Making a Claim for Care Home Fees

If you are paying for your own care, or paying for care on behalf of another individual then you may be able to reclaim these fees and ensure you get free care in the future too. We are fortunate enough to have available to us the National Health Service which provides publicly funded health care to all individuals in the UK, free at the point of use.

When an individual is in a nursing or care home, if that person’s primary need is determined to be a ‘health need’ then the NHS should provide free health care so the NHS should pay the individual’s care home fees.

If their health needs are determined to be “incidental to” or “ancillary to” their accommodation needs then it is the local authority Social Services Department who will organise the care home placement and payment for care home fees is means tested and may be the individual’s responsibility to pay or contribute toward.

This system can lead to individuals being wrongly assessed, or not assessed at all for NHS funding. As a result individuals may be paying huge sums of money in care home fees when all along the services should be provided free by the NHS.

Am I eligible?

The earliest date you can consider reclaiming fees from is 1 April 2012.  The NHS deadline has now passed for submitting a claim for reimbursement of fees for any dates prior to 1 April 2012.

Care home fees can be reclaimed on behalf of both living and deceased individuals as the claim for free NHS care can be made retrospectively. To be eligible to claim the individual’s health needs must be:

  • Complex, unpredictable or severe / intense; and
  • Not incidental to the accommodation the local authority is under a duty to provide.

In 2007 the NHS produced national guidance for Primary Care Trusts (PCTs) to use when determining an individual’s eligibility for free NHS care. Our Solicitors and Nurses will be able to advise you on potential eligibility for free NHS care.

Who can claim?

In most of these cases the individuals involved are not well enough to deal with the matter themselves. Please contact us to find out if you can pursue a claim for repayment of fees on behalf of a relative or other person who is in care.

How are these cases funded?

Retrospective claims for repayment of care home fees are usually funded by a contingency fee agreement, also called a No Win – No Fee agreement). We will be happy to advise you about your options when you contact us. We do not charge unless you win. You need have no worries over legal fees.

What should I do now?

Please contact us. Our Solicitors will be able to provide you with expert advice about your potential claim for repayment of care home fees.

For further information please contact Laura Nabozny 033 3344 9600, or complete our online enquiry form.

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