The high cost of aged care service

by Scott Hyams

Home care service providers are charging the elderly up to 52 per cent of their government subsidy payments for administration, case management and other fees.


The Federal Government provides Home Care Package support via the Aged Care Assessment for elderly citizens who want to stay living in their own homes.


After their ACAT has been processed, a determination will be made as to their eligibility for a home care package, and which package level best meets their care needs.


They will be approved for one of the following levels of Home Care packages. They will be prioritised for care based on their assessed need. The Home Care packages are structured in the following way:

Level 1 Basic needs $8000 per year
Level 2 Low -level care needs $14,500 per year
Level 3 Intermediate care needs $32,500 per year
Level 4 High-level care needs $49,900 per year


Once they have been assigned a package, which may be less than their assessed level, it is the responsibility of Home Care recipients to find service providers.  


Services covered under the Home Care package include:

  • Personal services: assistance with personal activities such as bathing, showering, toileting, dressing and undressing, mobility and communication.
  • Nutrition, hydration, meal preparation and diet: assistance with preparing meals, including special diets for health, religious, cultural or other reasons; assistance with using eating utensils and assistance with feeding.
  • Continence management: assistance in using continence aids and appliances such as disposable pads and absorbent aids, commode chairs, bedpans and urinals, catheter and urinary drainage appliances, and enemas.
  • Mobility and dexterity: providing crutches, quadruped walkers, walking frames, walking sticks, mechanical devices for lifting, bed rails, slide sheets, sheepskins, tri-pillows, pressure-relieving mattresses and assistance with the use of these aids.
  • Nursing, allied health and other clinical services: speech therapy, podiatry, occupational or physiotherapy services, hearing and vision services. Home care level 1 and 2 packages are not intended to provide comprehensive clinical or health services. Home care level 3 and 4 packages have a greater emphasis on delivering complex care in the home, including more clinical care where needed.
  • Transport and personal assistance: assistance with shopping, visiting health practitioners and attending social activities.
  • Management of skin integrity: assistance with bandages, dressings and skin emollients.


  • A home care package may also be used to support the use of:
    • telehealth: video conferencing and digital technology (including remote monitoring) to increase access to timely and appropriate care
    • assistive technology: such as aids and equipment (particularly those that assist a person to perform daily living tasks), as well as devices that assist mobility, communication and personal safety
    • aids and equipment: some aids and equipment that are directly associated with your care needs can be purchased using funds from your package budget. Read more about aids and equipment.

The problem for care recipients is that the service providers may take up to 52 per cent of the government subsidy in administration and case management fees and other fees.


As all the providers have different levels of recipient contribution, and some have entry and exit fees the following comparison is over a four-week period on a Level 2 package of Government subsidy of $40.65 day or $1138.



Provider Administration  Fee Case  Management Fee Total Fees %
RSL Life Care $304.50 $246.00 $550.50 48%
Maclean Care  $284.50 $136.60 $421.10 37%
Go Co $292.99 $297.50 $580.49 52%
Kincare $105.26 $163.87 $269.13 24%
Home Nursing Group

  • Travel fee
  • Service fee
$213.15 $78.25



$451.32 40%


For most care recipients who for whatever reason are unable to source the lowest cost Home Care Provider, the exorbitant fees charged by these so called service providers will essentially mean that care will be substandard and some services which may be a necessity will be unattainable.


The government needs to place a cap on these fees, so that the Home Care Packages can actually do what they are supposed to do enable people to stay at home rather than be placed in Aged Care facilities