What the 'No Worse Off' principle means under Support at Home
Understanding the ‘no worse off’ principle in aged care
As the aged-care landscape shifts with the introduction of the Support at Home program, many older Australians and their families are asking: Will my care change? Will I have to pay more?
The good news is that for those already approved for or receiving a Home Care Package before 12 September 2024, the answer is reassuring. Thanks to the 'no worse off' principle, grandfathered clients will continue to receive the care they rely on, without unexpected costs or disruptions.
What does it mean to be a grandfathered client?
According to the Australian Government, a grandfathered client is someone who is already receiving a Home Care Package, or has been approved for one before 12 September 2024. These clients will transition into Support at Home with their current contribution rates protected, meaning you won’t pay more because of the move to Support at Home. Instead, your fees will be the same or lower.
Let’s explore what this means through the stories of three very different clients, all of whom remain protected under the new system.
Full Pensioner: No out-of-pocket surprises
Full pensioners who are grandfathered into Support at Home will continue receiving fully funded clinical services and support, with no additional paperwork required from Services Australia. These grandfathered full pensioners currently pay nothing and will continue to pay nothing into the future.
Case Study: Elsie, 82, lives independently in her home in regional Queensland. Since early 2022, she’s been approved for and supported by a Level 3 Home Care Package. As a full pensioner, Elsie has never paid income-tested fees and under Support at Home, that won’t change.
Elsie was concerned when she heard that new client contributions might apply to services like domestic help. But because she’s a grandfathered client and a full pensioner, her contribution arrangement is protected. She won’t ever be asked to pay new fees for services like:
- Wound care from a nurse
- Monthly help managing bills online
- Support with using her walking frame safely
- Garden maintenance and vacuuming
These services will now be grouped under the new clinical, independence and everyday living categories but for Elsie, the funding continues seamlessly. No new assessments, no new costs, just the same trusted support.
Part Pensioner: Stability and predictability
Part pensioners who entered aged care before the September 2024 cut-off date will pay no more than their current income-tested fee. Under Support at Home, contribution rates will be determined by Services Australia and applied only to services received, replacing the previous daily fee model that charged regardless of services being provided or not.
Case Study: Mo, 79, lives in a unit in Coffs Harbour and has been receiving a Level 3 package since mid-2021. As a part pensioner, he contributes a small income-tested care fee. It is manageable, but something he budgets for carefully.
With Support at Home launching on 1 November, Mo was understandably curious about how the new contribution tiers might affect him. The answer? They won’t. Because Mo is a grandfathered client having been approved a Home Care Package prior to 12 September 2024, he won’t pay more than his current income-tested fee. While contribution rates will be recalculated by Services Australia, they’ll be based on the services that Mo receives, with no new financial assessments required.
Mo’s care includes:
- Podiatry
- Daily personal care, including showering support
- Regular home cleaning and meal preparation
These services will be reclassified under the new system, but Mo’s experience will remain unchanged. His care is stable, his costs are predictable and he can plan with confidence.
Self-Funded Retiree: Protected contributions, continued support
For self-funded retirees who began receiving care before the 12 September 2024 cut-off date, the transition to Support at Home won’t bring financial surprises. Contribution rates are protected and services continue uninterrupted.
Case Study: Leo, 80, lives in a quiet townhouse in Gungahlin, ACT, and has been approved and on a Level 2 Home Care Package since 2021. As a self-funded retiree without access to the Commonwealth Seniors Health Card, Leo pays the full income-tested care fee, something he’s always expected.
With the upcoming changes, Leo was concerned about potential increases in his contributions. But again, the no worse off principle applies. He won’t face additional assessments or unexpected costs. While contributions will be recalculated under the new model, he’ll pay no more than his current income-tested fee and only for the services he actually receives.
His care includes:
- Weekly physiotherapy
- A medication reminder system
- Social visits
- Weekly cleaning
These will continue uninterrupted. While new clients may face higher contributions for similar services, Leo’s arrangements remain unchanged.
What this means for you or your loved one?
If you or someone you care for has already been receiving a Home Care Package, or was approved for one before 12 September 2024, rest assured the transition to Support at Home won’t bring financial surprises. Whether you’re a full pensioner, part pensioner or a self-funded retiree, your current contribution arrangements will be honoured.
Whether you're new to aged care or already receiving support, we're here to help. With decades of experience and a local team by your side, integratedliving offers personalised care that adapts as your needs change over time. As the aged care system evolves, we’ll guide you through the transition and support you every step of the way: your care, your way, every day.
At integratedliving, we’re here to help you navigate these changes with clarity and confidence. If you have questions about how Support at Home might affect your care or costs, we’re just a phone call away on (02) 4987 8910.