By Steve Hadfield, AgedCareActionPlan.au · Last updated: 9 June 2026
At some point, almost every family hears the same thing from their provider: "That's not covered."
Sometimes it's true. The government has a list of services that cannot be funded under Support at Home — full stop, no exceptions. Rent. Prescription medications. Gambling. Buying a car. These are permanent government exclusions and no provider can override them.
But sometimes "not covered" means something else entirely. It means that particular service is not in that provider's catalogue. It's a commercial decision — what the provider has chosen to offer — not a government rule. The two situations look identical from the outside. Providers rarely explain which one applies. Most families never ask.
That distinction is the most important thing in this guide. Everything else follows from it.
Support at Home — which replaced Home Care Packages on 1 November 2025 — organises every funded service into three categories. The category determines what the government pays and what, if anything, you contribute. See the full funding breakdown by classification →
Clinical services are fully funded by the government for every participant regardless of income, assets, or classification level. You pay nothing.
This covers nursing and wound care, physiotherapy, occupational therapy, speech pathology, podiatry, dietetics, and continence support. From 1 October 2026, personal care — showering, dressing, toileting assistance — moves from Independence into Clinical Care, making it fully funded at no out-of-pocket cost.
Independence services help a person manage daily routines safely at home. The government subsidises these; you contribute a portion based on income assessment by Services Australia. Until October 2026 this category includes personal care, along with transport to medical appointments, mobility aids, and home modifications including ramps and grab rails.
Domestic assistance, meal preparation, cleaning, gardening, shopping assistance, and funded social programs fall here. These attract the highest co-contributions.
The rule that governs all three categories is identical: the service must directly relate to your assessed care needs — health, safety, or independence at home. If a service doesn't connect to what was identified in your assessment, it won't be funded regardless of which category it falls under. This is why "get it in your care plan" is not a cliché — it's the mechanism.
These are permanent exclusions. No provider, no care plan, no clinical justification can override them.
Rent and mortgage payments. The program funds care, not housing costs.
Prescription medications. Medications are covered by the Pharmaceutical Benefits Scheme. What can be funded is medication management — a nurse or support worker assisting with administration, organising prescriptions, or opening Webster packs. The clinical assistance is fundable. The medication itself is not.
General grocery shopping. Shopping as a living expense is excluded. Shopping assistance — a support worker accompanying you, or meal delivery through an approved service — can be funded when it's linked to an assessed need.
Entertainment and leisure with no care connection. Gambling, holiday club memberships, and entertainment tickets are excluded. Approved social support must be delivered through a recognised service.
Large asset purchases. Buying a car or general home renovations are excluded — with one important exception covered in the next section.
Services that fall under another government program. If a service is available through the NDIS, the Commonwealth Home Support Programme, or another government scheme, it won't be funded through Support at Home. The programs are designed to complement, not overlap.
The government's own service list states explicitly that the exclusions are not exhaustive. Context matters. An item that is normally outside scope can become fundable when it directly supports an assessed care need and is documented in the support plan.
The most concrete example is home modifications and equipment. Standard safety items — grab rails, ramps, handholds — are routinely funded. But the principle extends further. A recliner chair is furniture. If an occupational therapist has assessed that a specific chair position is necessary to manage a mobility or health condition, that chair becomes a clinical item with a documented care connection. The item hasn't changed. The justification has.
The same logic applies to larger modifications. A bathroom renovation is excluded. A bathroom modification — roll-in shower, lowered vanity, accessible fittings — recommended by an OT and documented in the support plan as a safety requirement, can be funded. It also draws from the AT-HM budget stream — a separate pool of funds that does not reduce your regular quarterly care hours budget.
The three-part test
The Department of Health applies this test to grey-zone items:
All three: the item can often be funded even when it superficially resembles an exclusion. If your provider said no to something in this territory, it is worth going back and asking: "Is this excluded under the Support at Home rules, or is this something that could be approved with a clinical recommendation in my care plan?"
Use the agreement checker → to review what your current service agreement does and doesn't allow before your next care plan review.
Here is the situation that recurs in aged care families every week. Someone asks their provider whether a service is available. The provider says no. The family accepts this. The service goes unfunded for months or years.
In many of these cases, the government rules don't exclude the service at all. The provider simply doesn't offer it.
Providers are required under the Aged Care Act 2024 to publish the services they offer in their My Aged Care profile. There is no requirement to tell a participant when a service they've requested is absent from that provider's catalogue rather than absent from the rules. The distinction is almost never volunteered.
What this means in practice
A government exclusion has no workaround. Accept it and move on.
A provider exclusion has three possible workarounds: request that the provider adds the service to your care plan (some will, especially for self-managed arrangements); access the service through a self-managed arrangement directly; or switch to a provider whose catalogue covers what you need.
The objection most families have at this point is: "My provider would tell me if something was available." This is a reasonable assumption — and it's often wrong. Providers manage their own service profitability. A service that is fundable but operationally inconvenient to deliver may simply not appear in the offer. There is no obligation to flag what's missing.
Navigator checks what most families never think to check — the care management percentage against the legal cap, every quarter, automatically.
If your provider is charging above the 10% cap, Navigator tells you — with the exact words to get it fixed. If everything is correct, you hear nothing. That certainty is the product.
Start Navigator — $29/month →Cancel any time. 30-day money-back guarantee.
These are legitimate funded services that are regularly not offered, not raised, or turned down without challenge.
Funded under Independence Services. Gives the primary carer a break while the participant is supported by a trained worker. Regularly absent from care plans when nobody specifically requests it.
Funded under Everyday Living. Not informal outings — structured, facilitated programs with a documented care connection. Social isolation is a recognised contributor to health decline in older Australians, and the program is designed to address it. Many providers don't proactively offer this.
Occupational therapy, speech pathology, dietetics, and podiatry are all Clinical Care — zero co-contribution for every participant. Many families only encounter physiotherapy because it's the allied health service providers most commonly offer. The others are equally fundable and equally free.
Assistive technology and home modifications are funded through a separate budget stream — not your regular quarterly budget. A walking frame or bathroom modification does not reduce your care hours. It comes from a different pool. Many families decline AT-HM items assuming it will affect their services. It won't.
If after-hours or weekend support is in your assessed needs, it can be funded. Many providers don't offer it — which is a provider catalogue decision, not a program exclusion. If you need it and your current provider can't deliver it, that's a switching conversation, not an appeal.
See the full breakdown of what your support worker will and won't do →
Already receiving services? Check your statement.
Clinical Care — nursing, physio, OT, speech, podiatry — has zero co-contribution. If any of these appear with a charge on your monthly statement, that is a billing error. The statement decoder translates every line and flags anything above the legal benchmark. The overpayment calculator tells you the exact dollar amount recoverable if your care management fee exceeds the 10% cap.
Changing from 1 October 2026
Personal care — showering, dressing, continence support — moves from Independence Services (co-contribution applies) to Clinical Care (fully government-funded, zero co-contribution). If personal care is a significant part of your package, the quarterly saving can be substantial. This change is confirmed and proceeding independently of the price caps deferral.
How Support at Home funding works
Quarterly budgets by classification, contribution rules, and how your budget is released.
Care management fees explained
What the 10% cap means in dollar terms, how to check your fee, and what to do if it's wrong.
What you'll actually pay
Co-contribution rates by service type, income assessment, and how costs differ under the three categories.
What your support worker will and won't do
The scope boundaries most families only discover after services have started.
Self-managing your Support at Home
How self-management expands your service options — and what it involves day-to-day.
How to switch providers
What happens to your funding, notice periods, and how to avoid a gap in services.
General grocery shopping is excluded as a living expense. What can be funded is shopping assistance — a support worker accompanying you, or meal delivery through an approved service with a care connection in your support plan.
Yes. Domestic assistance including cleaning is covered under Everyday Living services, subject to a co-contribution. It must be in your support plan and delivered through your provider arrangement or a self-managed contract.
Standard safety modifications — grab rails, ramps, handholds — are covered under Independence services. Larger modifications can be funded if clinically justified, recommended by an occupational therapist, and documented in the support plan. Assistive technology and modifications also have their own separate AT-HM budget stream that doesn't reduce your regular quarterly budget.
Ask specifically: 'Is this excluded under the Support at Home rules, or is this a service you don't offer?' These are different situations. A government exclusion is final. A provider catalogue gap may be solved by a different provider, a self-managed arrangement, or in some cases a direct request to your current provider to include the service.
No. Clinical Care — which includes nursing, physiotherapy, occupational therapy, speech pathology, and podiatry — has zero co-contribution for all participants regardless of income. If you're being charged for these services, that is an error. Use the statement decoder to check, or the overpayment calculator to quantify the discrepancy.
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This guide is for information only — not legal, medical, or financial advice. Verified against the Aged Care Act 2024 and Aged Care Rules 2025. Check myagedcare.gov.au for current rates and rules.