If one spouse incurs a debt solely in his name, it's usually his responsibility to pay it – unless he happens to live in one of the nine community property states. In these jurisdictions, both spouses are liable for all debts taken during the marriage, regardless of which one signed or contracted for them. It's not that simple, however, when it comes to medical debts. Even some of the other 41 states will hold a spouse liable for medical bills incurred by the other.
Whether or not medical debt will become a joint spousal liability depends on the specific state in which the debt was incurred and its rules regarding community property.
Jointly and Severally Liable
In some jurisdictions, you may be "jointly and severally liable" for your spouse's medical bills. In community property states, this is typically the case, and in the common-law states that consider medical bills joint debts, the law also uses this term. It means that the medical provider can pursue your spouse for the money, pursue you for the money, or pursue both of you. The entire bill belongs to both of you; you don't just owe one half. In other states, such as Maryland, you're only liable for your spouse's medical bills if you agreed in writing to be responsible for paying for them.
If your state does hold you responsible for your spouse's medical bills, an important distinction sometimes exists regarding your marital status. For example, in Virginia and Minnesota, if you and your spouse have separated, you're not liable for his medical debts. It doesn't matter if your divorce is final yet. Your marital status might fall into a gray area if you and your spouse are planning to divorce, but you're still living in the same household for economic reasons. If this case, confer with an attorney to find out how vulnerable you are.
Some common-law states also draw the line at costs incurred for "necessary" care. In other words, if your spouse wants to have a mole removed for cosmetic reasons, you might not be liable for the bill. If he has a heart attack and medical intervention is necessary to save his life, however, you could be. Generally, treatment for serious health issues and emergency care is considered necessary. Nursing home care may be necessary. Elective surgery or optional care is not.
Possible Conflict of Interest
Another wrinkle involves who gets to determine if your spouse's care is optional, elective, or a non-emergency. Ultimately, the doctor or hospital who is billing you is the same entity who determines whether your spouse's care was necessary. Assuming the care provider is ethical, this shouldn’t be a problem. However, if your spouse has defaulted on the debts and the provider can only seek payment from you, this may be an issue and you could need legal help.
If neither you nor your spouse pays the medical bills, your marital property might be vulnerable. This is almost universally true in community property states – a creditor can go after all property acquired by either you or your spouse during the marriage. Assets you owned prior to the marriage are generally safe, however. In common-law states, the same rule of thumb applies if the law holds you both responsible for medical debts: marital property owned jointly is vulnerable. However, if your state doesn't hold you responsible for your spouse's debts, only his separately owned property is usually at risk for creditors' actions.
Beverly Bird has been writing professionally for over 30 years. She specializes in personal finance and w, bankruptcy, and she writes as the tax expert for The Balance.