Paying privately for home care

There is a gap in the aged care system that nobody designed and everybody falls into. Need arrives suddenly, an assessment takes weeks, and a funded place can take longer still.

Paying privately is how a lot of households cover that gap. Done with clear eyes it is a sensible, temporary purchase. Done in a hurry it is where people sign things they should not.

This is general information, not financial advice. For your own numbers and eligibility, speak to My Aged Care and to the provider directly.

The three reasons people do it

Bridging. Something has changed, often a fall or a hospital stay, and help is needed now rather than in eleven weeks. This is the most common reason and usually the most defensible, because it is time-limited and it prevents the deterioration that happens while waiting. If that is your situation, read waiting for a Support at Home place alongside this.

Topping up. A funded budget exists but does not cover everything wanted, so extra hours are bought on top. Perfectly reasonable, and worth doing with the budget in front of you so you know what you are actually adding.

Choosing to. Some people would rather buy the service directly and skip the assessment, the reporting and the reviews altogether. That is a legitimate choice, and it costs more.

Start with the assessment anyway

Even if you intend to pay privately, get the My Aged Care assessment underway.

It costs nothing, the clock is long, and it establishes what the person is eligible for. The mistake is paying privately for two years and only then discovering that a funded arrangement was available all along, which happens more than it should.

What to check before you sign

This list is the whole point of the page. Get every item in writing.

1. The base hourly rate, and the minimum visit length. A one hour rate billed at a two hour minimum is a different price
2. Every rate that is not the base rate: Saturdays, Sundays, public holidays, evenings, overnight, and travel time or kilometres
3. Cancellation terms. How much notice, and what you are charged if you cancel inside it. Reasonable providers have a policy; unreasonable ones charge full price for a visit cancelled two days out
4. Notice to end the arrangement, and any exit fee. If leaving is expensive, that tells you something
5. Joining, administration or care management fees, stated separately rather than folded invisibly into the hourly rate
6. Insurance. Public liability and workers compensation, and who carries it
7. Employees or contractors. This determines who is responsible if something goes wrong, and who is supervising and training the worker
8. Screening. Police checks and NDIS or aged care worker screening, plus first aid, and how they are kept current
9. Who actually comes, and what happens when that person is sick or on leave
10. What happens when the need is clinical. A support worker cannot do nursing tasks, and that boundary should be explicit. It is set out in home nursing and support work

The traps

The long lock-in. A twelve month agreement for help that may be needed for six weeks. Ask for month to month, or for a short initial term.

The package paid up front. Discounted blocks of hours bought in advance are a bad idea when needs change fast and when a provider might not suit. Pay as you go until you know.

A rate that is only quoted for weekdays. Then the first Saturday arrives, or a public holiday, and the invoice is not what anyone expected.

Vagueness about who is coming. If nobody will tell you whether it is the same worker each week, assume it is not. That matters more than almost anything else, and the hidden cost of carer churn explains why.

Cash arrangements with no paperwork. Cheaper, and no insurance, no screening, no cover when the person is sick, and no recourse. That is a real risk being carried by an older person in their own home.

Paying for a level of care nobody assessed. It is easy to buy four hours a day when two would do, particularly when a family is frightened. An assessment, even an informal one from a provider willing to be honest, is worth having first.

A reasonable way to do it

Work out what is actually needed, in hours and on which days, and write it down before you ring anyone. Get quotes from three providers with the full rate card, not just the headline rate. Start small, on a short term, and see who turns up. Keep the assessment moving in the background. And review it at six weeks, because the need that felt permanent in week one has often changed by then.

Then check the invoices against the rate card each month. It is the same discipline as reading a funded statement, and it applies just as well to a private one.

What we do

We offer private, self-funded arrangements, and we support people who self-manage a funded budget. Month to month, on a written rate card, with no lock-in and no block of hours bought up front.

We are equally happy to tell you when we think you would be better off waiting for a funded arrangement, because a household that feels pushed into a purchase is not a household we want.

If you want someone to go through a rate card with you, including another provider’s, ring us and a person will answer. Current eligibility and assessment information is at myagedcare.gov.au.