Dispelling The Myths Of Who Pays For Care

Annabel-KayNew laws governing social care are set to put a cap on how much money anyone has to pay towards the cost of their care.

And in what is set to be the biggest reform to the system in 60 years, the Care Act 2014 aims to put people and their carers in control of their own care and support.

Annabel Kay, a lawyer with leading West Midlands firm Higgs & Sons who specialises in care home fees and planning elderly care, says families currently arranging full time care for themselves or a relative might be accessing the wrong information about fees and the NHS.

She commented: “People need to be aware that the new Care Bill will make significant changes to the way people are assessed, both in terms of their needs and the contribution they will have to pay for their care.”

Annabel added: “NHS Continuing Healthcare funding for full-time care is available to people with health needs who meet certain criteria for nursing care and covers 100% of care costs, including 100% of the cost of being in a care home.

“Information about this funding, even when provided by the health and social care authorities, can be confusing. Getting it wrong may lead to you or your relatives paying tens of thousands of pounds when the NHS actually has a duty to cover the cost instead.”

In a bid to dispel some of the myths surrounding who will pay for care, she explores five common misconceptions when it comes to funding:

“I have savings of over £23,250 or my own house, so I will have to pay for care.”  Wrong – NHS Continuing Healthcare funding is an assessment of your health and care needs, not your assets and property. People frequently assume that if they have a certain level of savings and assets, then they have to pay for their own care regardless. This is not true; it’s only if you are not eligible for NHS Continuing Healthcare funding that your assets and property should even be discussed.

“I have dementia so I’m not eligible for NHS Continuing Healthcare.” Again, wrong, although sadly many families believe it! However, it is clear from the guidelines about Continuing Healthcare that funding has nothing to do with any specific diagnoses. Instead it’s to do with a person’s day-to-day health and care needs regardless of diagnosis and regardless of whether or not a person has dementia.

“I will have to sell my home to pay for my care.” The first question should be ‘what are your health and nursing needs?’ and not ‘do you own your own property?’. You should only have to sell your home if you are not eligible for NHS Continuing Healthcare, if your care needs are definitely social rather than nursing needs, if you have no other savings or if you actually choose to sell. You may be able to negotiate a Deferred Payment Arrangement with the local authority. Continuing Healthcare eligibility depends on your day-to-day health and care needs, and a person may remain in their own home and still receive NHS Continuing Healthcare funding.

“There’s no point in me having an assessment because it is means tested and I won’t qualify.”

The key thing to remember here is that care is not just care. It is split between social care and health/nursing care. Generally speaking, health/nursing care is provided by the NHS and is free as access to the NHS is NEVER means tested. Social care, on the other hand, is provided by the local authority and IS means tested. Before any person is means tested, they should first be considered for NHS Continuing Healthcare funding.

No one can say whether or not a person will be eligible for NHS Continuing Healthcare until the proper assessment process has been followed. Many people are simply told they ‘don’t qualify’ and yet their needs will either not have been assessed at all or will have been assessed without due regard to the Continuing Healthcare guidelines.

“I won’t be eligible for NHS Continuing Healthcare because my spouse can pay for my care.” Not true. No one should be asked to pay for anyone else’s care nor should anyone be asked to move out of or sell their home to pay for someone else’s care.

Annabel concluded: “At Higgs & Sons, we understand that it is often difficult to understand all of the information provided and that many myths circulate about NHS Continuing Healthcare funding.

“If you are arranging care for yourself or a relative or if you are already in care, we can make sure that the information you’re given about care fees and care funding is correct.”

For more information on NHS Continuing Healthcare, please contact Annabel Kay on 0845 111 5050.





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