This is the question everyone who comes to me is worried about. Do I have to pay for care? With our care system, it would be ideal if the situation was clear for all people. People should have a strong basis of their rights, and of what they have to pay. Sadly, this isn’t the case. Many people are left unsure of exactly what they are entitled to – indeed, if anything at all – but in some cases, you may not have to pay at all.
So to answer the common question “Do I have to pay for care?” it really depends on the situation. Here are the different scenarios commonly faced – and what you are entitled to, or may be expected to pay for.
When social care is actually healthcare.
A lot of people aren’t made aware that social care is not a generic, one-size fits all category for care. Healthcare doesn’t start and end at hospitals. Nursing homes can provide healthcare, as well as social care. Yet, when it comes to elderly people especially, people shrug off healthcare needs as just part and parcel of getting older. This means that many may conflate social care and healthcare, and assume that regardless of situation, if care of any type is required then it has to be paid for. This is not the case. You don’t always have to pay for care.
You don’t have to pay for healthcare.
When a person requires healthcare for a primary health need, then that care should be fully provided for by the NHS. There is a specific care fund available: NHS Continuing Healthcare funding. It is not means-tested. If a person meets the criteria, and is classified as having a primary health need, then their care should be paid for. They do not have to pay at all for the cost of their care, and family members should not be asked to contribute.
You might have to pay for social care.
Social care is not universal. Some people will be expected to contribute towards the cost of their social care, if not all of their care. Social care is not a form of healthcare. Social care, whether that is through a residential facility or home care, is not specialist health support. It is a more general form of support, for people who may need a bit of extra help. This could be help with reminding to eat, checking that someone is looking after themselves at home (such as putting the heating on in winter) or potentially extra help with hygiene.
People may then be asked to contribute to their social care through savings, or even weekly through their pension. The price of their property may also be a contributing factor but this does not necessarily have to be sold immediately. The local authority may be reimbursed when the house is eventually sold – at the discretion of whoever owns the property, for instance, if it is joint owned by two individuals.
Where do third party top-ups come in?
Top-ups are when people are asked to pay additional costs towards social care. In many cases, top-ups are requested when the council should be meeting the full costs of care. Top-ups are voluntary, unless a family is trying to find a care-home or residential facility that goes beyond the individual’s needs. The local council must provide at least one residential place that meets a person’s needs. However, anything beyond that then families would have to pay a ‘top-up’.
A complex system.
It’s not always clear whether an individual may qualify for healthcare funding, or whether their needs are strictly social care. If you have queries about what you or a relative may be entitled to, contact Just Caring Legal today.