Does Anyone Actually Get 24-Hour Care Funded?

It's a fair question, and an honest answer should be given instead of marketing.

In aged care funding almost no one is provided with 24-hour, ongoing, paid care at home. The maximum Support at Home classification is $78,106 per year, while the active cover costs are $700,000 to $900,000 per year. It doesn't work out in the arithmetic.

Some do, but not nearly as many as the word suggests, and almost invariably in certain contexts and not as an entitlement.

This article will shed some light on where the line truly lies, what is actually funded, and what options are really available when continuous care is not.

What Support at Home Funds for Older Australians

Support at Home succeeded Home Care Packages on 1 November 2025 and operates under 8 classifications.

Funding is provided in quarterly budgets starting at approximately $10,731 per year at level 1 and increasing to $78,106 per year at level 8, with 10 percent of each quarter devoted to care management before services are purchased.

If you live at the top-level classification (after care management) you will have access to approximately $1,350 per week in services. They are buying around 20 hours a week at blended market rates. Helpful and not continuous.

Three things make the picture even better than it looks in families' minds.

Treatment is free for all. The contributions are not applicable to nursing, wound management, medication management, occupational therapy, physiotherapy, podiatry, continence support and dietetics. For a person with health requirements, a realistic, non-trivial contribution of professional expertise is cost free and doesn't take away some personal care time.

The extra cost for personal care is removed from the price of your care from 1 October 2026. Showering, dressing, grooming and continence assistance are now classified as clinical supports and will be government funded for all from that date within the allocated budget.

Outside the scope of your support hours: equipment and modifications. Hoists, beds, pressure mattresses, bathroom modifications and ramps come from capital funding, arranged via an occupational therapy assessment, which is also free.

This means that the real value of a Support at Home package is much higher than the headline reads. It has not yet made it to continuous care.

What the NDIS Funds

This is not the case for those under 65 who have permanent and significant disability, and there are, in fact, genuine 24-hour funding models for these individuals.

The NDIS supports include funds that are reasonable and necessary, and are assessed against a person's disability. There is no set ceiling equivalent to the Support at Home classifications. Where someone's needs can only be met with ongoing support for their safety (and where that is truly necessary), plans can and do provide it.

In practice, the funding occurs in a few situations.

Supported Independent Living (SIL), a person lives with others, and supports are shared amongst the people living in the home. This is the most widely used form of funding continuous support, the cost is spread out. A ratio of one worker to three residents overnight is a fundamentally different economic proposition from one to one.

High and complex needs that include 1:1 or 2:1 support, including those for ventilator dependence, unstable airway, frequent seizures that require rapid intervention or behaviours of concern that pose a significant risk. These plans are available and large in size.

Active overnight support, where the person requires repositioning, suctioning or monitoring overnight. Provided on a separate line rather than as a part of a general package.

Intensive periods of short duration after hospital discharge, in crisis or when an arrangement is being put in place.

The NDIS is not intended to provide ongoing support for convenience or support to give reassurance to family members where the person is objectively safe or to replace services that are a part of the health system.

The Honest Gap: People Aged Over 65 With High Needs

This is the most difficult point in the system, and certainly the place to call out by name.

A person who becomes aged care dependent after the age of 65, because of a stroke, complicated dementia, Parkinson's or progressive frailty, is likely to have been living in the care system, with a ceiling of $78,106. If they have the same needs at age 63, and they were to access the NDIS, the funding they could access could be many times that.

Families find out when they're least expecting it, and assume they may have made a mistake with their application. They have not. It is documented and a structural aspect to the way both systems are designed.

For an older person with very high needs the practical implications are that home-based care may be available, with significant family contribution or private top-up, or a combination; at some stage residential aged care becomes the option that allows the provision of ongoing care and support on site.

It's better to find out this early rather than after a family has exhausted their health and their money.

What to Do When Continuous Care Is Not Funded

The value of the reframing is from coverage to risk. You are not attempting to raise money for 168 hours. Your goal is to get the unsafe hours safe.

Know the true risk times. The typical family has two or three: the morning routine, the evening and the night. The remainder is typically not too difficult to deal with.

If it's a problem, solve the night first. Overnight care is the most cost-effective intervention that can be implemented, and whether it can be a sleepover or an active support is the single biggest lever on cost. Discuss with your clinician what would need to be different to make a sleepover safe, often a pressure mattress, a change of continence, treating the cause of night waking, or sensor technology.

Take full advantage of all the free clinical services. Nursing and allied health cost nothing. There is no charge for an OT assessment and equipment is separately funded. This is an underutilised resource.

Properly use the equipment stream. Every piece of equipment that does work a person would otherwise do reduces the hours you need to raise funds for.

Lower the hourly rate. When you hire a direct engagement, you can expect to pay $40 to $70 an hour, but a traditional agency will charge you $65 to $95 per hour. That difference is worth a few extra hours of support for the same money for twenty hours a week.

Utilise respite intentionally and in a timely fashion. Chronically underused, it is a bookable service that enables a family carer to continue to be functional. It is reserved for use after someone has broken down, and is much less effective.

Check your classification is right. A reassessment may result in a change of classification if a person's needs have changed markedly. Instead of a diagnosis list, the evidence that works is a specific functional description, ‘requires two people for transfers, needs repositioning three times overnight, cannot be left unattended for more than thirty minutes’, not a list of diagnoses.

Making the Case at Assessment

If you think the classification is not indicative of the need, the manner in which you present the situation matters more than most families understand.

What is the most difficult day of a typical week (not the easiest) and what made it so? Evaluations take place on a good day, the individual rises to the occasion, and families make the picture look better out of protectiveness. The end results of the classification are a performance, not a life.

Measure the amount of care family is already providing. ‘My mother gets up four times a night and I have reduced to three days a week at work’ is a fact that influences an assessment. ‘We manage’ does not.

Take clinical documentation to the appointment. Any report from GP, specialist, OT or community nurse about the functional impact is a consideration.

Be clear about how risk is expressed. What has actually occurred, not what may occur, for instance falls, wandering, failure to take medications, or a hospital admission.

If English is not the person's mother tongue, request an interpreter. It is free, available through TIS National (131 450), and an assessment conducted without one will underestimate need.

When the Answer Is Residential Care

The truth is sometimes that the needs are ongoing and that no funding is available to support them at home, and residential aged care can offer the staff to meet the needs which home care can't on its own at an affordable cost.

To make that determination is arithmetic, not failure. Families who stretched out their time at home for two or three years and then made the change have got something real. The aim was never home at any cost; it was to enjoy the best possible life at every stage.

Also, it's worth noting that the transition is almost always easier in practice than in theory, when the person has visited, been involved, and chosen, and a planned transfer, versus a fall and a crisis transfer, is a very different deal.

The Bottom Line

The maximum classification for aged care is $78,106 and continuous cover is an order of magnitude more expensive, so it is not often funded under aged care. It is funded under the NDIS in certain situations, usually as a shared SIL or in the case of high clinical needs requiring 1:1 support.

The question for all others is not how to pay for the hours but how to make the unsafe hours safe. That typically means overnight coverage, equipment doing work a person would otherwise do, using free clinical services fully, and a rate that buys more hours from the same funding.

And when home cannot be made safe, it's better to know that early than late.

The Evidence That Changes an Assessment

Since much of the classification is dependent on this, it is important to be specific about what is actually moving an assessment outcome.

Don't diagnose, describe the function. ‘Has dementia’ does not provide much information to an assessor. ‘Cannot be left unattended for more than thirty minutes, has left the house twice at night in the last three months, needs prompting and supervision for all personal care, and can't manage medication independently’ tells them a great deal.

Frequency and duration. The term ‘needs help at night’ is ambiguous. ‘Wakes 3 to 4 times, needs help to the toilet each time, and takes 20 to 30 minutes to settle’ is assessable.

What has actually happened. Falls with dates. Hospital admissions. A trip and the repercussions. A medication missed and the repercussion. Concrete incidents are more significant than concern in general.

What family is currently providing. This is the most under-stated element in most assessments. Facts that belong in the assessment are ‘my husband and I take turns sleeping 4 nights a week’ and ‘I have cut myself back from full-time to 3 days’.

Written clinical evidence. A letter from GP, geriatrician or occupational therapist or community nurse outlining functional impact and risk. Assessors are more willing to take clinical documentation into consideration than family report alone.

Interpreter access where needed. This is free through TIS National (131 450). An assessment conducted in a second language systematically underestimates need, and is one of the more frequent reasons for an inaccurate classification.

Where to Get Help Navigating This

Most families try to do this alone, and do not need to.

My Aged Care on 1800 200 422 is the front door for assessment and reassessment.

Aged care navigators and advocacy services are free, and they are in place because the system is complicated. The Older Persons Advocacy Network operates nationally.

Support coordinators under the NDIS are there to do this work, and if your coordinator doesn't seem to be doing this, that's an issue to raise.

Financial advisers who understand these issues are a key asset where aged care, property or means-testing are involved, as the ramifications of the decisions taken can have a profound and lasting impact and may be hard to reverse.

Your GP, who will have the clinical information that enables assessments to turn on, and who will also be able to identify treatable causes of decline that lessen the support required in the first place.

Common Misunderstandings About Funding

Here are six of the most common missteps that affect families, each of which comes at a cost in opportunity or dollars.

‘It's not worth our while to get anything.’ Support at Home is not dependent on income or assets. Means don't determine if you can get into the program, but rather what you can contribute. And clinical care is available free regardless of means.

‘There is a need to wait until the situation deteriorates before applying.’ From approval to funding, there is a time lag of three to six months. Early application is free of charge and the funding is there when it is required, not months later.

‘Accepting help means losing the house.’ Funds for home care do not relate to property. Means-testing for residential aged care is another issue and is important to discuss separately, but it is not triggered by support at home.

‘This is a final classification.’ It is not. Reassessment is offered if there are significant changes in needs, and classifications often lag behind progressive situations.

‘Unspent funds roll over.’ The quarterly budget carry-over is capped at 10 percent or $1,000, whichever is greater. Above that it is permanently lost.

‘Equipment is produced during our hours.’ It does not. Assistive technology and home modifications are funded from capital, and not as part of support hours, and are funded through a free occupational therapy assessment.

If Your Application or Classification Is Wrong

Many families don't know that they have the right to dispute a result, and many end up accepting a classification that is not suitable.

Ask for the reasons in writing. You have the right to know how the decision was made.

Seek a new assessment if there is a change in need or circumstances, if there is information that was not available at the time, or if the assessment did not reflect the reality. New clinical evidence is the strongest basis.

Utilise the formal review procedures. There are internal processes for review of both aged care and NDIS decisions with clear timelines and additional review options. Processes vary between systems and over time, so check current processes directly with My Aged Care or the NDIS.

Get an advocate. The Older Persons Advocacy Network and disability advocacy services around the state are free and independent, and they do this every day. Families that rely on an advocate regularly will get better results than those that don't, simply because the advocate is familiar with the evidence that is important, and with how the process works.

Keep a record. Names, dates, what was said, what was submitted. Reviews turn on documentation.

None of this is adversarial. The assessment is based on limited information and a short visit, and is often both missed and incorrect. Correcting one is a natural part of the process and not a complaint that needs to be fixed.

Frequently Asked Questions

Is Support at Home funding of 24 hour care available?

Not in the sense of continuous paid cover. The top level classification pays $78,106 per year, or approximately twenty hours per week at market rates. What is funded is a real package of support, free clinical care on top, and funded equipment separately, and many families use this in conjunction with their family care and overnight arrangement.

Does the NDIS cover 24 hour care?

It can, if continuous support is determined to be reasonable and necessary. It is usually funded from Supported Independent Living (SIL), which is shared between the residents of the house, or with a person with high clinical needs who needs one to one support. It's not widespread, it's not universal.

Why are those over age 65 eligible for less than those under?

They are part of the aged care system and not the NDIS, and have different funding mechanisms. If someone gains high needs at age 63, they could be eligible for the NDIS; if they gain high needs at age 66, they fall under Support at Home with its classification ceiling. It's a structural feature, not a mistake in your application.

What are the real costs of Support at Home?

Clinical care, including nursing, wound care, medications, occupational therapy, physiotherapy, podiatry, continence management and dietetics, is fully funded and there is no contribution regardless of income or assets. From 1 October 2026 personal care is also fully funded. Equipment and home modifications are not based on your support hours; they come from capital funds.

What will have to happen to achieve a better classification?

Seek a review and bring details of function, not diagnosis. Outline the toughest day of an average week, quantify the work the family is currently doing, and have written reports from clinicians describing the impact on function and risk.

Is respite funded?

Yes, and it is one of the most under-used entitlements in the system. It is used regularly and booked in advance and keeps family carers functioning. It is much less effective when used only during a crisis.

What if the money really isn't sufficient?

The options include using equipment and clinical adjustments to decrease the hours required, direct engagement to decrease the hourly rate, adding private services, expanding family participation, or moving to residential care. If you work through them in that order, you will get a better answer than if you take for granted that the last one is inevitable.

If someone is sent home from the hospital does this change what they are able to obtain?

It can. If a substantial increase in needs occurs after admission, there is a need to reconsider this, and hospital social workers can play an important role in facilitating the reassessment. Begin this process during the admission and not after the discharge, as it takes weeks.

May I get funding from NDIS and aged care?

Generally a person is in one system or the other rather than both. If an individual was an NDIS participant prior to their 65th birthday, they will normally continue to be a participant in the scheme. This is worth checking carefully as there is a significant variation in the funding available.

Is it worth getting advice?

Yes, for anything complicated. There's a reason these care systems are complicated, and there are people who are there to help: the aged care navigators, advocacy services and support coordinators, most of them free. The most frequent reason families take on a classification that is not appropriate is that they go into the process without advice.

Support Network assists families to decide what they are able to purchase with their funding and how they can make it last. See our 24 hour care services or call 1300 671 931.

Sources and further reading

• My Aged Care, Support at Home funding classifications and participant contributions
• NDIS, reasonable and necessary supports; Supported Independent Living
• Aged Care Act 2024 and supporting Aged Care Rules