Attendance Allowance in Hospital and Care Homes: The 28-Day Rule Explained

The Core Rule: Payments Stop After 28 Days

If you receive Attendance Allowance and get free inpatient treatment in hospital, it is not payable after the first 28 days of inpatient treatment. Neither the day of admission nor the day of discharge counts as a day of free inpatient treatment. After discharge, Attendance Allowance is payable from the first pay day on or after the discharge date.

The same 28-day rule applies to care home admissions, but with a crucial distinction based on who pays the fees.

Hospital Stays in Detail

The 28-day count is based on days when you receive free inpatient treatment. Day visits, outpatient appointments and A&E attendances that do not result in an inpatient stay do not count.

The linking rule catches people out. If you are discharged and then readmitted to hospital within 28 days of your previous discharge, the two stays are linked — the day count picks up where it left off rather than resetting to zero. This means two short hospital stays close together can trigger suspension faster than a single admission.

Tell the office that pays your Attendance Allowance about a hospital stay as soon as possible. In England and Wales, call the Attendance Allowance helpline on 0800 731 0122. In Northern Ireland, call the Department for Communities on 0800 587 0912. Report the admission date and the hospital name. If you forget and are overpaid, the DWP or Department for Communities can recover the overpayment.

Care Home Admissions: It Depends on Who Pays

This is where the rules diverge.

Local authority funded or part-funded care. If the local authority contributes towards your care home fees — either fully funding the placement or paying a share after a financial assessment — Attendance Allowance stops after 28 days, the same as with hospital. The logic is that the state is already meeting your care needs through the care home.

100% self-funded care. If you pay the full care home cost yourself, you may be able to continue receiving Attendance Allowance. Most benefits usually stop within 28 days if the stay is funded by the NHS or local council. You will need to provide evidence that you are fully self-funding — typically a copy of your care home contract showing no local authority involvement.

This distinction matters enormously. Someone paying £1,000 a week in care home fees out of their own savings can continue receiving Attendance Allowance at the Higher Rate (£114.60 per week), which may also help them qualify for linked benefits like Pension Credit's extra amount for severe disability.

Hospice Admissions

Attendance Allowance can continue during a hospice stay if you are terminally ill and the DWP decision maker has been told. This is a separate rule from the hospital 28-day rule.

Temporary Absences and Respite Care

Short respite stays in a care home (for example, two weeks of respite care while a family carer takes a break) follow the same 28-day rule — if the local authority funds the respite placement, the 28-day clock starts. Self-funded respite does not trigger suspension.

Going abroad temporarily can also affect your claim. The rules on temporary absence are separate from the hospital and care home rules and depend on how long you are away and where you go.

What to Report and When

You must tell the organisation that pays your benefit as soon as possible if you go into a care home for one night or longer. You should also tell it if you stay in hospital. Report:

• Hospital admission (date and hospital name).
• Transfer from hospital to a care home.
• Entry into a care home from home.
• Whether the care home placement is self-funded or council-funded.
• Discharge home (so payments can restart).

Failure to report can lead to overpayments, which the DWP or Department for Communities can recover. Underpayments (for example, if payments were stopped but you were actually a self-funder) can be corrected, but only if you notify the DWP.

The Attendance Allowance Claim Guide covers the care-setting rules in detail, including what documentation self-funders need and how the 28-day linking rule works across multiple admissions.

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