responsible for the other spouse’s medical bills matter?
Well, the obvious
answer is that the surviving spouse would have to pay those bills… But… If the
surviving spouse failed to pay those bills then those bills could attach to the
surviving spouse’s estate when the surviving spouse passes away.

For example: If the surviving spouse passes away and
they owned a home, maybe other real estate, perhaps some monies and/or
investments that they wish to pass to their children and grandchildren, then the
debts of the spouse that predeceased the surviving spouse could then be
attached to those assets as they pass through the probate estate or estate administration
of the 2nd (surviving) spouse.

The surviving spouse, no doubt, may feel an extreme sense of
confidence that they have no debt and that they will not be burdened by the
spouse who passed first. In the example above, let’s posit that the first
spouse needed extensive nursing home care. The state may even send a lien
notice after that spouse passes away that (for the purposes of this example) $126,000
is owed to the State of North Carolina, Department of Health and Human Services
(DHHS). The surviving spouse may even ignore this notice, not realizing that
this amount will attach to his/her estate when they eventually pass away and
risk sacrificing assets that would otherwise pass to the next generation lien

Are there ways to save the assets of the surviving spouse
from these liens of the deceased spouse?
Yes. There are multiple ways to
prepare the assets of the surviving spouse to not only protect the home, other
real estate, money and investments but to also keep the surviving spouse in
control of those assets for the remainder of their lives.

Deed planning with deeds like life estate and ladybird deeds
can keep one in control of their properties for the rest of their lives and
protect them from a recovery under the Doctrine of Necessaries or because of a
personal lien they may have at their death. Trusts can also help protect assets
and pass them lien free to loved ones.

READ: Lady Bird Deed Article Here.

Watch Video on How Ladybird Deeds Work Here.

READ: Trusts Article Here.

Watch Video on How Trusts Work Here.

Watch Video on Deed Planning Here.

We at McIntyre Elder Law would be glad to talk through
options with you. We can help. You may call us at: 704-749-9244 or reach us
online at

Greg McIntyre JD, MBA
Elder Law Attorney


Greg McIntyre

Elder Law Attorney


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