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

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 free.

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

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Greg McIntyre, founder of McIntyre Elder Law, is more than just an attorney. As a Navy Veteran, father to six kids, and a loving husband, he values family deeply. This drives his commitment to helping clients safeguard their futures and pass down legacies.

Greg has a passion to help people. Beyond just legal advice, he loves having conversations and strives to build a long-term relationship with every clients that comes through his door.

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