Why is this important?
Claiming back wrongly charged care costs
Date: 27 July 2012
If you have a relative who is having to pay for their care, they may be charged for care that they should have been getting for free. This includes the costs of care home fees or care they are getting in their own home. It can include fees for any type of care home, whether it's a residential or a nursing home.
When people start to need care, or have to go into a care home, they are often assessed by social services. The care they receive is then means-tested. This means many people are told they have to pay for their care, often having to sell their homes to afford the care home fees.
However, if your relative needs care because of their serious physical or mental health needs, they should be assessed for NHS continuing care. If they are found to need NHS continuing care, this must be provided free of charge, including a free place in a care home or a free package of care. Many people are not aware of this and don't ask for the correct assessment to be carried out.
How to claim back care home fees or other care costs
If you believe that your relative should have been assessed for NHS continuing care but was not, you can ask their local Primary Care Trust (PCT) to carry out a retrospective assessment. This means asking for an assessment going back in time to when they started to need care. In some cases, you can ask for an assessment going back to when their condition got worse, because they would have had greater care needs. You can ask for a retrospective assessment even if the person who needed care has since died.
When do you have to claim by?
There are deadlines for making a claim for a retrospective assessment. These are based on the period of care:
- for care received between 1 April 2004 and 31 March 2011, the deadline is 30 September 2012
- for the care received since 1 April 2011, the deadline is 31 March 2013.
You can’t normally ask for an assessment for care received before 1 April 2004.
Can you make a claim yourself?
You may have been approached by a claims management company who offered to claim back care home fees on your behalf. If you do use a solicitor or a claims management company, you should be aware that although they may take your case on a 'no win, no fee' basis, they are likely to take a cut of about 25% of any care costs you get back.
However, you don't need to use their services - you can make a claim yourself and for free.
Where to get more information and advice
To find out more about NHS continuing care and how to claim back care costs, go to the Age UK website at: www.ageuk.org.uk.
You can also find very useful information about how to ask for an NHS continuing care assessment, including how to find out if one was ever carried out, on the Alzheimer's Society website. They also have a template letter you can use. This information will help you understand the process you need to go through. The information about this is suitable for people with all health conditions, not just Alzheimer's or dementia.
To find out more about how to get NHS continuing care and how to reclaim care costs, go to the Alzheimer's Society website at: www.alzheimers.org.uk.
If you need more help, you can get advice from your local citizens advice bureau.