Health Insurance Fair Deal - Expert Advice needed to decide whether to take it up

[cody101]

Expert help needed both off and online!
We have been back and forth trying to decide whether to go on fair deal or not for our mother. We get very limited, unhelpful, curt answers from the lady we are dealing with in the HSE. And a lot of what she says contradicts info here. Are there any financial advisers offering expert Fair Deal advice that we can visit to talk over options? We have tried calling a number to no avail. None deal directly with FD.

OUR SITUATION: (any help appreciated)
Last October our mother was approved for the Fair Deal. She was assessed as having a total contribution of 1366 (664 income, 10 cash assets and 692 assessed on her PPR).
As our planned nursing home was 1200, we asked would she just pay that (not 1366) and we were told in no uncertain terms that no - she will have to pay the full 1366 - and that the line about not paying more than the cost of care is to do with the lifetime of the contributions - it made no sense to me, but she threatened to hang up on me when I questioned the logic.

From what I'm reading here - our mother wouldn't take up or be offered the FD option at all - but we could apply for a lower loan - is that right?

She did tell us that the 3 year period for the PPR under Fair deal applies from first entering the home - so any time she can pay for herself will save in the long run. For that reason when she entered a nursing home in March this year we paid privately to buy time - paying from
savings at 1300 a week privately. Fairdeal price is 1200.

Her savings are depleting but we are looking at renting out her house and possibly supplementing her cash with ours.

Questions we cannot find answers on:
1. Any experts we can visit to get advice on this please?
2. At current rate of assessment - she would not get any support but could apply for a smaller loan?
3. If she is on Fairdeal - you are assessed on after-tax income. If you then get a lump sum tax refund the following year for the contributions she makes- how does the HSE treat that - as Income or Assets? (This would make a big difference to her available cash)

Thanks so much to anyone who can shed light on this. I am actually in Australia and trying to sort this out with my sisters - who are exhausted.

 

[elcato]

She was assessed as having a total contribution of 1366 (664 income, 10 cash assets and 692 assessed on her PPR).

Is this weekly ? She is on a pension of around 800 a week ? In 3 years time she will only be assessed on her income and cash in bank. Given that the cash will be depleted by payments at that stage, this will reduce her contribution a good bit and makes sure that if prices go up in the nursing home you are insulated to a degree.

 

[twofor1]

Her savings are depleting but we are looking at renting out her house and possibly supplementing her cash with ours.

Questions we cannot find answers on:

2. At current rate of assessment - she would not get any support but could apply for a smaller loan?

Being a landlord is a headache and might not be as financially advantageous as you think as net rental income will be assessed at 80% under Fair Deal.

Had you mother applied for Fair Deal and the loan last October and assuming she lived for 3 years, then €692 x 156 weeks would be owed.
If she applied for Fair Deal and the loan now then €692 x maybe 110 weeks or thereabouts would be owed, so yes she would be applying for a smaller loan if she opted for Fair Deal rather than private now.

 

[Slim]

As our planned nursing home was 1200, we asked would she just pay that (not 1366) and we were told in no uncertain terms that no - she will have to pay the full 1366 - and that the line about not paying more than the cost of care is to do with the lifetime of the contributions - it made no sense to me, but she threatened to hang up on me when I questioned the logic.

@twofor1: can you clarify this 'no one pays more than the cost of care' versus '..lifetime of contributions'?

 

[twofor1]

Hi Slim, I can’t clarify but my opinion is the lady from the HSE is not correct.

My understanding is no one pays more than the weekly / monthly cost of their care. I have never heard of the ‘’lifetime of contributions argument’’

I was surprised by this HSE response but without searching I could not readily back up my opinion so did not comment on this issue.

 

[Slim]

@twofor1: I agree, she is not correct. I have looked at the Act of 2009 and the HSE's Guidance booklet and checked with HSE FD office and it is clear that if financial assessment is higher than NH costs, the applicant simply pays the NH fee directly and the 3 years runs parallel.

However, if the applicant does not have the cash to make the NH payment directly and wishes to avail of the Ancillary Support, I think they would have to pay/owe the higher amount. One can't have it both ways.

 

[AlbacoreA]

This is my understanding.

Its 80% of income, then 7.5% of cash assets above 37k, (includes all property if not your principle home) then 7.5% of your PPR home capped for 3yrs.

If you meet the cost of care from income, they don't go to the next source. otherwise they keep going to the next one.
You can defer the 7.5% from property, as a loan paid later.
If there is a shortfall after all sources, then the HSE fund the shortfall.
If you can fund it from say just income, then they don't include the cash assets, or the PPR. and the HSE don't fund anything.

If you have say no income, but you have say property other than your PPR, (imagine 3 houses)
they take 7.5% until your cash assets are down to 37k. Its not capped at 3yrs. Only the PPR is capped at 3yrs.

If someone is going to live a long time in care, then you have to consider you will end up paying a lot of the cost yourself if you have cash assets to do so.
If all you have is modest pension and your own house they take 80% every year and only the 7.5% for 3yrs.
If you have no income or assets it will be paid for you.

Also consider that if its a private nursing home, and also if you don't have a medical card, you may have a lot of extra expenses other the the base cost of the nursing home. If its public pursing home, or you have a medical card, probably not that much extra costs.

I'm open to correction on all this. Its a bit confusing. I think that assessed income is a very confusing phrase how they use it.

There's also something about if you paid for 3yrs care before you enter the fairdeal, it means the PPR is excluded from the fair deal from the start. I could be wrong about that.

 

[AlbacoreA]

The other issue is with GDPR, many advisers, banks etc. are reluctant to talk to family about their parents financial affairs.

 

[AlbacoreA]

I don't know how the different costs of a private nursing home, or a public one, are factored into the calculations.

 

[T McGibney]

The other issue is with GDPR, many advisers, banks etc. are reluctant to talk to family about their parents financial affairs.

I can't for a second imagine how that could be so, in the case of professional advisers giving advice in a confidential setting?

Banks don't give advice anyway, as they'll tell you sharpish whenever anything goes wrong.

 

[AlbacoreA]

Its not the kids data its their parents. By the time you need this advice the parents are unable to attend these meetings. Which is why you should plan for these things in advance. Usually only done when there is a medical crisis.

 

[sooty]

"Nursing Homes Support Scheme
Information Bookle
t
7

Finally, there are important safeguards built in to the Financial Assessment
which are worth noting.
(a)
Nobody will pay more than the actual cost of care."


Taken directly from the Booklet


What area specifically are you looking for information on - i have gone through the Fair Deal process twice if you want to PM me - i might be able to give you some answers.

Sooty

 

[twofor1]

However, if the applicant does not have the cash to make the NH payment directly and wishes to avail of the Ancillary Support, I think they would have to pay/owe the higher amount.

Hi Slim, I think that even those who apply for the loan do not pay more than the cost of their care.

The amount assessed on the family home is the maximum that can be borrowed. When that full amount is not required, the loan reduces to meet the cost of care.

In cody101’s case the amount assessed on the house is €692, if they were to avail of the loan only €526 would be needed, so this is the amount that would be borrowed weekly. (Note the assessed amount on income and other assets remain unchanged)

Cody101’s mother would then be borrowing €526 on the house which the HSE would pay to the nursing home, together with the €664 assessed on income and €10 on cash assets equals the €1200 weekly charge.