Support at Home cracks are widening – in-home aged care cost confusion impacting senior choices and multiple sectors

Well understood across the aged care sector is that most Australians wish to live out their final years in the comfort of their own home. However, the hope to retire, age and have care needs met at home is rapidly being replaced with a growing sense of unease and confusion at not only navigating the aged care system, but understanding how much it will cost. With the recent changes to the Support at Home pricing model, advocates and providers heads alike have been sounding the warning on the impacts to seniors being able to access in-home care and the compounding impacts on occupancy in hospitals and RAC. Advocates and many provider heads are clear, making in-home services accessible to seniors is a critical strategy in the sustainability goal of both health and aged care.

Moving targets

Until July 1 2026, the government is allowing a free market in terms of in-home services. Increasingly seniors are finding that prices are wildly fluctuating, exasperating opportunity to budget reliably and sustainably.

Government messaging is clear on the pricing openness, “for the first year of the program, providers will continue to set their own prices for services.” However, this approach is already showing signs of an increasingly difficult market for seniors and loved ones to navigate.

A loved one speaking to Hello Leaders shares that overnight they received communication that the in-home services for a parent was going to increase from “$88 per hour, to $122”, marking a roughly 40% increase.

Advocates are increasingly detailing the stories of seniors now approaching the need for aged care and finding the complexity of online hurdles to be confusing at best, and impenetrable at worst.

The head of BaptistCare, Charles Moore, has shared the confusion his own parents have been wading through in their navigation of the care system. Wondering at their level of fear and confusion, even with his support, his thoughts go to those that, “don’t have an aged care expert in the family”.

Peter Willcocks, a retired businessman and now well-respected advocate in aged care is forthright, for the Support at Home program and everyday Australians navigating it, “he doesn’t have a biggest concern, he just has so many of them.”

Retirement savings goals

With the now active co-payment model for Support at Home, where full pensioners, part-pensioners and self-funded retirees are to be exposed to staggering percentages of their weekly income to maintain access to in-home services, Willcocks predicts grievous consequences for not just the seniors in heart-wrenching decisions but also the aged care sector, both in-home services providers and RACs.

With the removal of means testing, those on full pensions on a level 8 package, may be exposed to having to pay 22% of their pension towards care. For those still needing to cover rent, food, medication, the horror of the situation starts to unfold.

What is of growing concern to advocates across the country is that the prices the calculations of in-home care that have been conducted on may be on the conservative end, with prices looking to rise above predictions.

New research from Just Better Care shows that for many Australians, only half of what the nation’s superannuation fund association recommends for a comfortable retirement, inclusive of covering in-home service costs, has been saved.

The survey conducted by the group highlighted a growing sentiment around the country, seniors are increasingly fearful about being able to afford retirement and in-home services.

Willcocks has been consistent from the beginning, along with fellow advocate and academic Kathy Eagar, means testing must be a central component to how much seniors must contribute to their in-home care. Deanna Maunsell is an engagement officer at Allcare, speaking to the ABC recently, she is of the same opinion, “we are seeing full pensioners needing to contribute to their care.”

“They just don’t have the funds for it.”

Unpredictability and lack of clarity

Maunsell sees that many seniors are unknowingly going into aged care, in trying to navigate services they need soon, “blindly”.

Echoing what Moore has spoken of with his parents, and many advocates second, seniors are feeling increasingly bewildered about even the ability to understand how much they will need. With the target of support at home prices fluctuating, and pricing models for programs opening up co-payment exposure to heights never experienced before, not only is unaffordability a problem, it’s the seeming impossibility to even know how unaffordable the situation is that chaffs.

Warren McKeown, an accounting fellow at the University of Melbourne, spoke to the ABC about the opaqueness of the aged care system and the difficulty most are finding to pin down costs, “no one really knows what aged care monies they will have to provide when they get to that stage.”

“You might have various illnesses and new states of health at that [future] time.”

Maunsell shares, “people are making guestimations about how much they will have to contribute.” For a nation of wealth, resources and organisation, allowing such confusion is not just unnecessary, it’s an indictment on the construction of the entire program.

The lack of clarity is increasingly becoming evident across all demographics of Australia when it comes to understanding aged care, and what it will cost. Just Better Care’s general manager, Callum McMillan, also spoke to the ABC, detailing that, “everyday I’m speaking to families who want their loved ones to stay at home but they’re not sure exactly how to plan for it or how much it costs.”

Consequences in-home services providers

McMillan details, with the ABC, that in the survey conducted, “people have set aside, on average $312,000, for their retirement.”

“At an average of $100 an hour, for aged care in-home services of moderate support, a year, or four months of 24/7 care”.

For those surveyed, close to 50% of participants said they were worried about covering costs for retirement as a whole, not inclusive of covering any unexpected and deteriorating mobility and increased in-home care needs. 

Experts are increasingly seeing that seniors will be forced into positions to go without in-home services, this means providers are likely to increasingly face the consequences of this.

Willcocks has modeled the potential consequences for seniors as well as providers. For seniors having to prioritise food and paying rent, he sees that many will forgo the formal services of in-home care, seeking to have needs met outside of the established market and scheme. Willcocks predicts that home care providers could increasingly run into issues of the viability of their services being used, and financial cash-flow impacts

“Fully Self Funded Retirees without a healthcare card will soon find that paying amounts of $656.50 and upwards for greater levels of services [is not viable], [they] will soon look for other ways of accessing the care that they require.”

Consequences for hospitals and RAC

A fellow advocate shared with Willcocks what many industry leaders have been articulating, if the government does not safeguard vulnerable seniors to stay at home for as long as they can, and be as healthy as they can, the crisis of hospital beds being ‘taken up’ and emergency departments overwhelmed will only become worse.

Particularly in light of the impediments the aged care sector has voiced to the commonwealth about the difficult environment hampering bed builds, the government must do all in its power to minimise the need for RAC beds, and a sector irrevocably overwhelmed.

“By not enabling older people to stay at home longer, the new restrictive home support system will create a nation burdened by nursing homes instead of a country that respects and values its elders and their culture.”

It is both a moral imperative to look after the nation’s seniors, and financially sustainable, for the tax-payer to keep seniors from entering hospital and RAC early. Russell Brickell of WA’s Juniper group has repeatedly called for the government to see investing in home care as an investment against looming hospital costs and crisis.

In speaking to the ABC, Maunsell agrees, “they’ll end up in residential aged care [early] and end up in a medical model and put more pressure on our medical system [and RAC]”.

Not only is this the opposite to what the majority of Australians want, to age in their own home, but exacerbating an already strained healthcare system and RAC at its highest occupancy levels in recent times.

Reform must equilise and stabilise

In order to safeguard the ability of seniors to stay in their home longer and healthier, as a moral and strategic issue, the government must lean into focused reform to allow Australians to predict in-home care costs and be able to afford them.

The consequences of the current system, of confusion, complexity, fear and impossible choices not only puts thousands of Australians in grievous positions, it is likely to have a negative impact on the sector at large, with compromised financial viability for in-home providers, and increased occupancy rates on an already near full-capacity RAC.

As well, facilitating seniors to access in-home care is to support seniors to stay at home healthier and longer, is to invest to ease the strain on a healthcare sector that has seen costs and hospital occupancy rates at bursting point.

Australians must be able to navigate aged care without a PHD. Australians must be able to receive home care packages without dying on the waitlist. Australians must be able to reasonably predict the costs of in-home care so as to have the chance to save and prepare. Reform must follow where the cracks are showing. This is what Australians and the sector deserve.