When the time comes to consider long-term residential or nursing care, one of the biggest concerns for families is the financial side. The nursing home support scheme cost of care can feel overwhelming, but the Irish Government introduced the Fair Deal Scheme to make this process more manageable. In this guide, we break down exactly how the scheme works, who qualifies, and what you should expect when it comes to the cost of care.
What exactly is the Nursing Home Support Scheme?
The Nursing Home Support Scheme, more commonly known as the Fair Deal Scheme, is a government initiative that helps people meet the cost of long-term nursing home care. Instead of paying the full fees yourself, the scheme allows you to contribute based on your means (income and assets), while the State pays the balance.
Its goal is to ensure that everyone who needs nursing care can access it without being placed under unreasonable financial strain.
Who is eligible under the Fair Deal Scheme?
To qualify for the scheme, you must:
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Be ordinarily resident in Ireland.
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Undergo a care needs assessment to confirm that long-term nursing home care is required.
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Undergo a financial assessment to determine how much you are required to contribute.
There is no strict age limit, but the majority of applicants are older adults who can no longer live independently.
How is the cost of care calculated under the scheme?
The nursing home support scheme cost of care is based on two main factors:
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Care needs assessment – This confirms that nursing home care is necessary.
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Financial assessment – This determines how much you must pay towards your care.
Under the scheme, you are expected to contribute:
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80% of your assessable income (such as pensions or rental income).
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7.5% of the value of your assets per year (up to a capped amount and limited to three years for your family home).
The State then covers the shortfall between your contribution and the approved cost of care in your chosen nursing home.
What costs will you still have to cover?
The Fair Deal Scheme covers the basic cost of care, which generally includes:
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Nursing and personal care
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Bed and board
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Basic laundry services
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Routine aids and appliances
However, you may still need to pay separately for:
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Social activities and outings
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Hairdressing and personal grooming
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Specialist medical services not included in standard care
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Certain therapies or upgraded room options
It’s important to confirm with your nursing home what is included in the approved fee and what extras may apply.
How does income and assets affect your contribution?
The financial assessment reviews both your income and your assets:
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Income – You will usually contribute 80% of your weekly income (for example, your State pension or occupational pension).
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Assets – You may need to contribute 7.5% of the value of assets per year, including savings, investments, or property.
Special protections are in place for the family home:
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Only 7.5% per year is assessed, and this is capped at 3 years (so a maximum of 22.5% in total).
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If a spouse, partner, or certain dependants live in the home, additional safeguards apply.
This structure ensures fairness while still making care accessible.
What happens if your circumstances change?
Life circumstances can change, and the Fair Deal Scheme accounts for this. If your:
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Income decreases (e.g. loss of a pension), your contribution can be reassessed.
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Assets are reduced or sold, this must be declared, and your contribution may change.
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Health status changes, the level of care required might also be reassessed.
Always inform the scheme administrators of significant changes, as this can reduce your required contribution.
How to apply and what to expect
The application process has three stages:
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Care needs assessment – A healthcare professional assesses whether long-term care is appropriate.
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Financial assessment – Your income and assets are reviewed to determine your contribution.
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Approval and placement – Once approved, you can select an approved nursing home. The HSE pays the balance directly to the home, while you contribute your share.
You’ll need documents such as proof of income, bank statements, and details of property or savings. Processing can take several weeks, so applying early is recommended.
Tips to minimise or manage your cost of care
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Plan early – Understanding the rules before care is needed can prevent last-minute stress.
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Seek advice – Professionals like Fair Deal Advice can help you navigate assessments and protect your assets.
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Understand what is included – Clarify which costs are covered and what extras may arise.
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Keep records updated – Ensure all income, savings, and property details are accurately declared.
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Review regularly – Your contribution can be reassessed if circumstances change.
Summary & Key Take-aways
The nursing home support scheme cost of care is designed to ensure fair access to long-term residential care. Under the Fair Deal Scheme, you pay a contribution based on your means, while the State pays the rest. While it doesn’t cover every extra expense, it greatly reduces the financial burden for families.
For tailored guidance and to make sure you don’t pay more than you need to, professional advice can make a significant difference.
Frequently Asked Questions (FAQs)
Q: What is the difference between the Nursing Home Support Scheme and the Fair Deal Scheme?
They are the same. The Nursing Home Support Scheme is the official name, while the Fair Deal Scheme is the commonly used term.
Q: If I have limited savings, will I still need to pay under the scheme?
Yes, but your contribution will be based only on what you can afford. If your income and assets are low, the State covers the majority of the costs.
Q: Can my contribution increase over time?
Yes. If your income or assets rise, your assessed contribution could also increase. However, the 7.5% annual charge on your home is capped at 3 years.
Q: What happens if I disagree with the financial assessment?
You can request a review or appeal if you believe the calculation is incorrect or unfair.
Q: Can I switch from private care to the Fair Deal Scheme later?
Yes. You can apply to the scheme at any stage. Once approved, the State begins contributing towards your care costs.
Q: How often is my payment or contribution reviewed?
Your situation is usually reassessed if your financial or personal circumstances change, or if you request a review.
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