What Services Are Not Covered Under Support at Home?

Key Takeaway

Why Does Support at Home Have Funding Boundaries?

Support at Home is designed to fund approved aged care services that help an older person remain safe, independent and connected while living at home.

The Australian Government maintains a defined service list covering three broad categories:

Each service type has activities that are in scope and activities that are excluded.

This means eligibility cannot be decided only by asking whether something would help. The provider must identify the relevant service category and confirm that the proposed activity is permitted.

Are Ordinary Living Expenses Covered?

No. Support at Home does not generally pay the ordinary expenses that everyone must meet regardless of whether they receive aged care services.

A support worker’s time assisting with an approved activity may be funded even when the underlying purchase is not.

For example, assistance with grocery shopping may be an approved service, but the participant still pays for the groceries.

Does Support at Home Pay For Groceries?

Support at Home does not generally pay for ordinary groceries, food ingredients or personal shopping.

Funding may be used for approved assistance with:

• preparing a shopping list
• accompanying the person while shopping
• completing essential shopping on their behalf
• arranging an online grocery order
• transport connected with approved shopping assistance

The participant remains responsible for the cost of the items purchased.

Meal services can involve a different cost structure. Support at Home may contribute to approved meal preparation or delivery, while the ordinary cost of ingredients or food may remain payable by the participant.

Are Professional Cleaning And Specialist Household Services Covered?

Support at Home may pay for approved domestic assistance that helps keep the home safe and liveable.

However, this does not create unlimited access to every cleaning or household service.

Activities generally outside ordinary domestic assistance may include:

• specialist or premium cleaning unrelated to assessed aged care needs
• pest-control services
• dry cleaning
• pet care
• large-scale rubbish removal
• cleaning connected primarily with moving house
• work that goes beyond maintaining a reasonably safe and liveable home

The provider should explain the difference between approved domestic assistance and a private household service.

Does Support at Home Pay For Pet Care?

Routine pet expenses and pet-care services are generally not covered.

This includes costs such as:

• pet food
• veterinary bills
• grooming
• boarding
• dog walking
• routine cleaning performed solely for the pet

A provider may consider immediate safety issues within an approved service visit, but Support at Home is not a pet-care program.

Where pet care has become a barrier to the person accepting help or remaining safely at home, the care partner may help identify community, family or privately funded alternatives.

Are Major Renovations Covered?

Support at Home can fund approved home modifications through the Assistive Technology and Home Modifications scheme.

That does not mean it will pay for general renovations or property upgrades.

Examples of work that should not be assumed to qualify include:

• renovating a kitchen for appearance or resale value
• replacing an entire bathroom when a smaller safety modification would meet the assessed need
• building an extension
• installing luxury fixtures
• painting or decorating the home
• general property modernisation

Home modifications generally require assessment, prescription, approval and use of the correct funding pathway before work begins.

Are Major Repairs And Property Maintenance Covered?

Support at Home may fund limited home maintenance and minor repairs where they directly support the older person’s safety and ability to remain at home.

It is not intended to replace the property owner’s responsibility for maintaining the house.

Work that may fall outside the program includes:

• major structural repairs
• roof replacement
• extensive plumbing or electrical upgrades
• repairs caused by long-term property neglect
• general improvements unrelated to an aged care need
• work primarily intended to increase property value
• maintenance that would ordinarily be required whether or not an older person lived there

The distinction is usually whether the work is minor and directly connected to the participant’s assessed safety or independence.

Does Support at Home Pay For Major Gardening Or Landscaping?

Limited gardening may be approved where it helps maintain safe access and reduces risks around the home.

Support at Home does not generally fund landscaping, garden redesign or extensive property work.

Activities that should not be assumed to qualify include:

• landscape design
• installing decorative gardens
• major tree removal unless a specific approved safety need is established
• building retaining walls
• installing irrigation systems
• large-scale clearing unrelated to the participant’s immediate safety
• routine maintenance of investment properties or areas not used by the participant

A provider should define the approved gardening tasks rather than describing the service only as general garden maintenance.

Are Medical Appointments And Hospital Costs Covered?

Support at Home does not replace Medicare, public hospitals, the Pharmaceutical Benefits Scheme or state and territory health services.

The program may fund approved assistance connected with accessing health care, such as:

• transport to an appointment
• a support worker accompanying the participant
• approved nursing at home
• approved allied health services within the support plan
• care coordination between services

It does not generally pay costs that belong to another health system, such as:

• hospital treatment
• ambulance charges
• ordinary GP fees
• specialist medical fees
• medical procedures
• diagnostic tests
• services already funded through Medicare or another government program

Some services sit near the boundary between health care and aged care. The provider should explain why the cost belongs within Support at Home rather than another funding system.

Does Support at Home Pay For Medicines?

Support at Home may fund approved medication assistance delivered through nursing or personal care.

This could include:

• medication prompting
• assistance with self-administration where permitted
• clinical medication support within a nurse’s scope
• monitoring and escalating medication concerns

The medication itself is generally a personal or health-system expense and may instead be subsidised through the Pharmaceutical Benefits Scheme.

Ordinary pharmacy purchases should not be charged to a Support at Home budget unless the item is specifically eligible under an approved service or equipment pathway.

Are Dental, Optical And Hearing Costs Covered?

Support at Home does not operate as a general dental, optical or hearing-benefits scheme.

Routine costs such as dental treatment, prescription glasses and ordinary hearing expenses should not be assumed to be covered.

Certain assessments, therapeutic supports, prescribed assistive technology or related services may be available through Support at Home or another government program when eligibility requirements are satisfied.

The provider should identify the exact service-list or assistive-technology category before suggesting that funding can be used.

Are Holidays, Entertainment And Recreation Covered?

Support at Home does not generally pay for holidays, tickets, accommodation or ordinary entertainment costs.

This includes expenses such as:

• airfares
• hotel accommodation
• cruises
• holiday packages
• restaurant meals
• cinema or theatre tickets
• club memberships
• sporting-event tickets
• general recreational purchases

An approved social-support worker may help the person participate in a community activity, but the participant may still need to pay their own admission, food and personal costs.

The provider should separate the cost of delivering the approved support from the participant’s ordinary recreational expenses.

Can Support at Home Pay Family Members Or Friends?

Support at Home is not designed as an unrestricted payment to compensate relatives or friends for informal care.

Family members may continue providing unpaid support, but their time does not automatically become a claimable Support at Home service.

Where a family member has a formal role within a registered provider’s workforce or subcontracting arrangement, separate provider, employment, conflict and service-delivery rules may apply.

Families should not create private payment arrangements and assume the provider can reimburse them from the participant’s budget.

Can Funding Be Given To The Participant As Cash?

No. A Support at Home budget is not a cash allowance or personal bank account.

Government funding is held within the aged care payment system and used to pay for eligible services delivered and claimed through the provider.

The participant cannot ordinarily:

• withdraw unused funding as cash
• transfer the budget to a family member
• use it to pay personal debts
• spend it on unrelated goods
• keep the entire unused balance indefinitely

Participants retain choice and control over their approved service arrangements, but that control operates within program rules.

Are Services For Other Household Members Covered?

Support at Home funding belongs to the approved participant.

It should not be used primarily to provide services for:

• a spouse who has not been assessed for the service
• adult children
• grandchildren
• housemates
• visitors
• another person living at the property

Some approved work may naturally benefit the household. Cleaning a shared bathroom used by the participant is different from providing a full cleaning service for every resident.

The central question is whether the service is being delivered to meet the approved participant’s aged care need.

Can Support at Home Pay For Services At An Investment Property?

Funding is intended to support the participant in the home and daily environment in which they live.

It should not be used for maintenance, cleaning, gardening or modifications at an investment property, holiday home or another property unrelated to their approved care needs.

Where a person regularly lives across more than one location, the provider should confirm what can be delivered under the support plan rather than assuming every property is covered.

Are Luxury Or Premium Upgrades Covered?

Support at Home funding is intended to meet approved care needs, not provide premium lifestyle upgrades.

A participant may sometimes choose a more expensive item, service or modification than the program will fund.

In that situation, the participant may need to:

• pay the difference privately
• choose a lower-cost eligible option
• demonstrate why the higher-cost option is clinically or functionally necessary
• obtain approval before committing to the purchase

Never assume the budget will cover an upgrade simply because a basic version of the item may be eligible.

What Happens If A Provider Says Something Is Not Covered?

A provider should give a clear reason rather than responding only with “the program does not pay for that”.

Ask which of the following barriers applies:

These are different problems and may lead to different next steps.

A service-list exclusion cannot usually be fixed by changing the budget. A support-plan gap may require review. A provider-capacity problem may require a different worker, subcontractor or provider.

Common Mistakes To Avoid

What You May Really Be Trying To Decide

The visible question is:

“Is this covered under Support at Home?”

The deeper concern is often:

“Are we about to agree to a cost because we misunderstood what the government funding would pay for?”

That uncertainty becomes more serious when a family has already committed to a service, purchased equipment or scheduled building work.

The safest time to establish the funding boundary is before money is spent.

Decision Support

Before agreeing to any uncertain purchase or service, work through four questions.

A rejection does not always mean the underlying need is unimportant.

It may mean the family needs a different service, another funding pathway, a support-plan review or a private solution for the part that aged care funding cannot cover.

Summary

Support at Home funding is restricted to services and supports permitted under the official service list and approved funding pathways.

It generally does not cover ordinary living costs such as housing, utilities, groceries, clothing, entertainment, holidays, personal debts or unrestricted household spending.

It also does not replace Medicare, hospitals, the Pharmaceutical Benefits Scheme or the participant’s ordinary responsibility for maintaining and improving their property.

Approved assistance may be funded even when the underlying personal expense is not. A worker may assist with shopping, for example, while the participant pays for the groceries.

Before committing money, confirm that the proposed service is in scope, connected to an assessed need, approved through the correct pathway and affordable within the participant’s available funding.