Chapter 4: Care provision, other sources of assistance and their costs Flashcards
What is PMI?
Private medical insurance (PMI) is insurance that pays for (or contributes towards) the cost of medical care. Plans can be arranged on an individual basis or through employers as part of the benefit package
PMI plans usually fall into one of three types, what are these?
comprehensive;
standard; and
budget.
What is PMI intended for?
PMI is only intended to cover the cost of short term curable medical conditions.
In general, PMI policies do not cover the cost of treatment of long term incurable conditions (known as chronic illnesses) such as diabetes, dementia and MS. This means that many illnesses that require continuous care would not be covered.
When looked at in terms of their contribution to the provision of continuous care, how helpful is PMI?
PMI policies are unlikely to help long term although they may be able to assist with the acute conditions that cause or perpetuate disability.
What are health cash plans?
Health cash plans are designed to pay a fixed cash sum or contribute towards out of pocket expenses.
Consequently, PMI usually pays the benefits direct to the provider whereas health cash plans pay or reimburse the policyholder
What is a decumulation plan
Plan for how to sell down / release the money in your pension in order to fund care.
How is an employer defined for autoenrolment?
A body that employs at least one member of staff aged over 22 who earns over £10,000 in 2023/24
Why would autoenrollment costs be a consideration when it comes to planning on how to fund care?
it is a cost that needs to be considered, if the person being cared for pays for live-in help where the carer’s only source of income is from the person they are caring for, or their family.
There are potentially wider issues such as National Insurance, but the main point to make is that any auto-enrolment costs could contribute to the costs of providing care for someone.
What is the cost of providing care in your own home restricted to?
The equivalent cost of a residential care home placement.
The cost of care provided by an agency in an individual’s home will vary depending on, what?
- geographical location;
- nature of the care service;
- frequency/duration; and
- whether care is required during the day or night.
What is an assistive device?
A tool or implement that makes a particular function easier to perform for a disabled individual.
Where there is an assessed need, the social services department of the local authority has an obligation to provide services to support disabled people. What is the cost of equipment that social services must provide for free?
minor adaptations – defined as costing £1,000 or less – must be provided free in England. Above this amount, local authorities are able to take their own resources into account, which means a charge may be made.
What are first party top-ups?
Where the person requiring care is able to pay a ‘top up’ for their preferred accommodation from their own resource.
What are the circumstances whereby a first party top up is allowed?
The person is subject to a 12-week property disregard. This would allow them to take up a place in accommodation that is more expensive than the local authority maximum for the duration of this twelve-week period;
The person has a deferred payment agreement (DPA) in place with the local authority. This follows the principle that by entering into such agreements, the individual has greater scope to fund more expensive care once the value of the home is realised.
The person is receiving accommodation provided under S117 for mental health aftercare.
What is a third party top up?
If an individual who requires care selects a more expensive care home than the local authority would normally provide based on their assessed needs, someone (such as a relative) can pay the difference between the care home fees and the local authority contribution.
