Usually, yes. A dementia diagnosis does not by itself exempt anyone from care fees in England. The standard means test applies: savings and assets above £23,250 mean self-funding (2026/27). The important exception is NHS Continuing Healthcare, which can pay for care in full, without a means test, when someone’s needs are primarily health-driven.
That first paragraph surprises a lot of families, and frankly it surprised us when we started out too. So let’s walk through how the rules actually work, where the real money-savers hide, and why the word “primarily” in that paragraph is doing an enormous amount of work.
Why doesn’t a dementia diagnosis change the funding rules?
Because of a line the system draws between “health care” and “social care”. Health care (hospitals, GPs, nurses) is free through the NHS. Social care (help with washing, dressing, meals, supervision, the things dementia most often affects) is means-tested. Dementia is a medical condition, but most of the support it creates a need for is classed as social care, so most families pay under the same rules as everyone else.
Is that distinction fair? Plenty of people, including several government commissions, have asked exactly that question. We will leave the philosophy to them. Our job is to make sure you know how the rules work today, and every route through them, because there are more than most families are told about.
What does the means test actually look at?
For England in 2026/27, the council’s financial assessment works in three bands (source: gov.uk social care charging circular, published 17 February 2026):
| Your savings and assets | What happens |
|---|---|
| Over £23,250 | You pay the full cost of care (“self-funding”) |
| £14,250 to £23,250 | The council contributes; you pay £1/week for every £250 between the limits |
| Under £14,250 | Savings ignored; most income still goes to fees, minus a £31.80 weekly personal allowance |
One myth to clear up while we are here: there is no cap on care costs. The planned £86,000 lifetime cap was cancelled on 29 July 2024 and nothing has replaced it, whatever an older article or a confident relative may tell you. We have written a full guide to what happened to the care cap.
Now the part that matters enormously for dementia care specifically: where the care happens changes what counts as an asset. For care in your own home, your house is never part of the means test. For a permanent care home place, it usually is, unless your partner (or certain other qualifying people) still lives in it. Since many people living with dementia are cared for by a spouse at home, that single rule quietly protects a lot of family homes, and it is one more reason the care-at-home route deserves a proper look before anyone reaches for a brochure.
When does the NHS pay for dementia care instead?
Through NHS Continuing Healthcare (CHC), and this is the section to read twice.
CHC is a package of care arranged and fully funded by the NHS for people whose needs are primarily health-driven. It is not means-tested. Your savings and house are irrelevant. And it can be delivered in your own home, not just in a nursing home. The catch: eligibility rests on assessed needs, not on the diagnosis itself. A dementia diagnosis alone does not qualify; complex, intense or unpredictable needs might. In practice, people in the later stages of dementia, or with significant health complications alongside it, are the ones who most often meet the threshold.
The process, briefly: a Checklist screening first, then a full multidisciplinary assessment using the Decision Support Tool across 12 care domains, with a decision usually inside 28 days. There is a fast-track route for people who are terminally ill, usually decided within 48 hours. The NHS guide to Continuing Healthcare explains it well, and asking for the Checklist costs nothing. Families are regularly never told this assessment exists, which is why we bring it up at ours.
Two smaller NHS contributions worth knowing: NHS-funded Nursing Care pays £267.68 a week (standard rate, from 1 April 2026) toward the nursing element for people in a care home with nursing, and it is not means-tested either. And district nurses visit at home free of charge, arranged through the GP.
How much does dementia care actually cost?
Care homes charge a premium for dementia care. The UK averages, per carehome.co.uk (updated 30 July 2026):
| Option | Typical cost |
|---|---|
| Residential dementia care home | £1,343 per week average |
| Nursing dementia care home | £1,564 per week average |
| Aims dementia care at home, visits | From £22 per 30-minute visit; 1 hour from £28 |
| Aims live-in dementia care | From £225 per 24 hours, about £1,575 per week |
For early and middle-stage dementia, a familiar home, a familiar routine and a familiar face are not just cheaper than a £1,343-a-week room. Many families tell us the routine itself is the point: same kettle, same chair, same view of the garden. Our carers are dementia-trained, DBS-checked, and turn up as the same faces on a rota, not a rotating mystery cast.
What can bring the bill down?
- Attendance Allowance. £76.70 or £114.60 a week (2026/27), not means-tested, for people over State Pension age who need help with daily living. Someone living with dementia very often qualifies, and it is one of the most under-claimed benefits going. Start at gov.uk, and our funding support team will happily do the form with you. We bring biscuits and unreasonable patience.
- A free council needs assessment. Free regardless of wealth, and it anchors everything else. Surrey adult social care: 0300 200 1005.
- Carer’s Allowance. £86.45 a week if you care for someone at least 35 hours a week (earnings limit applies). One caution: claiming it can affect the cared-for person’s own benefits, so get a free benefits check from Carers UK or Citizens Advice first rather than working it out at the kitchen table.
- The CHC Checklist. Costs nothing to request, and the outcome changes everything if it goes your way.
- Section 117 aftercare, the route almost nobody mentions. If someone was previously detained in hospital for treatment under section 3 of the Mental Health Act, their aftercare services can be free of charge under section 117, without a means test. It applies to a minority of people, but where it applies it changes everything. Ask the community mental health team or the council whether it covers your situation.
- A word of caution on giving assets away. Transferring the house or savings to family to duck the means test is called deprivation of assets, and councils can treat you as still owning whatever you gave away. Please take proper regulated advice before moving anything; MoneyHelper is the free, impartial place to start.
What should you do next?
- Request the council needs assessment (free, any wealth level) and ask about a carer’s assessment for yourself at the same time.
- Ask the GP or social worker for a CHC Checklist if health needs are significant. Put it in writing.
- Claim Attendance Allowance. The form is long; the money is real.
- Compare home care honestly against the care home quote before deciding anything. Our free assessment prices the actual needs, and if a care home genuinely suits better, we will say so.
Frequently asked questions.
Does an Alzheimer’s diagnosis qualify someone for NHS Continuing Healthcare?
Not by itself. CHC eligibility rests on the nature, intensity, complexity and unpredictability of someone’s needs, not the diagnosis. Many people living with Alzheimer’s do not meet the threshold; some, particularly in later stages, do. The free Checklist assessment is how you find out.
If savings are under £14,250, is dementia care free?
Savings are ignored below £14,250, but the means test still assesses income, and most income above the £31.80 weekly personal allowance goes toward fees. The council pays the rest. Truly free care generally only comes via NHS Continuing Healthcare.
Will the council take our house if my husband moves into a care home?
Not while you still live in it. The home is disregarded from the means test while a partner, or certain other qualifying people, remain living there. And for care in your own home, the house is never counted at all.
Is dementia care at home cheaper than a dementia care home?
For visiting care, usually much cheaper: from £22 a visit with us against a £1,343 weekly average. For round-the-clock needs, live-in care from about £1,575 a week is comparable to the £1,564 nursing dementia average, so the decision becomes about routine and familiarity rather than money.
If dementia has arrived in your family and the funding maze has arrived with it, call our Leatherhead team on 01372 386222 or book a free assessment. We will map out the options honestly, including the ones that don’t involve us.
Sources and references.
- GOV.UK, Social care charging for 2026/27, local authority circular, 17 February 2026
- NHS, NHS Continuing Healthcare
- GOV.UK, NHS-funded Nursing Care rates from April 2026
- carehome.co.uk, Care home fees and costs, updated 30 July 2026
- GOV.UK, Attendance Allowance and Carer’s Allowance, 2026/27 rates
- Carers UK, help and advice; Citizens Advice, carers support
- MoneyHelper, Long-term care guidance
- Aims Homecare price sheet, July 2026, at aimshomecare.co.uk/pricing