In end of life care we often are faced with a question like: "My relative just died. We don't have the money to pay for a funeral. What do we do?" These situations are never easy, but here are some tips to consider when handling a request for funeral assistance. The good news is that you can make funeral planning choices that reduce expense, and perhaps get some modest financial help to cover some (but probably not all) of the costs. The bad news is that I personally don't know of any way to get the full cost of a typical funeral covered by public sources.
Before anything else, it's important to recognize that this is a common problem. In the United States, funerals are very expensive. The burdens of medical care may have already depleted family finances. It's not something to be ashamed of. Hospice professionals are used to these questions, and helping the family face stress after a death is part of the job of providing total family support. In hospice the unit of care is the family, and facing financial facts is part of the family dynamic.
Questions to ask
Here's my list of questions to ask. If you don't get what you need from one source, try another.
Was anything planned in advance? Funerals take time to arrange. If death is expected you or a family friend can do a lot of research up front. Anything you do to reduce the need to make decisions in a hurry usually results in a better outcome. In my experience if you talk about funerals with family members ahead of time, nine times out of ten people express a desire to go with a simple, respectful, and low-cost scenario. Having a conversation in advance can be a be help to the survivors, who sometimes overspend due to feelings of guilt, or just because they haven't considered all the options. Advance planning can be as simple as discussing wishes or as detailed as paying in advance for merchandise and services. Sometimes people ask for funeral assistance after they have already signed a funeral contract, which is the wrong time to be asking for advice.
Is there a family friend who can take charge of the financial planning for the funeral? Before you start calling, consider who should do the footwork. Try to get somebody who is not already overwhelmed with caregiving to do the shopping. Immediately after a death the family and close friends are emotionally in no condition to haggle over prices. This is the perfect time to enlist help from a detached friend who can comparison shop and help make rational spending decisions. If that's not possible at least take a friend with you before you sign anything.
Can you get a social worker involved? You may be eligible for social work services from more than one agency. If hospice care was being provided at the time of death, the first thing to do is to contact the social worker at the hospice where the death took place. The social worker may be able to make local referrals and guide you toward resources they know to be useful. If the death took place in a hospital, skilled nursing facility, or other type of residential facility, or if the decedent was on public assistance, there may be a social worker available as well. Most social workers will at least try to help, but not all have experience with this issue. I know of jaw-droppingly unhelpful conversations with social workers that leave me wondering how any institution with a high annual death count can't have a protocol for handling funeral assistance questions. Remember, social workers can't provide you with resources, they can only point you in the right direction so you can get the resources on your own.
Have you screened at least three different funeral directors? Funeral directors deal with these issues every day and can be very helpful in locating benefit sources. Crack the Yellow Pages and call at least three funeral homes in your area to ask what benefit sources exist in your area. This initial screening will turn up options you would miss if you just call one funeral home. Ask each of the funeral homes what your options are for a low-cost funeral. You will be surprised at the range of options to consider, all of which must be itemized as line items on a price sheet. That's required by law in every state, as far as I know.
Have you called your state, county, and city departments of Social Services? In addition to calling funeral homes directly to ask about benefit sources, call the Department of Human Services in your state, county, and city to find out if there are any funeral assistance benefits offered locally. Some localities have "indigent funeral" benefit funds and others do not. It's best to call all three offices because the local options may vary from the state baseline. There is no national Medicaid funeral benefit that I know of, but many states and counties do have some nominal Medicaid funeral benefit that can be paid if the decedent met certain qualifying conditions such as having been enrolled prior to the death. If any Medicaid or local funeral benefit is available, you may need to use one of the funeral homes on an approved list.
Was the deceased a member of any organizations and religious groups? You never can predict what these organizations offer in the way of support for members. Since calling around can take some time, this is a good task to do in advance of need. Some religious organizations have funeral committees of members who make a special effort to provide practical support at the time of a death. These folks are angels on earth, and can be of great help in doing the footwork necessary to obtain benefits. If you don't belong to any organization, you can try to find help from non-denominational organizations in your area. It's difficult to say what will be available in town, but your social worker or funeral director can be helpful in getting local referrals.
Was the person a veteran? If so, they probably are entitled to burial in a national cemetery and some other benefits such as burial honors. Call your VA office for details or check the Department of Veterans Affairs FAQ on Burials and Memorials. In certain circumstances, a Burial Allowance is available from the Veterans Benefits Administration. For assistance call 1-800-827-1000.
Was the person a child? Some funeral homes provide services for infants and children at reduced rates. Don't hesitate to ask about discounts for children. Some organizations such as Kids Wish Network have funeral assistance programs.
Does the family want burial or cremation?
This is the key question that will have the most impact on total funeral costs. Any benefit probably will not be enough to cover the full cost of a burial, but may cover the full cost of a cremation. Cremation is much less expensive than burial. With cremation you don't need an expensive container or urn The cremated remains can be returned to the family in a small box at no extra charge. Disposal of the remains can take place at little or no cost as part of a separate service. Check local laws to be sure it's legal to dispose of remains in the place you are considering. Disposal at sea or in a lake is popular in some areas. In my own case, I admit I'm biased in favor of cremation after my own demise. I would ultimately like to be mulched into the landscape (but hopefully not anytime soon).
There are several costs that add up when you have a burial. Expensive items include the cemetery plot, the vault or grave liner, the casket, the grave marker, and embalming. These cost are unlikely to be fully-covered by any public funeral benefit.
- Buying a cemetery plot is similar to any other real estate transaction. Think location, location, location. Prices vary a lot depending on which cemetery you use, and what part of the land is used. Does the great view really matter? Call several cemeteries and get price ranges. The cemetery probably won't give you a loan to buy a plot, so you need to come up with cash. There is also a secondary market for plots that may be worth looking into. Sometimes people buy a plot and then move away, divorce, or have other family changes and can't use the plot themselves. Some of these plots wind up on the market with independent cemetery brokers, or for sale directly by the owners. (Yes, you can buy a FSBO cemetery plot.) There isn't much of a foreclosure market on plots, so prices haven't fallen in line with home values, however.
- The casket can be a big-ticket item. Low-cost burial containers can look just as good as a fancy casket and make little or no difference to the long-term preservation of the body. A cardboard cremation container with a flag or beautiful cloth draped over it can look just as beautiful as any other funeral arrangement. If you have chosen cremation, this is certainly the best way to go. You can buy caskets from wholesale suppliers, but be aware that some funeral directors may resist this practice. Yes, you can get caskets at Costco, and no, you don't have to buy three at a time. Expedited shipping is available.
- If you bury a body in the ground, some cemeteries require that the coffin be placed inside another more solid solid box to keep the ground from sinking. This "outer burial container" may cost as much or more than the coffin itself. Ask for specific line item prices for this accessory. A "grave liner" will probably be cheaper than a "vault", and neither will really protect the body from decomposition in the long run. Remember that some cemeteries don't require anything at all (see "green" options, below).
- The grave must be marked with a headstone or other type of grave marker. What you can use is regulated by the cemetery you choose. Most contemporary gravesites use markers that are flush with the ground and have a limited range of design options. Above-ground raised markers (the typical "gravestones") can be quite expensive.
- It's cheaper to have a closed-casket funeral, or a memorial service later with no body present. Embalming and restoration are skilled services that need to appear as line items on your funeral bill. Embalming is generally not a legal requirement for a funeral but may be required to have an open casket viewing in some states.
Out-of-the box ideas
- Use a mortuary school. This is like going to a dental school to get your teeth repaired. The funerals are handled by students with close supervision by instructions. The quality can be excellent and is generally much cheaper than prevailing retail rates. For a listing of moruary schools by state check www.mortuaryschools.com.
- Have an eco-friendly "green funeral". Some of these "green" options will lower the cost of the funeral, such as not having embalming and using a biodegradable casket. Some funeral homes offer "green" services and others do not. When selecting a funeral home ask specifically how choosing sustainable options can reduce the price of the service. The Green Burial Council [888-966-3330, www.greenburialcouncil.org] offers good educational materials about green practices and has a searchable database of providers in the United States.
- Handle some or all of the funeral on your own. Home funerals were the normal method of caring for the dead before funeral homes grew as a service industry. In most states the family or a religious group can perform most funeral duties, but some states require that a licensed funeral director assist with these home funerals to ensure compliance with local laws. Caring for your own dead can be a deeply loving experience for all concerned. The books Dealing Creatively With Death: A Manual of Death Education and Simple Burial (get the current edition) and Caring for the Dead: Your Final Act of Love both have information on ways you can reduce expenses by getting directely involved with some or all of the steps in conducting a funeral. Final Passages provides education about home funerals including CEU programs for professionals.
- Donate the body to a medical school. This sometimes involves no cost to the family at all, or just the cost of transporting the body. In most cases the family will receive cremated remains back from the school within one or two years. ScienceCare [www.sciencecare.com] is a nationally-accredited tissue bank and body dontation program that can help you find an appropriate program.
- Rely on the County Coroner for public disposition of the body. When people who are indigent and friendless die, each county has some process for caring for and disposing of the body. This public service is provided for persons who have no families or assets. If you call your County Coroner they can tell you what the local regulations provide for, and may be able to refer you to low-cost funeral options that they know of in their area. Since coroners deal with indigent deaths frequently that are experts in undertanding the problems.
- Use videoconferencing to avoid travel expenses. Some funeral homes now offer web-based streaming video services to permit remote participation, either by coming to a local funeral home that is equipped with a video link, or simply by using the Internet.
For more information
The Funeral Consumers Alliance (FCA) is one of my favorite sources for information about funeral issues in general. Don't fail to read their Ten Tips For Saving Funeral $$$. FCA has been around for a long time and has a solid pro-consumer stance. Their web site is a gold mine of information on how to cut costs and improve quality of the final event. Their member associations provide a range of funeral-planning information and can help you find local resources. Some of their local groups do local funeral price surveys and some have negotiated a discounts for members at participating funeral homes.
The National Funeral Directors Association (NFDA) [http://www.nfda.org] has a Funeral Service Help Line at 800-228-NFDA (800-228-6332). They offers information about funeral planning and referrals to NFDA-member firms, as well as materials about grief. The Funeral Service Help Line cannot provide funding for funeral services. NFDA has a list of state funeral directors' associations to help you zero in on your area.