If you need long-term residential care in a hospital or rest home, you may be able to get a Residential Care Subsidy() from Te Whatu Ora – Health New Zealand.
To qualify for Residential Care Subsidy you need to:
1. Be a NZ citizen or resident, 65 years or older, some people aged 50-64 may also qualify.
2. Have a needs assessment that confirms you need care in a rest home or hospital indefinitely.
3. Meet the Ministry of Health eligibility criteria for publicly funded services. This is a complex area. As a general rule you are eligible if you are a NZ resident and receive a NZ Work and Income benefit.
4. Meet the financial criteria of the income and asset test administered by Work and Income on behalf of Ministry of Health.
5. Receive services provided by a certified rest home or hospital with a District Health Board (DHB) contract.
Residential Care Subsidy is not available for convalescent care or Accident Compensation Corporation clients.
The Work and Income Residential Subsidy Unit at Whangarei process financial means assessments for residential care for all New Zealand. You can phone them on 0800 999 727 or look at information on the Work and Income website().
People in receipt of Residential Care Subsidy are required to pay NZ Super towards the cost of their care. They may also have to pay an income contribution such as interest from assets or 50% of private super payments. Any agreed additional costs eg ensuite, are not publicly funded.
Your home counts as an asset for single people or couples where both are in long term residential care. If you are not financially eligible for Residential Care Subsidy, have other assets of $15,000 (per person) or less, you can apply for an interest-free Residential Care Loan().
You arrange a loan by completing a financial means assessment in the usual way then answering additional questions specific to the loan. If you qualify, Ministry of Social Development (through Work and Income) will ask you to sign a legal contract called the ‘Residential Care Loan Agreement’. There is a cost for the legal work involved in loan setup.
The loan is usually secured over your home by a caveat registered against the title. The loan is repaid when your home is sold, or within twelve months from your estate.
Application forms are provided as part of the needs assessment process. Work and Income require the Needs Assessment Certificate to be filled in before they process the form. It is a good idea to make copies of the application and any related documents. It is your responsibility to send to the Centralised Processing Service via:
Post: Residential Subsidy Unit, Private Bag 9032, Whangarei 0148
Courier: Level 2, Rathbone Business Centre, 49 - 53 James Street, Whangarei 0110
Or you can take the forms to your local Work and Income Office and they will forward your documents to the processing unit.
Payment can be backdated 90 days from the time application is received by Work and Income. You are responsible for the cost of care until subsidy / loan payments begin. Discuss with care provider if this is a problem.
Once assessed as meeting the criteria for residential care, you can test your eligibility for Residential Care Subsidy / Loan at any time through Work and Income.
If you receive residential care subsidy / loan most of your NZ Super is paid to the care facility. You can arrange an automatic payment from your bank account or ask Work and Income to pay it directly to the facility. The rest of your NZ Super will be paid to you as a fortnightly personal allowance. You also receive an annual clothing allowance paid in April each year.
It may be possible to claim subsidy / loan into a retirement village Occupation Right Agreement unit certified for rest home or hospital level care. These are sometimes known as ‘Care Suites’. Eligibility criteria apply. Providers of this type of care must refund the resident the accommodation portion (18%) of the District Health Board Maximum Contribution rate. Please seek advice on how well this arrangement meets the needs of your family member.