What happens at a funeral when someone dies bankrupt who pays the bills?

My grandparents are in a nursing home, and they will eventually run out of money, and will have to cash out their life insurance policies to pay privately in order to qualify for care paid for in a really crappy Medicaid nursing home once they run out of money. They have already consumed much of their home equity... show more My grandparents are in a nursing home, and they will eventually run out of money, and will have to cash out their life insurance policies to pay privately in order to qualify for care paid for in a really crappy Medicaid nursing home once they run out of money. They have already consumed much of their home equity and their car was wrecked years ago with liability only insurance.

Their estimated funeral expenses for each of them are
2100 for funeral home services
12000 for casket
700 for embalmer
4000 for cemetery
800 for burial vault
500 for florist bill
700 for musicians and singers
325 for undertaker to transport body to funeral home

Which of these services are negotiable, they have a writen funeral instruction document stored long side their wills and it would be a crime to skimp on the funeral costs. Who pays for these expenses when medicaid estate recovery will leave the estate with a negative value before the funeral.

Do we. Need a lawyer now to figure out how to plan for this?

Which funeral vendors are likely to negotiate a lower rate? Does medicaid allow prepayment for a funeral or any ancillary services as part of a spend down. I'm sure paying for a funeral singer in advance is treated with suspicion by medicaid as a disqualifying transfer? Is this so?

What are we to do?
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