healthcare costs

Available funding options to pay for healthcare costs

Jul 31 • Health • 1610 Views • No Comments on Available funding options to pay for healthcare costs

The UK Government recently announced measures to ensure that council funded loans are available to every elderly person going into residential care. Government officials appear to recognise the extreme pressures on the sick and elderly to pay expensive care bills. However many people feel the schemes to help people fall short or are hard to access and so don’t help everybody. In this blog I’ll look at several funding options available to pay for healthcare costs.

Continuing Healthcare

Continuing Healthcare is an NHS funded scheme that aims to ensure the most in need people have their care costs covered. Need is determined by the level of care required, referred to as the ‘Primary Health Need’. The NHS requires this need to be ‘complex’ and ‘ongoing’, to use their terms. The level of need that must be present before Continuing Healthcare can be granted is as follows:

  • One or more priority need
  • Two or more severe needs
  • One severe need together with ‘several’ other needs
  • ‘Several’ high and/or moderate needs

Assessors also separate social and health needs. Social care should be provided by Social Services rather than the NHS. Social Services assistance is entirely means tested. This frequently results in suffers of conditions such as Alzheimer’s being siphoned into Social Services despite degenerative physical issues. In a purely means tested system more people will be liable to pay large care bills.

As you can see the assessments for Continuing Healthcare are somewhat narrow in their view and rely on a check box method that can’t possibly account for the full complexity of individual cases. The number of people who appeal after being rejected for Continuing Healthcare and who are then granted this funding highlights the failings in the assessment process.

However if you’re unsuccessful in your initial application and an appeal that doesn’t mean the end of the line in seeking financial assistance:

Means tested help to fund care

If your primary care needs are insufficient to recommend you for NHS Continuing Healthcare then you can apply for means tested assistance. Your personal assets will be assessed to determine if you must self fund your care entirely, in part or not at all. The threshold for funding is slightly different depending on whether you’re in residential care or not. The current allowances are as follows:

  • Your care will be fully paid for if you have less than £14,250
  • In England assets below £23,250 mean that you’ll have some assistance
  • In Wales that figure is £22,000, in Scotland it’s £24,750 and in Northern Ireland it’s £23,250
  • If you’re moving into residential care those figures should include the value of your home. If you’re applying for home care then they exclude the value of your home.

NHS-funded Nursing Care

It’s possible to be rejected for funding toward complete care in a residential facility but qualify for assistance toward the cost of nursing care. NHS-funded nursing care is open to anyone who doesn’t quality for Continuing Healthcare, has need of a nurse and who lives in a care home.

There are no other clear criteria as eligibility for this funding is assessed at the same time as Continuing Healthcare.

Self-funding your care

If there are no avenues for financial assistance it may seem quite daunting. However there’s plenty of advice on self-funding your care, just be careful who you listen to.

The Government’s new Care Bill requires councils to write to elderly people who are moving into residential care offering them a meeting to discuss all possible funding routes. This meeting will include advice on self-funding.

Beware private services that claim to help people protect their home from care costs. Trust firms claim to help you remove your property as an asset and thus lower your total assets, potentially putting them below the threshold for financial assistance. However a report by the Telegraph revealed that there are hidden catches to these so called ‘trusts’. The fees to set up such a trust could be thousands of pounds- quite a substantial amount if you only have a state pension.

Another reason not to go in for a trust of this kind is that they face being banned by the Government in a bid to crack down on those seeming to avoid paying their rightful care costs.

Many people attempt to hide assets themselves; transferring the deeds of a property to somebody else so it won’t be count toward your assets. However there are several reasons not to do this. For one it might not help. The property might still be counted if it’s clear that all you did was transfer the name on the deeds. Secondly you might not need to resort to this as the property might not be counted if your partner still resides there.

Instead it’s far better to invest your money and make it go further.

The government are also hoping that the councils loans (mentioned at the start of the blog) will make self-funding a less frightening prospect. These will be easy access council-funded loans which allow deferred payment:

Council loans

Your local authority offers loans to elderly people to help pay for their care if they’re entering a residential care facility. You may not have heard of this scheme before because up until now some councils have failed to advertise it properly. That’s set to change. The Government has ordered councils to offer these loans to everybody going into care, sending a letter and inviting them to a meeting.

The loan should be available regardless of your assets say the Government. Previously people may have been refused the loan on the grounds that they appear to have sufficient funds. However the Guardian newspaper reported last year that around 40,000 people sell their homes each year to pay for their care. The idea of a council loan is that if you don’t have enough cash to pay for your care without selling your home you won’t be forced to sell it.

The upshot of that is that the house will eventually be used to repay the loan- that eventual conclusion occurring on the death of borrower.

All in all few of these options sounds that desirable or easy to navigate but the issue of paying for care is at least at the forefront of Government plans. Help is there and now it’s availability is being more widely advertised than in the past.

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