Get it in Writing: Planning for death can alleviate financial, emotional tension

Michelle Swafford

Thursday, May 12, 2005 | 8:14 a.m.

Dying is inevitable but many people are reluctant to plan for it.

That can leave big decisions and bills for surviving family members during a time of grief.

Prices can range from no charge if the body is donated to a medical science center to more than $15,000 for a full funeral service followed by a burial in a top-notch casket.

Although funeral and burial arrangements can be costly, there are a variety of funeral and burial options for the budgets of the poor, the prosperous and everyone in between.

Funeral planners and people who have had to make arrangements for people who died unexpectedly say it is important to make decisions in advance to save their families frustrations and financial hardships.

That's exactly why 24-year-old Las Vegas resident Sandra Nevarez wanted to select her burial arrangements and set aside money now.

Two years ago Nevarez watched her friend struggle financially to pay for her grandfather's funeral. She didn't want to put her family through that agony. When Nevarez's friend had to bury and memorialize her friend's grandfather, she said it was a "financial hardship. It put everybody under more stress."

She said she had thought about planning for her death, but put it off until Florida resident Terri Schiavo's story made national news. Schiavo's husband and parents debated whether or not to remove the brain-damaged woman's feeding tube because her wishes were not in writing.

Nevarez met with a funeral services preplanner at Palm Mortuary on April 9 -- 10 days after Schiavo died -- to set up a financial plan for her funeral and put her wishes in writing.

"When an individual passes, there is a financial hit whether they have money or not," said Palm preplanner Lee Garza, who assisted Nevarez through the planning process. "They overspend at a time of need."

Prearranging funerals includes choosing a burial option, casket or urn, and the theme and details for the funeral service if there is one. It can also include a list of who is and isn't allowed at the funeral.

Preplanning also typically includes setting up a payment plan to pay for the selected products and services, which locks most of the items at today's prices.

Many mortuaries offer payment plans for less than $100 a month for up to 10 years, and those plans pay for funeral products and services at current prices.

The exceptions to that are the costs of ministers, musicians, flowers, travel, the death certificate, coroner's fees and taxes, Garza said, adding that those costs could be estimated so money could be placed into a separate account.

"Most people, especially Mexicans, think they have to pay until they die because that's how it is in Mexico," he said.

The prearrangement plans include insurance policies -- with premiums based on age -- and those policies cover the person in the event that they die before their funeral service is paid for.

Once the policy is paid in full, the plot or crematory niche can be transferred to pay for the burial of another family member, but the casket and service are nontransferable, Garza said.

The Funeral Consumers Alliance says preplanning can be advantageous, but there are several factors consumers should consider before handing money to a mortuary, including:

If the mortuary goes out of business, the prearranged money might be lost.

It is possible that funeral homes could substitute less-expensive merchandise if funeral costs inflate beyond what is prepaid if there is no written guarantee that the original price (plus interest) would cover future costs.

If the preplans are canceled, part of the money could be lost.

About 30 percent of the 6,500 funerals Palm Mortuary handled last year were for people who preplanned their burials and other death arrangements, said Patrick Downey, vice president of sales and marketing for Palm.

There are several reasons why more people do not preplan their funerals.

"Some people feel that if they plan, it will hasten the event," Downey said. "(But) it's always good to have the plans in place, in writing and ahead of time."

People also hesitate to plan their death wishes because they fear that planning is too costly and too complex, which Downey said is typically not true.

Some people do not know where they will live when they die, which is another reason they are reluctant to plan their funerals, said E.G. "Ned" Phillips, vice president of community relations of Palm Mortuary.

The prearrangements -- including the burial plot -- are typically transferable to other cities if a person moves out of Las Vegas, and they can be set up to include transporting the body to another state or country, Phillips said.

Many cemeteries participate in an exchange network that allows people to transfer property on a dollar-for-dollar basis, but the overall prices can vary, Downey said.

Whether or not people opt to plan their burial and memorial, the costs can vary widely based on how the deceased is remembered and how their remains are disposed.

Science option

The least-expensive way to dispose of a body is by donating it to science. The recently opened Medical Education and Research Institute of Nevada (MERIN) -- started by Henderson orthopedic surgeon Dr. Michael Crovetti -- accepts body donations that are used for up to two years for numerous surgical procedures.

People with human immunodeficiency virus, hepatitis B and hepatitis C are currently prohibited from donating their bodies because they are contagious.

MERIN pays all of the costs associated with transporting the body to MERIN, body preparation and cremation after the medical procedures are completed. The cremated remains are not returned to the families, but are scattered in a local memorial garden with a plaque to honor them.

If the families want to hold a memorial service, they would be responsible for those costs.

In lieu of donating the whole body, people can donate their organs and tissue to the Nevada Donor Network if the age at the time of death is under 80 and they do not have HIV, tuberculosis, hepatitis B, rabies or other infections resistant to treatment.

"We always encourage everyone to sign a donor card and make their wishes known because the technology is forever changing," Nevada Donor Network Executive Director Ken Richardson said, adding that having high blood pressure and diabetes used to prevent people from donating.

People who want to donate their organs can sign up through the state Department of Motor Vehicles and can call the Nevada Donor Network if they want to donate their tissue. About 700,000 Nevadans are registered to donate their organs and about eight donations can be made per person, Richardson said.

The Nevada Donor Network covers the $25,000 in hospital and preparation costs associated with organ donation, he said.

"They're on their own for memorials," he said. "You can't pay an inducement to get them to donate. It's very clear in statute -- we cannot pay anything related to the funeral."

When people die in a hospital and do not plan to donate their bodies or organs, health professionals assist families by providing a list of funeral homes and assisting with calls to have the deceased person's body transported, said Gretchen Papez, spokeswoman for Valley Hospital Medical Center.

If the family doesn't know where they want to send the deceased person or they don't care, then the body is taken to the funeral home that is on rotation with the coroner's office, she said, adding that the family can change their mind later and have the body transferred to a funeral home of their choice.

Once a person has been transported to the mortuary, decisions must be made on how to dispose of the body, meaning with above- or below-ground burial or cremation.

If no arrangements have been made, the next of kin must make a decision on how to dispose of the body, Phillips said.

Basic service

There is one fee that everyone who uses a funeral home must pay, and that is the basic service fee, which includes filing of the death certificates and providing copies to the families; arranging plans with the cemetery or crematory; filing for Social Security, veterans and insurance benefits; and overhead costs such as permits and preparing death notices, according to the Funeral Consumers Alliance, which is based in Burlington, Va.

The consumer group says that some funeral homes have abused this mandatory fee "by inflating it to several thousand dollars," though the national average fee is $1,200.

At Palm Mortuary, the service fee is $1,225 and is added to most services, but is included in the cost of direct cremations, immediate burials and forwarding or receiving of remains.

There are ways to curb costs at a time when emotions are high and resources may be low because most other funeral costs are optional, depending on which services and products are selected.

A direct cremation without a memorial service costs from $1,050 to more than $1,220, depending on the type of container used, Downey said. A service costs between $1,800 and $2,000, he said.

Cremation caskets that are used to transport the body to the crematorium and for memorial services start at $25 for a cardboard box or $295 for a flattop steel casket with white crepe lining.

Prices increase from there, depending on the quality of the casket. Palm's most expensive casket -- the velvet-lined, solid mahogany presidential casket -- sells for $10,000.

The Federal Trade Commission requires mortuaries to accept caskets that are not purchased from them, but there are few retail options in Las Vegas outside of the funeral homes.

Caskets for sale

Costco launched casket and urn sales last year in its stores in 26 states including Nevada. Caskets sell from $925 for 18-gauge steel in three styles to $4,000 for 48-ounce bronze in one style, according to the company's Web site.

Costco's prices range from $85 for a 10 1/2-inch marble urn to $90 for a pebble stone or rock salt urn. Keepsakes, which are smaller decorative items to hold the remains, range from $20 for a 5-inch marble holder to $40 for a pebble stone or rock salt holder.

From funeral homes, people can purchase glass-front niches that allow them to place personal items next to the urn, and prices at Palm range from $200 to $2,000, Downey said.

At Palm a full-service casket burial costs about $4,000. Casket prices can range between $300 and $10,000, and a typical Palm burial plot costs about $1,800.

A myth about funeral services is that embalming the body is required. Embalming is not required by law, but most funeral homes require it if the funeral service includes viewing of the body. Embalming costs about $500 at Palm.

Funeral services are often personalized with photos and memorabilia from the deceased person's life and some include themed services such as golf, patriotism or motorcycles.

"We have suggestions and we're open to their ideas and plans," Downey said.

Headstones range from $500 to $10,000. Mausoleum burials cost between $1,800 and $90,000, depending on whether a person has a private mausoleum within a cemetery.

Another cost to consider is what to put the casket in when it is buried. Many cemeteries require people to purchase a grave liner or burial vault to prevent the grave from sinking. Concrete grave liners start at $425 and increase to $6,600 for a triple-reinforced concrete burial vault at Palm.

Those who wish to be transported to other states or countries must buy a casket with a sealer, and the least-expensive one at Palm is $1,325. There is a $150 charge for the air tray that the casket is secured inside and a fee of $1,430 to embalm the body and transport it to Palm for preparation. A fee of $375 covers washing and cosmetology.

The cost to ship the body varies by weight, but is estimated at $1,025 to go to Mexico, which is a common request for Las Vegas residents, Garza said.

The costs can add up, but mortuaries offer package deals and will work with people to meet their requests and help them stick to their budgets, Downey said.

The Funeral Consumers Alliance cautions consumers to keep in mind that buying items a la carte may be cheaper if they do not want each item in the package.

Full disclosure

Everyone who enters a funeral home is entitled to a copy of its general price list, which the Federal Trade Commission requires, said Rick Rico, manager of Palm Mortuary's Eastern Avenue location.

Funeral homes, such as Palm, work with families to make financial arrangements using cash, credit cards or assignable insurance policies, but all costs must be paid prior to the services or disposal of the body, Rico said.

People who have no financial resources are referred to Clark County Social Services, which will pay for funeral arrangements and burials for people who meet certain asset and income requirements.

When survivors are referred to Clark County Social Services, they must complete an in-person interview and application, Social Services Manager Bobby Gordon said.

"If you've got a decedent who has $5,000 and the family says, 'We need assistance with (the) burial,' that person wouldn't qualify," Gordon said. "Maybe you can't get everything you want but you can make some arrangements."

The majority of the deceased people that Clark County Social Services pays for are cremated, because it is less expensive and requires less land, she said.

The exceptions are when the deceased cannot be identified, they are part of a homicide investigation and may need to be exhumed, or when there are religious prohibitions that are supported in writing by the church, she said.

In addition to mortuaries referring people for county assistance, they can provide discounts to people who need help, Rico said.

When an insurance policy is assigned to cover funeral costs, the mortuary only takes the amount needed to cover its costs and the rest of the money is given to the family, Rico said.

"Insurance is basically designated for the survivors and it's to help the survivors survive," he said. "It's not designed for funeral arrangements, although many people use it for that."

Some death-related costs aren't affected by how the body is disposed of, such as $11 for a copy of the death certificate from the Clark County Health District and $45 for transportation if the body is taken to the Clark County coroner's office for an investigation.

Clark County Coroner Mike Murphy said an average of 35 people in Clark County die each day, but his office does not investigate every death, only those that are suspicious or are because of unnatural causes.

In 2003, 12,751 people died in Clark County, but only 3,112 of them had a coroner's investigation, he said. Eight valley mortuaries rotate transporting bodies from the coroner's office.

While most families use the mortuary that transports the deceased person, there is no requirement for the family to use that mortuary, and the mortuary is not allowed to pressure them if they choose another one, Murphy said, adding that his office is not allowed to recommend any service or mortuary.

While people in the East and Midwest tend to use the same mortuary for generations, that is not the case in Nevada, he said. "Because a lot of people are new to Las Vegas, they really don't have a preference."