The system explained
My Aged Care, home care packages, residential aged care, the means test. The path through, in plain English.
My Aged Care, home care packages, residential aged care, the means test. The path through, in plain English.
The first time I called My Aged Care, I was on hold for forty-six minutes, then got cut off. The second time, I got through to a person who asked me to confirm Mum's Medicare number, which I didn't have on me, and I had to call back. The third time I got through, did the registration, scheduled the assessment, and the woman on the phone said something that helped: "Most people only ever do this once. The system is designed for repeat users, but you're not one. Don't beat yourself up that it's not obvious."
She was right. The Australian aged care system is not obvious. This module is the map.
Everything starts with My Aged Care. It is the federal entry point for all government-subsidised aged care in Australia. Home help. Home care packages. Residential care. Respite. The lot.
You cannot skip this step and go directly to a provider. You can pay for private services without it (a cleaner, a private nurse), but anything subsidised flows through here.
What to have ready before you call:
You can register on her behalf if she's given you verbal consent. The call taker will note it. If she's in the room, even better; they may want to speak to her briefly to confirm.
A practical note: have your parent in the same room or on speakerphone for the first call. The system needs her voice on record. Otherwise you'll be asked to call back.
Once registered, the system funnels you into one of two assessment teams, depending on what level of help is needed:
Most parents start with RAS, then escalate to ACAT when needs grow. Some go straight to ACAT if there's been a hospital admission or a clinical referral.
Two real things to know about the assessment:
The middle tier of the system. Subsidised in-home support, paid as a budget the parent (or you, on her behalf) directs.
(Numbers approximate, indexed annually.)
The package pays for: personal care (showering, dressing), domestic help (cleaning, laundry), transport, meal prep or delivery, allied health (physio, podiatry, OT), some equipment, some home modifications. It does not pay for: rent, mortgage, utilities, food itself, holidays, or anything not care-related.
A package is administered by an approved provider. The provider takes a management fee (typically 10-30% of the package). This is the single biggest variable in how much actual care your parent gets. A provider with a 30% management fee on a Level 3 package is taking $12,000 a year off the top.
Push for a low-management-fee provider. Look at the My Aged Care provider directory. Ask the fee directly. Don't accept "around 20%, it depends" as an answer. Get the percentage in writing before signing.
The wait time for a package, after ACAT approval, is the part nobody warns you about: typically 3 to 12 months for level 2, longer for higher levels. This wait is shrinking as the system reforms (the Aged Care Taskforce 2024 reforms have the pipeline being cleared faster), but plan for it. While you wait, CHSP through RAS is the holding pattern.
The other end of the spectrum. Full-time care in a facility.
Three financial gates to clear before placement:
1. ACAT approval for residential care. No approval, no admission to a subsidised place.
2. The means test. Centrelink (or DVA) assesses your parent's assets and income. The result is a daily means-tested care fee, capped annually and over a lifetime. This sits on top of the basic daily fee everyone pays.
3. The accommodation cost. This is the big one. Either paid as a Refundable Accommodation Deposit (RAD), a lump sum (typically $300,000 to $700,000, refundable when the parent leaves or dies), or as a Daily Accommodation Payment (DAP), an interest-style daily charge on the equivalent of the RAD, or a combination of both.
The RAD vs DAP decision is one of the most consequential financial calls in aged care. Get a Centrelink Financial Information Service (free) appointment and an aged care financial adviser before deciding. The wrong call costs $30,000-$50,000 over a typical 2-3 year stay.
Wait times for residential care vary wildly. A high-demand facility in a desirable suburb has 6-18 months waits. A facility you'd be happy with that's 30 minutes away has 0-3 months. Look earlier than you think. Tour at least three. The website doesn't tell you what the smell at 4pm tells you.
The most underused part of the system. A residential facility takes your parent for a short stay (1-9 weeks) so the carer can rest, recover, travel, or just sleep through the night.
If you are a primary carer for an ageing parent and you have not used respite, use it. The body of the carer breaks before the body of the cared-for. We come back to this in module 5.
Push for:
Skip:
Save this in your phone now: 1800 200 422.
Save it under "Mum aged care" or "Dad aged care", not "My Aged Care", because at 8pm on a Tuesday when she's fallen for the third time, "Mum aged care" is the search term you'll think of.
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