Key takeaways

  • Medicare coverage ends on the date of death, with doctors having 1 year after that date to submit claims for services that occurred before the person’s death.
  • In most cases, a person’s estate is responsible for any medical debt left behind after death, with the executor ensuring bills get paid out of the estate.
  • Beneficiaries of the deceased person may be eligible for a Medicare premium refund at the time of death or may qualify for Social Security survivor benefits.

If you or a loved one is enrolled in Medicare, coverage ends on the date of death. Medicare will cover its portion of healthcare services up until a person’s date of death, even if deductibles, copayments, or coinsurance bills still need to be paid.

In most cases, a person’s estate is responsible for any medical debt left behind after death.

In some cases, the beneficiary of the person who died may be due a Medicare premium refund at the time of death or may be eligible for Social Security survivor benefits.

This article takes a look at Medicare and Social Security coverage after death.

Does Medicare pay claims submitted after death?

Doctors have 1 year after a person’s death to submit claims to Medicare. During this time, the person who has died may still receive Medicare summary notices in the mail. And copayments or deductibles associated with these notices may still need to be paid.

When someone enrolled in Medicare dies, a member of their family or the person in charge of their affairs must notify Social Security. In some cases, the funeral home will report the person’s death to Social Security.

If you prefer to have the funeral home notify Social Security, you’ll need to give the funeral director the Social Security number of the person who has died, as it needs to be included in the Statement of Death form.

You can call Social Security toll-free at 800-772-1213 (TTY: 800-325-0778).

Does Medicare cover funeral expenses?

While Medicare does not cover funeral benefits, the Social Security Administration offers a $255 lump sum death benefit to a surviving spouse or child of the deceased.

You can apply for this benefit by calling Social Security at 800-772-1213 (TTY: 800-325-0778) or by visiting your local Social Security office. It’s good to be aware of the information you will need to apply.

When a Medicare enrollee dies, their unpaid medical debt doesn’t automatically disappear. In most cases, a person’s estate is responsible for any debt left behind after death. An estate consists of money left in bank accounts plus any assets, such as stocks or bonds.

An executor named in the person’s will ensures the bills get paid out of the estate. If the deceased person does not have a will, the courts may appoint someone else to do the job.

The executor prioritizes debt payment based on federal and state laws. If there isn’t enough money in the estate to cover all the debt, creditors may look for someone else to pay the money owed.

In most cases, family members aren’t obligated to pay a loved one’s debt after death. Exceptions to this rule include if:

  • You co-signed for a loan for which you still owe money.
  • You’re a joint account holder for a credit card for which you owe money.
  • The person who died was your spouse and you live in a community property state (which requires you to pay healthcare costs).
  • You were the executor of the will and you didn’t follow state probate laws.

What to do if a debt collector contacts you

If a debt collector contacts you about a loved one’s unpaid medical debt, here are some steps to take before handing over any money:

  • Ask for proof of what is owed and why the debt collector believes you’re responsible for it.
  • Ask an estate law attorney to help you determine whether you’re responsible for the debt (some attorneys offer free or reduced-cost services; you can look up legal aid offices in your area with this online search tool).
  • If you’re legally obligated to pay the debt, you may be able to negotiate a lower payment.
  • You may also be able to deduct medical expenses when filing your taxes.

Medicare issues monthly refunds for overpayments, which may occur when an enrollee dies. For example, Medicare premium payments are sometimes taken out of Social Security benefits in advance.

If a policyholder dies, the Medicare premium cost may have already been subtracted from the Social Security benefits check. In this case, the money will be refunded.

Medicare premium refunds are given to the family member or executor of the estate in the following order:

  1. the legal representatives of the deceased’s estate
  2. the surviving spouse, who was either living in the same house as the deceased at the time of death or who, for the month of death, was entitled to the same monthly benefit as the deceased
  3. children who, for the month of death, were entitled to the same monthly benefit as the deceased
  4. parents who, for the month of death, were entitled to the same monthly benefit as the deceased
  5. a surviving spouse not qualified under the rules outlined in bullet 2
  6. children not qualified under the rules outlined in bullet 3
  7. parents not qualified under the rules outlined in bullet 4

How to apply for a Medicare premium refund

To apply for a Medicare premium refund, complete this form and send it to your local Social Security Office. You can use this online search tool to find the location of an office nearest you.

The Social Security Administration provides survivor benefits in the form of monthly payments to eligible family members of people who paid Social Security taxes before they died. This includes spouses and ex-spouses, children, and dependent parents.

Eligibility for spouses and ex-spouses

If you’re the spouse of the person who died, you may be eligible for survivor benefits if you are age 60 years or older (or ages 50 to 59 years and have a disability) and were married for at least 9 months before your spouse’s death.

Ex-spouses may also be eligible if they were married for at least 10 years to the person who died. You might also be eligible, regardless of your age or how long you were married, if you’re caring for a child of the person who died.

Eligibility for children

Children of the person who died may also be eligible if they:

  • are not married
  • are age 17 years or younger
  • are any age and have a disability that began at age 21 years or younger

Eligibility for dependent parents

You might also be eligible for monthly payments if you’re age 62 years or older and were financially supported by your child who has died.

How to apply for survivor benefits

You can set up an appointment with Social Security by calling 800-772-1213 (TTY: 800-325-0778). Tell the agent that you’d like to apply for survivor benefits. They’ll schedule an appointment, which will either be over the phone or in person.

Medicare coverage ends on the date of death. Doctors have 1 year after this date to submit claims for health services incurred in the months leading up to death.

This means bills for deductibles, coinsurance, or copayments may continue to arrive after a person’s death and may still need to be paid. In most cases, a person’s estate is responsible for any debt left behind after death.

Beneficiaries of the person who died may be eligible for a Medicare premium refund or Social Security survivor benefits.

Contact the Social Security Administration or Medicare to see if you’re eligible and to apply:

  • Social Security: 800-772-1213 (TTY: 800-325-0778)
  • Medicare: 800-633-4227 (TTY: 877-486-2048)