Are you eligible for NHS continuing healthcare?
Who is eligible for NHS continuing healthcare?
NHS continuing healthcare is a
package of care arranged and funded solely by the NHS, which can be
received in hospital, a nursing home or at the individual’s
home. This is often described as ‘fully funded care’.
If you demonstrate a primary health
need then the NHS must pay for your care in full, regardless of
your personal wealth. To qualify, you must demonstrate your needs
are:
- Complex, intense or
unpredictable
- Not incidental or ancillary to the
accommodation your local authority is under a duty to provide
or
- Not of a nature typically provided
for by a social services department.
Where the primary need of the
individual is a health need, then the responsibility is that of the
National Health Service.
Therefore, if someone is in a
nursing or care home because of physical or mental health needs
they may be paying fees that should be funded by the NHS.
What if you are not eligible for
NHS continuing healthcare? The capital limits.
It is the local authority (social
services), rather than the NHS who are responsible for the care.
Unlike the NHS, social services are able to assess the individual’s
ability to pay. This will mean that they do a financial
assessment.
If a person has savings which
amount to more than the upper capital limit (set out by the
National Assistance (Assessment of Resources) Regulations 1992 as
amended), they have to pay the full cost of their care home
placement until their savings reduce to that amount. The capital
limits are different in England and Wales.
In England and Wales
the upper capital limit is £23,250. Savings of less than
£14,250 are ignored. A person who is in between the capital limits
will have to make a contribution to their care costs on a tariff
rate depending on how much they exceed the minimum.
Your savings include any money in
bank and building society accounts, stocks and shares, and property
(land and buildings). Any joint ownership is counted according to
that person’s share.
If you are not eligible for NHS
continuing healthcare and you are receiving care in a care home
that provides nursing care, you should receive NHS funded nursing
care which is a contribution towards the nursing home fees.
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more.
