How Do I Know if My Family Member is Eligible to Claim Back Their Care Home Fees?

Making the decision that your family member needs the additional support that a care home offers, can be a difficult one, not only emotionally but financially too.

The interpretation of the rules around the NHS covering care home fee costs is all important. Many people have been told that their family members are not eligible for this type of funding and make their own arrangements to cover these costs. There may be an opportunity to appeal against that decision and to claim back money you have already spent and get your family member’s care paid for.

It is a common misconception that NHS funding is only applicable to care home costs which is not the case.  It can be applied to care in any setting including your own home.

Where there is a primary health care need, the care received should be paid for by the NHS, regardless of age or financial status.

The first step to be able to claim such funding is to ensure that an assessment is undertaken.  It is from this initial assessment the Clinical Commissioning Group will make a decision as to whether your case should proceed to a full assessment. 

The full assessment is comprehensive and a score will be applied to the needs of your family member in each of the twelve specified care domains. These include factors such as mobility and continence and where a primary health care is identified, care should be funded.

To discuss your family member’s circumstances and the possibility of claiming back their care home fees, please contact Gareth Horner by phone on 01264 353411 or by email on carefees@bsandi.co.uk and he will be happy to talk you through the options.