What do we fund for younger people living in residential aged care?

When you live in a RACF your support needs may be met through a combination of:

  • supports provided by your RACF
  • additional supports funded by us, which meet the reasonable and necessary criteria.

Learn more about the reasonable and necessary criteria.

Your RACF provides accommodation that includes:

  • staff for your personal care
  • health practitioners which provide nursing, medical and other health services
  • cleaning services
  • furniture, and some basic equipment or assistive technology.

In some limited situations, we may be able to fund other supports you need because of your disability. In these circumstances, please talk to your planner who will work with your RACF, Support Coordinator and sometimes an allied health professional to work out the right reasonable and necessary disability supports for you.

This is explained in the section What other supports can we fund.

We can also fund supports to help you find more age-appropriate accommodation if you’d like to move out of your RACF. 

What RACF fees and charges do we fund?

We have an agreement with the Department of Health to pay some fees and charges for younger people in residential aged care. You will still need to pay some accommodation costs, living expenses, and care fees that we can’t fund.

The types of fees we may fund in your plan include:

  • funding to reimburse the aged care system for support they provide to you. This appears in your plan as “Cross Billing Payments For Residential Aged Care Subsidies And Supplements.” You don’t need to do anything with this item. It will be paid automatically.
  • other care and accommodation costs you’re asked to pay from your own money. When we agree to fund some of these costs, we’ll reimburse you for these fees. You or your plan manager must manage this funding. Learn more about How you can manage your funded supports.

There are some aged care fees we can’t fund, like accommodation deposits. We also don’t fund the Basic Daily Care Fee, which covers things like meals, cleaning, and heating. If you choose to get additional or extra services from your provider, we also won’t fund these in your plan.

RACFs can offer a range of services. This includes things like hairdressing, larger rooms, rooms with views, and nail salons. You may choose to pay for these services yourself. We can only fund reasonable and necessary services you need because of your disability.

Learn more about what RACF fees and charges we fund.

Learn more about residential aged care fees from the Department of Health  .

If you need help to understand what fees we can fund in your situation, please talk to your planner or Support Coordinator.

What information do you need to provide for plan funding?

To help us work out what fees we can fund, we will need some information from you. This includes:

  • a Services Australia Residential Aged Care Advice letter
  • RACF tax invoices for the last six months
  • your personal nursing/care plan
  • your Residential/Accommodation Agreement.

If you aren’t sure if you have all these, don’t worry. We can help you through this process. We’ll talk about these things during your planning conversation with us.

This page current as of
28 September 2020
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