Medical debts incurred before spouses are married are generally the sole responsibility of the spouse who received the medical care or treatment. Similarly, medical debts incurred after spouses are divorced are generally the sole responsibility of the spouse who received the medical care or treatment. But medical debts incurred during the marriage are generally considered a marital debt and the responsibility of both spouses. In some states, such as Minnesota and Virginia, a spouse is not responsible for the other spouse’s medical debts incurred following separation.

Under the (legal) doctrine of necessities, a spouse is generally liable for debts incurred by the other spouse—even if the spouse was not aware of and did not approve the purchase of the products or services, and even if, for example, the provider of the medical services did not know the spouse receiving the services was married. The doctrine of legal necessities generally makes spouses liable for the life necessities of the other spouse—food, basic clothing, shelter, medical care, and utilities—during the marriage. At least two states—Alabama and Virginia—have declared the doctrine of necessities unconstitutional. And in Maryland, for example, a spouse is only responsible for the other spouse’s medical bills if the spouse agreed in writing to be responsible for the other spouse’s medical bills.

Liability for medical debts incurred during marriage may be joint and several liability—meaning the creditor (medical services provider) may choose to pursue only the spouse who did not receive the medical care for payment of the medical bills. This is generally the case in community property states, and in states that consider medical bills joint debts.

In New York, medical debts incurred before marriage are typically the responsibility of the individual who received the medical care. Similarly, medical debts after divorce fall on the spouse who incurred them. However, medical debts incurred during the marriage can be considered marital debt, for which both spouses may be responsible. New York does not follow the community property system, but it does adhere to the doctrine of necessities, which may hold a spouse liable for necessary expenses, including medical care, incurred by the other spouse during the marriage. It's important to note that the application of the doctrine can vary, and specific circumstances of the debt and the couple's financial arrangement may influence liability. An attorney can provide advice tailored to an individual's situation, especially when dealing with the complexities of medical debt and marital finances.