Get the home care funding you need with expert help on the My Aged Care process

Most Aussies would agree that their homeland is the lucky country – not least because in Australia, we’re not left to fend entirely for ourselves in our later years.  There are various supports available for Australians who want to grow old in their own home and this support is increasing.

If you’re accessing that support for the first time, for yourself or an older family member, the layers of funding for aged care at home (or, indeed, at a residential facility) can be complex and confusing.

Fortunately, there are organisations such as Anglicare Southern Queensland, that employ aged care experts who know the federal government’s My Aged Care system like the backs of their hands and are ready to help you access the funding you or your loved one needs.

Catherine Hewett, an aged care consultant at Anglicare, explains that there are a series of steps you need to take to obtain financial assistance with the cost of home care – the service with which most people entering the aged care system start. She talked Starts at 60 through the process.

Who’s eligible for funding?

There are two main types of home care funding in Australia: Commonwealth Home Support Program (CHSP) funding and Home Care Package (HCP) funding. You’re eligible to apply for funding once you turn 65, or 50 if you identify as an Aboriginal or Torres Strait Islander person. To ascertain which funding is most appropriate for your circumstances, your first step is to get in touch with My Aged Care.

You can learn more about My Aged Care on its site, but in brief, My Aged Care is the first port of call for all Australians who hope to access government-funded, government-regulated aged care services. If you prefer to leave an enquiry message and have a My Aged Care expert call you back, there’s an online form that allows you to do so. You can also refer a family member or even a friend or neighbour to My Aged Care, if you prefer not to be personally involved in obtaining care for them.

Contacting My Aged Care

Contacting My Aged Care is easiest to do by calling 1800 200 422 from Monday-Friday 8am-8pm and Saturdays 10am-2pm. If it’s the first time you’ve contacted My Aged Care, you’ll need to go through a quick registration process over the phone.

You’ll need your Medicare card with your individual identity number on it during the registration process, so if you’re calling on behalf of a family member, make sure you have their Medicare card handy. If your loved one is already registered with My Aged Care, it’s important that you have their My Aged Care number to hand.

During this phone call, a brief verbal assessment (involving about five simple questions) will allow the My Aged Care consultant to determine whether an in-home assessment for a CHSP package or a HCP will be required.

If you’re directed to CHSP

The Commonwealth Home Support Program funds home care for people who have a lower level of care needs or need only temporary assistance, such as while they recover from an illness, injury or surgery.

“This could be suitable for someone who no longer has their drivers’ license but needs some transport,” Hewett says as an example of the type of care the CHSP provides. “It could also be some general gardening or domestic assistance too – the main thing is, it’s an episodic need, rather than an ongoing need.”

If, following your My Aged Care phone assessment, you’re directed to the CHSP, you’ll receive a home visit from a specialist assessor from the Regional Assessment Service (RAS).

During this visit, you can let the assessor know if you have a preference for which organisation provides your home care service, and your RAS assessor will communicate directly with that service provider to organise your care.

Unlike HCP funding, CHSP services don’t involve means testing, so all eligible applicants receive the same basic amount of funding from the government for the services they require. The cost to you or your family member for the service will vary somewhat depending on the home care provider you choose, but only by a relatively small amount, Anglicare’s expert says.

“They’ll be expected to pay a co-contribution of around $10 per service they receive,” Hewett explains. “The remainder of this cost is subsidised by the department.” 

If you’re directed to a HCP

If your telephone assessment determines that your own or your loved one’s needs are of a higher level or are likely to be ongoing, an Aged Care Assessment Team (ACAT) assessor will visit your home to gather more information on the help you require.

“With this assessment, [the assessor] will deem whether the client’s needs are one of four different levels: level one, two, three or four, with one being the lowest level of need and four being the highest,” Hewett says. “[The assessor] may actually decide to put the client on the CHSP in the short term, until the government has the funding to provide them with the higher level of care they need, so the client isn’t waiting for any extended period of time without care.”

(You can read more on the specifics of the four levels of needs below.)

Meanwhile, you or your family member will need to complete an income and assets test with Centrelink to determine what proportion of your home care costs will be covered by HCP funding.

“Once you fill out an income and assets form with Centrelink, they will then advise your service provider what amount you are required to contribute towards that Home Care Package,” Hewett says. “For example, if you’re on a full pension and you have no other income streams, it’s more than likely that your contribution would be zero.”

The maximum contribution for people assessed to have sufficient means to contribute to their own care is about $24 a day, she adds.

Once these assessments of needs and finances have been made, you or your loved one will be placed on a waiting list to receive a HCP.

Hewett notes that service providers are not privy to the waiting list, nor all of the factors My Aged Care uses to decide a person’s place on the list. She says, though, that there’s some geographical influence on the waiting list because the government spreads its funding across the country so, in theory, living in an area where there is high demand for care services could mean a longer wait.

“I know the department will look at factors such as, does the person have a carer? Do they live alone? Are they socially isolated? Are they at risk of harm or self-harm? Do they have a chronic condition? Do they have a chronic, life-limiting condition?” she explains. “There are a number of different factors that will determine where the client’s placed on the waiting list [and] that results in whether they’re waiting for one month, up to possibly nine months, for funding.”

Understanding the four levels of needs

The amount of subsidised care your or your family member are eligible to receive is based on which level of need the ACAT assessor determines is most appropriate, and thus the amount of funding that you’re allocated.

Level one is designed to cover basic care needs, level two low-level care needs, level three intermediate care needs and level four high-level care needs.

Hewett says that, roughly speaking, a level one home care package provides approximately $8,200 worth of services per year, rising to approximately $15,000 for a level two, $33,000 for a level three and $50,000 for a level four.

Although some may consider this to be a significant amount of funding, at times, this may not provide adequate support for an individual to remain living at home.  “Level four is the highest level you can go to before being recommended to transition into residential aged care,” she adds.

Are there any other costs?

Since July 1, 2014, the government has permitted home care providers to charge what’s called a basic daily fee (BDF) to clients who receive a HCP. BDFs aren’t income-tested and can be up to 17.5 percent of the basic rate Age Pension received by a single person, with the charge adjusted in March and September each year when the pension itself is adjusted in relation to prices and wages data.

The current maximum BDF is $10.43 for every day you hold a HCP (not every day you receive a service), but the money isn’t kept by the home care service provider. Instead, it’s added to the amount of funding you’re allocated by the government, in case you need to purchase extra care.

That means your BDF payments aren’t necessarily used immediately but accumulate over time, and are reimbursed to you or your estate when you stop using care services.

Hewett explains that Anglicare scrapped its BDF because it found that only a small number of clients used the extra funds they were accumulating.

“We made a decision that for the majority of our clients who live fortnight to fortnight on a pension, that money is better spent with day-to-day living expenses, such as food, medication, things like that,” she says.

How can I pay?

Your home care provider is the collection point for your contribution to your care costs, with most providers requiring fortnightly payment. These funds are passed from the provider to the government, and the government is then responsible for paying the full cost of your services to your provider.

Hewett acknowledges that, unless you live and breathe aged care funding, the system can seem complex. But Anglicare provides a free, no-obligation Concierge Service that offers advice on applying for funding and organising care services, with the advice customised to meet you or your family’s needs.

“Our concierges will support you through the process of understanding service offerings and determining which support you need,” she says.

Have you accessed the My Aged Care system? Did you find it straightforward or was it difficult for you to navigate? Are you happy with your outcome?

IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesn’t take into account your financial or legal situation, objectives or needs. That means it’s not financial product or legal advice and shouldn’t be relied upon as if it is. Before making a financial or legal decision, you should work out if the info is appropriate for your situation and get independent, licensed financial services or legal advice.