These are the best and worst U.S. places to die, report shows

Your end-of-life experience may be very different depending on where you live, according to a Policygenius report that ranks the country’s best and worst places to die. 

The report gave each state and the District of Columbia a numerical score based on seven factors, including funeral costs and services, green burials, palliative care, Medicare providers, at-home deaths and probate shortcuts.

“I think the big takeaway of this project is to get people thinking about the costs associated with the end of life,” said Logan Sachon, senior managing editor of research at Policygenius. “Because some of them can be mitigated through planning.”

“If you look at the top 10 and bottom 10, there aren’t any specific things they all have in common,” Sachon said. “They are each kind of unique in their own way.”

Indeed, Vermont, ranked as the No. 1 place to die, was among the most expensive for funeral costs but scored highest for palliative care, which focuses on pain relief, management and emotional support.

Florida, known for its high population of retirees, came in last place, with the fewest Medicare providers per capita, and scored low for at-home deaths and palliative care.

The best places in the U.S. to die

1. Vermont
2. Utah
3. Idaho
4. Ohio
5. South Dakota
6. Maine
7. Colorado (tie)
8. Illinois (tie)
9. New Hampshire
10. Washington

The worst places in the U.S. to die

1. Florida
2. Alaska
3. Texas
4. Hawaii
5. New York
6. Georgia
7. New Jersey
8. North Carolina
9. South Carolina
10. Connecticut

It’s never too early for older Americans to prepare for end of life, Sachon said.

While the Covid-19 pandemic has boosted awareness about the need to be proactive, 67% of Americans still don’t have an estate plan, according to senior living referral service Caring.com.  

Experts recommend an advanced directive, also known as a living will, covering your medical care preferences. You’ll also need a health-care proxy or power of attorney, naming someone to make medical decisions on your behalf if needed.

The report also focuses on each state’s probate process, which determines the cost and time it takes to settle your estate.

As of June 2021, only 17 states and the District of Columbia have an estate or inheritance tax, according to the Center on Budget and Policy Priorities.

With different laws in every state, a local estate planning attorney may share some options to protect your assets and carry out your wishes, depending on where you live.

There’s no federal estate tax on wealth below $12.06 million for individuals in 2022, and with proper planning, married couples can transfer their unused exemption to their surviving spouse, effectively doubling it to $24.12 million. 

However, this reverts to an estimated $6 million exemption in 2026 when provisions from the Tax Cuts and Jobs Act sunset.