Support at Home Contributions: Tiers, Categories, and Caps

One of the most significant changes in the Support at Home (SAH) program is the way client contributions are calculated and collected. The old Home Care Packages model used a basic daily fee plus an income-tested care fee — both applied as flat daily charges regardless of which services were delivered. SAH retains a basic daily fee (17.5% of the single basic rate of Age Pension per day) but replaces the income-tested care fee with a per-service contribution model where the amount a client pays depends on the type of service delivered and their financial means. For providers, this means fundamentally different billing processes, client communications, and financial reporting.

Under the former Home Care Packages program, client contributions were relatively straightforward. There was a basic daily fee (set at 17.5% of the single basic age pension) that all clients could be asked to pay, plus an income-tested care fee for clients whose income exceeded certain thresholds. These fees were calculated by Services Australia and applied as a flat daily charge — the same amount every day, regardless of whether the client received a nursing visit, a cleaning service, or no services at all.

SAH takes a fundamentally different approach to income-tested contributions. Instead of a flat income-tested care fee, clients pay a percentage of the cost of each individual service they receive (in addition to the basic daily fee, which is retained). The percentage varies depending on two factors: the category of service being delivered and the client's means-testing tier. This means two clients receiving the same service may pay different contribution amounts, and the same client will pay different contribution rates for different types of services delivered on the same day.

The practical impact for providers is substantial. Contribution calculations now happen at the individual service level — every service delivered must be categorised, the client's tier must be applied, and the contribution amount must be calculated and communicated. Systems built for the HCP daily-fee model cannot handle this without significant modification.

SAH divides all services into 3 categories, each attracting different contribution rates. Correct categorisation is critical — if a service is mapped to the wrong category, the contribution calculation will be wrong.

Clinical and Therapeutic services attract the lowest contribution rates. This category includes nursing services, allied health (physiotherapy, occupational therapy, speech pathology, dietetics, podiatry), wound care, continence assessment, medication management and review, and clinical monitoring. The rationale for lower rates is that clinical services are considered essential health care that should not be deterred by cost.

Independence services attract moderate contribution rates. This category includes personal care (showering, dressing, grooming, toileting), social support and community access, respite care, and meal preparation and delivery. These services directly support a person's ability to remain living at home and maintain social connections.

Everyday Living services attract the highest contribution rates. This category includes domestic assistance (cleaning, laundry), transport, home maintenance, garden maintenance, and home modifications. The higher rates reflect that these services, while valuable, are considered more discretionary than clinical or independence services.

Providers must ensure their service catalogue correctly maps every service type to the appropriate category. The Department of Health and Aged Care publishes a definitive service classification list — providers should reference this rather than making their own categorisation decisions.

Under SAH, clients are assessed into one of 3 means-testing groups by Services Australia, based on their income and assets. The group determines what percentage the client pays for each service category:

Full-rate pensioners. Clients pay 0% for clinical and therapeutic, 5% for independence, and 17.5% for everyday living services. Full pensioners contribute modestly for non-clinical services while clinical care remains fully government-funded.

Part pensioners and Commonwealth Seniors Health Card (CSHC) holders. Clients pay 0% for clinical and therapeutic, between 5% and 50% for independence, and between 17.5% and 80% for everyday living services. The exact rate within these ranges is individually determined by Services Australia based on the client's income and assets assessment — it is a sliding scale, not a single fixed percentage.

Self-funded retirees (no CSHC). Clients pay 0% for clinical and therapeutic, 50% for independence, and 80% for everyday living services. Clinical care remains fully government-funded regardless of means.

The assessment is conducted by Services Australia and communicated to the provider via a contribution determination letter. Providers must not attempt to assess a client's group or rate themselves — the determination must come from Services Australia. If a client has not yet been assessed, they are treated as having no contribution obligation until the determination is received.

The following table summarises the contribution rates across all categories and groups:

Clinical and Therapeutic: Full pensioner = 0%, Part pensioner = 0%, Self-funded = 0%. Independence: Full pensioner = 5%, Part pensioner = 5–50% (assessed), Self-funded = 50%. Everyday Living: Full pensioner = 17.5%, Part pensioner = 17.5–80% (assessed), Self-funded = 80%.

The contribution is calculated as a percentage of the actual service cost — the amount the provider charges, subject to any price caps set by the Department. For example, if a self-funded client receives a 2-hour domestic assistance visit costing $120, and domestic assistance is an everyday living service at 80%, the client's contribution for that service is $96.00. The remaining $24.00 is drawn from their quarterly SAH budget.

Providers must calculate and communicate contributions to clients for each service delivered, showing the service type, its category, the applicable rate, the contribution amount, and the amount drawn from the government-funded budget.

To protect clients from excessive cumulative costs, SAH applies a lifetime contribution cap that limits the total contributions a client can be asked to pay across their entire period of receiving aged care services.

The lifetime cap for new entrants (clients who commenced SAH services from 1 November 2025 onward) is $135,318.69 (as at 1 July 2025, subject to annual indexation). For grandfathered clients (those who transitioned from an existing Home Care Package), the lifetime cap is $84,571.66 (as at 1 July 2025, subject to annual indexation) — a lower figure that accounts for contributions already paid under the HCP program and protects transitioned clients from disadvantage. Verify current cap amounts with Services Australia.

Importantly, SAH does not apply an annual contribution cap. Unlike some other aged care funding models, there is no yearly reset — the lifetime cap is the only ceiling. Once a client's cumulative contributions reach the lifetime cap, their contribution drops to 0% for all services permanently. They continue to receive their full SAH budget with no further client contribution required.

It is the provider's responsibility to track cumulative contributions against the lifetime cap and cease charging when the cap is reached. Services Australia provides cap tracking data, but providers should maintain their own records as a safeguard. Statura Care's contribution tracking automatically monitors each client's cumulative total and alerts providers when a client is approaching the cap threshold.

SAH includes financial hardship provisions for clients whose contribution obligations cause genuine financial difficulty, even after means testing. A client (or their representative) can apply to Services Australia for a hardship determination, which may reduce or waive their contribution obligations.

The hardship assessment considers the client's income, assets, debts, essential living expenses, and any exceptional circumstances — such as high medical costs, supporting a dependent, or unexpected financial setbacks. If a hardship determination is granted, the client's effective contribution rate is reduced, sometimes to zero contributions. The determination is reviewed periodically, and the client may need to reapply if their circumstances change.

Providers have a clear obligation to inform clients about the hardship provisions when a client expresses difficulty paying contributions. This is not optional — failure to inform clients about hardship options could be considered a failure to support consumer dignity and choice under Standard 1 of the Aged Care Quality Standards, and may be raised during ACQSC assessment contacts.

In practice, providers should include hardship information in their client welcome packs, raise the option proactively during care plan reviews if a client's circumstances appear to have changed, and document that the client was informed of their right to apply.

Calculating per-service contributions manually — across 3 categories, 3 means-testing groups, varying service costs, and lifetime cap tracking — is operationally burdensome and error-prone. A single miscategorised service or missed cap threshold creates billing errors that are difficult to unwind and may trigger compliance concerns.

Statura Care's Support at Home module automates the entire contribution workflow. Every service in your catalogue is mapped to the correct SAH category (clinical and therapeutic, independence, or everyday living). When a service is delivered, the system automatically applies the client's means-testing group and assessed rate, calculates the contribution amount, deducts it from the quarterly budget, and updates the client's cumulative lifetime contribution total.

The platform generates client-facing statements showing each service delivered, its category, the contribution rate applied, the client's contribution amount, and the amount drawn from their government-funded budget. Lifetime cap tracking runs continuously — when a client approaches their cap threshold, the system alerts the care coordinator so the transition to zero contributions is handled seamlessly.

SAH contribution management is part of Statura Care's aged care compliance software — 35 modules purpose-built for the Aged Care Act 2024. For the broader SAH framework — including classification levels, quarterly budgets, wellness goals, and short-term pathways — see our Support at Home program guide. To see how Statura Care handles SAH billing end-to-end, visit our SAH contributions and claims page.