Should you continue to pay for care whilst undergoing a Continuing Healthcare assessment?
If you are claiming for Continuing Healthcare funding on an ongoing basis, i.e. the individual is still alive and there are no previous assessments, we will be looking to secure NHS Continuing Healthcare funding going forward from the date of approval. Therefore, if there are any current or previous care costs incurred, these should be paid by the client.
It is only when a positive Decision Support Tool assessment has been carried out and ratified and the decision confirmed in writing, that the Integrated Care Board (ICB) will start to pay the fees. The individual will be notified of this and can stop self-funding.
Learn more: What is the Decision Support Tool?
What about appeals?
With appeal cases, the situation is similar – individuals still have to pay the fees – but they will be reimbursed if the decision at the appeal is overturned, usually from the date of the DST, until present or until another assessment is carried out.
With retrospective claims where the client is deceased, families will need to pay the outstanding amount and if – after assessing the medical records – we believe they should have been eligible for NHS continuing healthcare funding during their lifetime, we would try to claim back some or all of the amount paid.
Learn more: How do I appeal a continuing healthcare decision?
Unsure if you or a loved one qualifies?
If you think you or a loved one may be eligible for CHC funding, don’t delay. We’re here to guide you through every step.
Submit an enquiry to get started.
