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FAQ’s

Does your service cover the whole of the UK?
No, the funding system and rules in Scotland and Northern Ireland are different and unfortunately, we DO NOT provide any services to patients whose care is being funded or provided in Scotland and Northern Ireland, we only deal with patients whose care is being funded and provided in England and Wales.
Do I have to pay for my long term care?
Currently if you have assets of more than £23,250, you will have to pay for the costs your care, whether that is care in your own home, or in a Nursing or Residential Care Home.The £23,250 threshold will not include the value of your property if your spouse or another dependant is living in your home.BUT – and this is the most important point to understand. If you think you have “primary health care needs”, you should have your eligibility for NHS Continuing Healthcare Funding assessed first.

If you are eligible for NHS Continuing Healthcare Funding, you will not have to pay for your care, regardless of your wealth, the NHS will pay.

For more detailed information about your eligibility for NHS Continuing Healthcare Funding please contact a member of our team, or download one of our helpful FREE Guides.

How does NHS Continuing Healthcare Funding work?
There are two stages to the assessment process. The first stage is called the Checklist Assessment and is usually carried out by a doctor or nurse, either in hospital or in a Care Home. The Checklist assessment looks at a patient’s care requirements in a number of areas and effectively allocates a score to determine the severity of a patient’s health care needs.If the initial Checklist Assessment suggests that a patient may qualify for NHS Continuing Healthcare Funding, then a Full Assessment will be carried out by members of what’s called a Multi Disciplinary Team (MDT) made up of other relevant healthcare professionals.The MDT will undertake a further assessment based on similar healthcare criteria and make a recommendation for eligibility to your local Clinical Commissioning Group, who make the final decision on eligibility for NHS Continuing Healthcare Funding.

You should be aware that we regularly hear from clients that staff within the NHS often suggest that patients won’t be eligible for NHS Continuing Healthcare Funding without undertaking an Assessment. So it is vitally important that you understand your “rights” to an Assessment.

For more detailed information about your eligibility for NHS Continuing Healthcare Funding please contact a member of our team, or download one of our helpful FREE Guides.

Can I deal with the NHS myself?
Yes.You are within your “rights” to request an Assessment of your eligibility to NHS Continuing Healthcare Funding yourself. You can undertake the whole process yourself and our FREE Guides are designed to help you to understand how to work through the process.However, our clients tell us that the process is often difficult and daunting, which is why we offer an Advisory Service to clients, where we act on your behalf throughout the process.

As Martin Lewis says on his Money Saving Expert website

“We don’t normally believe in using lawyers or claims handlers for things it’s easy to do yourself, such as PPI Reclaims, as they take a cut of your payout. Yet, even though we think it’s possible to reclaim care costs DIY, we’re not as militant in this case. If you’re struggling and need help, we strongly suggest using a solicitor rather than a claims handler. But never pay up front, and ensure it’s a ‘no-win no-fee deal’ …….While lawyers are regulated, care costs claims handlers are not (some other types of claims handlers are). If you weren’t happy with the claims firm, all you would be able to do is complain to Trading Standards.”

Martin Lewis – Money Saving Expert http://www.moneysavingexpert.com/family/care-home-costs-reclaiming

We understand the complexities of the Assessment process and use our legal expertise in combination with the clinical expertise of our senior nurses to give our clients the best opportunity to secure funding, including dealing with the Appeals process where necessary.

For more information about our Advisory Service, please do not hesitate to contact a member of our team.

I’ve already had an Assessment and didn’t qualify, or I’ve got an Assessment appointment coming up – what should I do?
If you’ve already been assessed and didn’t qualify for Funding, you should contact us to discuss your Assessment. The NHS should have provided you with a copy of the Assessment and we can advise you if we think that you have grounds to Appeal the decision.If you have a date for an Assessment, you can still contact us and we can arrange to represent you at the Assessment meeting, to give you the best chance of achieving a successful outcome.
How many people qualify for NHS Continuing Healthcare Funding?
The latest statistics from the NHS indicate that 58,000 people currently qualify for NHS Continuing Healthcare Funding, but with 450,000 people currently in care, we think the number of people who should qualify for Funding is much higher – perhaps as high as 150,000.People often miss out on Funding in many circumstances, including:

  • Being discharged from hospital straight into a care home.
  • Those whose eligibility has been assessed and rejected, whose condition subsequently worsened.
  • Those who received NHS Nursing Care – which pays for the nursing, but not accommodation – who never had an assessment for the benefit that would also have paid for their accommodation.
  • More affluent patients who assumed no help would be available. NHS Continuing Healthcare Funding is NOT means-tested so if you qualify for health reasons, you get it.

Don’t miss out.

For more detailed information about your eligibility for NHS Continuing Healthcare Funding please contact a member of our team, or download one of our helpful FREE Guides.

How much do your services cost?
The most common funding option is for us to act for you under what’s known as a Non Contentious Business Agreement (NCBA). Essentially that’s a form of No Win No Fee * agreement, where we will only charge you if we are successful in securing NHS Continuing Healthcare Funding. If we do not secure Funding, then we will not charge you anything, save for the costs of disbursements, for example obtaining medical records.If you are successful, we will charge you a percentage of what your Care Costs would have been had you not qualified for funding. Our charges will only be based on the next 12 months cost of your Care.

In terms of our Retrospective Claims Service, we only offer to provide this service under an NCBA.

We will always discuss all the funding options in detail with you before we agree to act on your behalf, to make sure you choose the option which is best for you.

Remember, we offer an initial assessment of your eligibility FREE of charge, so please contact a member of our team to discuss your initial FREE Assessment.

I’ve already paid for Care – can I claim these costs back?
If you were eligible for NHS Continuing Healthcare Funding but did not claim, or did not know that you were eligible, then you can claim back the costs you have paid for your Care whilst you should have been eligible.We can help you with this process, which involves a retrospective assessment of your healthcare needs.However, the Government has imposed some rules covering claims for previously paid Care Costs. You cannot recover any Care Costs paid before 31st March 2012, unless you had already submitted a claim prior to this deadline.

You should also know that you can recover Care Costs paid after 31st March 2012, on behalf of a relative or friend who may have since passed away.

For more information about our Retrospective Care Cost Claims Service please contact us and speak to a member of our team.

What happens if I don’t qualify for NHS Continuing Healthcare Funding?

Our initial assessments of your eligibility for NHS Continuing Healthcare Funding are always FREE of charge. If we believe that you are not eligible for Funding we will let you know at the outset, or it may be that we are unable to secure Funding on your behalf even after Appeal.

In these circumstances, you will have to pay for your Care, depending on the amount of assets you have.

However, you should remember that you are eligible for re-assessment at any time, if you believe that your healthcare requirements have changed. We will normally keep in touch with you if you are initially ineligible, so that we can advise you on your changing eligibility in the future.

Until then, if you currently have assets over £23,250 (excluding your property if your spouse or other dependant is living in the property) then you will have to pay for your Care.

If your Assets are below the £23,250 threshold then the Local Authority will pay for your Care and is obliged to find you accommodation in one of their Care Homes. (You will still have to pay some costs if your assets are between £14,250 and £23,250 – see our FREE Guides for more detail)

If you have to pay for your own care, there are a number of options open to you in terms of the Care or Residential Home you choose and you may benefit from specialist financial advice to help you plan for the costs of your Care.

In these circumstances please contact a member of our team for some helpful advice.

How can I protect my assets in the future?
There are ways in which you can legally mitigate your future Care Costs. However, if you have an impending need for Care, it may not be possible to mitigate your costs. You should seek specialist legal advice on your circumstances, so please contact a member of our team to discuss your individual circumstances.Often the relatives of patients in Care will recognise the importance of future care planning and it’s a good idea to seek advice early on how you can prevent yourself from having to pay all of your Care Costs in the future, by seeking specialist legal advice, which of course we can help you with.

* – Subject to terms and conditions

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