08. Long-term care insurance Flashcards
When is LT care required?
When a person becomes ill or suffers a disability or mental impairment that makes them unable to carry out their ADLs, with the probability that this disability will continue over the LT.
Significant variation in care by location is referred to as what?
The ‘postcode lottery’.
What does the Care Act 2014 require?
Individuals with savings to pay for their own care.
Name 2 things the NHS is responsible for.
- peoples’ medical & health care at home (through GPs) or in hospital
- prescription drugs (free for > 60s)
What is the NHS generally not responsible for? [2]
Personal or domiciliary care.
For which residents is the NHS responsible for meeting the full cost of care home costs?
Those whose ‘primary need’ for being in a care home is health-based.
(Called NHS continuing healthcare or “fully funded care”)
What other type of care does the NHS pay for?
Nursing care.
Individuals assessed as needing nursing care in a nursing home are entitled to receive what?
An additional nursing care allowance, known as NHS-funded nursing care.
How is NHS-funded nursing care assessed, what is the tax status and what does the amount paid depend on?
- non-means tested
- tax free
- where you live
How is payment for nursing care in the UK made?
Directly to the care home by the ICB.
Where an individual pays for their own care fees, what state benefit can they claim if they need help with personal care and/or supervision?
Attendance Allowance
When is Attendance Allowance available, who is it paid for by and what is it’s tax status?
- from SPA
- by the DWP
- paid tax free
What is the LA 3 step process re the criteria for means testing?
- assess, on request, someone’s care needs
- determine, through a means test or financial assessment, whether the LA should fund or partially fund the care needed
- determine max fee levels
For respite care, a LA is only required to apply the means-test benefit rules after how long?
6 weeks.
What is the personal expense allowance (PEA)?
When assessing an individual’s level of contribution, it is the amount of money a LA must leave a person to cover their personal expenses.
Who sets the personal expense allowance (PEA) and how frequently?
The government, annually.
What are the rules if a person’s assets are between the upper and lower thresholds?
Each £250 of assets (or part thereof) over the threshold is assessed as giving £1 a week of ‘tariff income’.
What are the 2024/25 lower and upper savings limits in the UK?
Lower = £14,250
Upper = £23,250
LAs must use national guidance contained in the Care Act 2014 when taking into account income & assets.
Name 3 incomes that are fully taken into account and 1 that is not.
- pension income
- state benefits
- investment income
- trust income
- letting income
- Attendance Allowance
- earnings
Name 2 things the LA disregards when it comes to assessing assets.
- personal possessions
- the surrender value of insurance bonds where there is an element of life assurance
The value of an individual’s home is disregarded if who is living there?
- resident’s partner, former partner or CP (unless resident estranged or divorced)
- a lone parent who is the claimant’s estranged or divorced partner
- a relative of the resident or member of resident’s family > 60 or child of resident < 18 or is incapacitated
What other circumstance might the LA disregard the value of the property?
Where someone who is not a relative of the individual in care has given up their home in order to live with that individual and provide care.
How long is the value of an individual’s home disregarded for when they enter a residential setting for care?
12 weeks.
If as person’s assets exc their property are worth less than £23,250, the LA cannot force the individual to sell their home. What can they do instead?
Request a charge be put on the property to be repaid on death.
