Could the NHS pay your care home fees? The £70,000-a-year benefit thousands of families don't know about

If you or someone you love needs long-term care, there's one question you should ask before paying a penny.

Could the NHS pay the entire bill?

Money Wellness spoke to Lisa Morgan, lawyer and head of the nursing care fees recovery team at Hugh James Solicitors, to find out more about NHS Continuing Healthcare (CHC), who qualifies and why so many families are missing out.

Lisa's team has recovered nearly £250 million for families who were wrongly denied CHC funding, and she says many people simply don't realise the support that may be available.

What is NHS Continuing Healthcare?

Lisa describes CHC as:

"A fully-funded package of care that some people are entitled to receive as a result of disability, accident or illness."

It’s available to people whose health needs are complex, intense or unpredictable, whether they live in a nursing home, residential home, hospital or their own home.

Care costs are rising fast

Social care helps people with everyday tasks like washing, dressing, preparing meals and living independently.

But the cost of that care is becoming more and more difficult for families to manage.

As Lisa explains:

"The average weekly cost of residential care now exceeds £1,100, with nursing care often far higher. For those with complex or long-term health needs, annual fees can easily surpass £70,000 - rapidly draining a lifetime's savings."

The NHS funding you might not know exists

Many people don't realise there is a form of NHS funding that could cover every penny of their care costs.

Lisa explains:

"If eligible, the NHS pays 100% of care costs - with no means test, contributions, or top-up fees."

CHC covers:

• nursing care
• personal care
• accommodation
• meals
• care provided at home, where appropriate

One of the biggest myths is that NHS funding depends on your finances. Unlike local authority funding, it isn't based on how much money you have and your savings don't determine whether you qualify.

As Lisa explains:

"Eligibility is not means-tested."

Instead, the NHS considers whether your needs are primarily health-related.

People with advanced dementia, neurological conditions or significant health needs may qualify.

Beware of top-up fees

If you don't qualify for CHC, your local authority may help with funding, depending on your finances.

However, Lisa warns that some families are wrongly asked to pay top-up fees, additional payments when a care home’s fees exceed the local authority’s usual rate.

She explains:

"Top-ups should be for lifestyle choices, not a condition of receiving care."

"If your relative qualifies for CHC, no top-up fees should ever be charged."

How do you get assessed?

The process usually involves:

• an initial checklist assessment, carried out by a health or social care professional
• a full assessment by a multidisciplinary team if the checklist suggests a higher level of need
• a final decision by your local Integrated Care Board

If you're refused funding, don't assume that's the end of the matter.

Lisa says many families successfully challenge decisions.

You could even claim money back

One of the least-known aspects of CHC is that families may be able to reclaim care fees they've already paid.

As Lisa advises:

"If your loved one's needs are significant, request a CHC assessment as early as possible.

"Even if the person has been in care for some time, retrospective reviews are available."

In England, these reviews can go back as far as April 2012.

Don't assume you have to pay

If you or someone you love needs long-term care, always ask whether NHS Continuing Healthcare could apply before paying privately.

It could save you tens of thousands of pounds, and in some cases, much more.