Don’t pay care fees until you’ve read this!
“I thought I had to use mum’s savings first before I could apply for CHC.”
This is a common statement which, unfortunately, we hear too frequently.
There is a general public misconception that you have to exhaust your savings and drain your bank account before you can be considered for NHS Continuing Healthcare Funding (CHC).
CHC is a FREE package of fully-funded care provided by the NHS for individuals (adults 18 and over) who have complex, intense or unpredictable healthcare needs arising out of a disability, accident or illness.
Critically, CHC Funding is free at the point of need. Unlike social care funding provided by the local authority, which IS means-tested, CHC is NOT. Therefore, your personal wealth and finances should never be a consideration. Quite simply, if you meet the eligibility criteria for CHC Funding, then the NHS should pay for ALL your assessed healthcare needs (including the cost of accommodation in a care facility), regardless of your financial means.
Read: What? You’re enquiring about care funding AND you’ve never heard of CHC!
Most people get confused or tripped up here and wrongly believe it’s all about their wealth. It isn’t! Remember: CHC is about health NOT wealth.
Unfortunately, availability of CHC Funding is not publicly advertised by the NHS and still far too little is known about how to access this area of FREE NHS funding to pay for their care fees. It is this area of secrecy and the unknown which promotes many misconceptions, including the most common one – that you have to pay for your own care and only once you have used up your finances and savings (or gone below the local authority threshold of £23,250) can you then look to the NHS to fund care. This is WRONG. The CHC assessment should always come before any local authority means-tested assessment.
So, you can imagine the surprise, astonishment and resentment when individuals learn about the existence of CHC and realise that they had been misled (or were misinformed), and could have been entitled to have all their care fees paid for in FULL by the NHS from the outset! They could have kept their prized savings or not sold their home to pay for their ongoing or past care!
Of course, in some circumstances you can also claim reimbursement retrospectively if care fees were wrongly charged when the individual might have been eligible for CHC. However, retrospective claims have their own procedural challenges and can take many months (if not years) of perseverance, emotional exhaustion, frustration, and stress, whilst battling with the NHS for fair reimbursement.
Read: How to recover care fees paid for unassessed periods of care going back to 2012
That said, in most of the cases we come across where retrospective awards have been successful, the sums to be reimbursed can be very substantial, especially once interest has been added to complete restitution. We strongly recommend you seek professional advice to assist with this onerous and time-consuming task and to give yourself the best chance of success.
In short, you should NOT have to use up your income, life savings, or even be forced to sell your house to pay for your care IF you meet the eligibility criteria for CHC Funding.
You can request an initial NHS Checklist assessment to determine whether you are eligible for CHC Funding. However, this is just the start of the CHC assessment process, which is complex and can take time. Understandably, the NHS are not renowned for helping applicants through their assessment process either, as inevitably it is not in their financial interests to do so. The same can be said of most care homes, as the rates they can charge self-funders are usually far in excess of what the NHS will pay to fund a successful CHC applicant for the same bed.
Read: Getting started with CHC? How does the CHECKLIST work?
In some cases, we have heard anecdotally and from contributors to our Facebook page, that the NHS assessors have misled applicants and tried to put them off seeking CHC Funding. We suspect this is largely due to ignorance and not fully understanding their own obligations as set out in the National Framework for NHS Continuing Healthcare and NHS– funded Nursing Care, but, if one was being sceptical, it could also be due to the prohibited practice of ‘financial gatekeeping’ to protect NHS funds.
Read: The 10 Most Outrageous Excuses For Not Having An NHS Continuing Healthcare Assessment
If you have been told that you have to pay for your own care, then you must insist on first having an NHS assessment for CHC Funding to ascertain whether you are indeed eligible for free NHS-funded care. If successful, we estimate that there could be an average saving of between £50,000- £65000 a year, if not more in certain areas.
If that fails, then as the next resort, the NHS assessors should look at Funded Nursing Care (FNC) as an alternative to CHC and whether you qualify for that instead.
FNC is paid as a fixed weekly rate, currently £235.88 standard rate, and is a contribution towards the cost of nursing care in a nursing home. Of course, this is substantially less than a full award of CHC Funding (estimated national average £1200 per week) but will still be a welcome contribution regardless, to offset the high cost of nursing fees.
Only after these initial routes have been exhausted should your wealth be considered as part of means-testing to find out whether the local authority have any responsibility to pay for your care. If you have capital or assets over £23,250, then you will have to pay for all your care needs from private funds or perhaps the sale of asset(s), such as your home.
In conclusion, you shouldn’t be misled or pushed down the route of paying for your care until you have first had a CHC assessment to see if you are eligible for CHC Funding. You may be one of the fortunate ones who are awarded this critical source of funding.
Contact us to see if you may be eligible for NHS continuing healthcare funding.
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I am 76 and trying to learn as much as I can about NHS funding for continued health care in advance of my need or my children’s need to actually apply for this funding.