Home Care Package · Level 4 of 4
Level 4 Home Care Package: High-level care needs
Level 4 Home Care Package is the highest level – federally subsidised at ~$60,000/year – supporting older Australians with high-level, complex care needs who choose to remain at home rather than enter residential aged care. Level 4 funds daily personal care, regular nursing involvement, multiple allied health inputs + a structured 7-day care regime. Combined with a committed family caregiver + an appropriate home environment, Level 4 can sustain a person at home through to end of life.
★Key takeaways
- ✓Level 4 Home Care Package: federal subsidy of ~$61,440/year paid by the Commonwealth to your provider (roughly $2,363/fortnight, $1,182/week).
- ✓Typical service volume: 10–13 hours of direct care per week – covering personal care, domestic help, nursing + allied health.
- ✓You pay the basic daily fee (17.5% of the single Age Pension, ~$12.75/day) and, if your income is above the threshold, an income-tested care fee capped at ~$36.04/day.
- ✓Care + package management fees combined are capped at 20% of the package value under the 2024–25 reforms. Exit fees are banned.
- ✓Gateway: ACAT assessment via My Aged Care (1800 200 422) – free, federally funded, conducted in your home.
Funding at a glance
Federal subsidy for Level 4
Annual subsidy
$61,440
paid to your provider, not to you
Fortnightly
$2,363
paid in arrears to provider
Direct care volume
10–13 hours
per week typical
Subsidy figures indexed twice yearly with the Age Pension by the Department of Health. Cross-check current rate at health.gov.au/our-work/home-care-packages-program/funding before any financial decision.
Who qualifies
ACAT eligibility for Level 4
ACAT assesses you as having high-level functional decline – typically: dependent on others for most ADLs, multiple chronic + progressive conditions, daily nursing involvement needed, significant cognitive decline (moderate-to-advanced dementia) OR significant physical disability (post-stroke, advanced Parkinson's, advanced cardiac/respiratory disease). For many people Level 4 is the alternative to residential placement; the decision depends on family caregiver capacity + home environment.
Application steps
- Apply via My Aged Care online or 1800 200 422.
- Complete an ACAT in-home assessment (typically 4–6 weeks scheduled out).
- Receive your written approval letter with assigned level.
- Choose an HCP provider from myagedcare.gov.au.
- Sign the Home Care Agreement + Care Plan with your provider.
- Services commence once the package is assigned + activated.
What it covers
Typical services in a Level 4 care plan
- Daily personal care (10–13+ hours/week – showering, dressing, toileting, transfers)
- Domestic + meal preparation assistance (5+ hours/week)
- Nursing visits multiple times per week (medication, wound care, complex care review)
- Allied health (physio, OT, dietetics, podiatry, speech, psychology)
- Transport (multiple trips/week including specialist appointments)
- Social support + community participation (specialised programs)
- Regular respite (in-home + centre-based + residential block)
- Dementia + behaviour-support specialist input
- Substantial home modifications (full-bathroom rebuild, hoist installation)
- Assistive technology (electric bed, ceiling hoist, falls detection, GPS tracker)
- Palliative-care coordination + advance care planning
What it doesn't cover
- × Continuous 24/7 staffing (Level 4 funds ~10–13 hours of direct care/week, not 168)
- × Permanent overnight live-in carer (overnight is by-exception, short-term)
- × Daily living expenses + housing costs
- × Acute hospital-level medical care
- × Services already funded under Medicare or PBS
Sample weekly budget
How a Level 4 package gets spent
Indicative breakdown for a typical Level 4 care plan. Actual spend varies by provider hourly rates, location + your individual care plan. Total annual federal funding ~$61,440.
| Service component | Weekly cost |
|---|---|
| Personal care (12 hrs/wk at $80/hr) | $960 |
| Domestic + meal prep (6 hrs/wk at $65/hr) | $390 |
| Nursing visits (twice weekly) | $260 |
| Allied health (physio, OT, weekly) | $180 |
| Transport (4 trips/wk) | $140 |
| Care + package management fee (20% cap) | $236 |
| Total weekly direct spend | $2,166 |
Hourly rates used: personal care ~$80/hr (varies $70–$110), domestic assistance ~$65/hr ($55–$80), nursing visit ~$130/hr, physiotherapy ~$120/visit. Provider rates published on individual provider websites; compare 2–3 quotes before signing the Home Care Agreement.
Transitioning between levels
If your needs change
Your care plan can be reviewed at any time by your provider, your treating clinician, your family or you. If needs grow beyond Level 4, request an ACAT reassessment through My Aged Care. The reassessment is free, in-home + can be triggered by anyone in your care circle.
- Reassessment takes ~2–4 weeks to schedule.
- Higher level is offered when available – interim period can use lower-level services.
- You can switch providers when changing levels – packages are fully portable.
Family caregiver considerations
For the family supporting the recipient
Level 4 is professional support – not a replacement for family caregiving. Families remain central to: care plan decisions, medication management, social companionship, end-of-life planning + advocacy when something isn't working.
- Free carer support: Carer Gateway 1800 422 737 + carer respite via residential respite.
- Carer Payment + Carer Allowance (Centrelink) if you provide substantial daily care.
- OPAN advocacy service: free, independent help if something goes wrong with the package. opan.org.au.
Common questions
Level 4 Home Care Package – common questions
Is Level 4 a real alternative to residential aged care?
For many people, yes – particularly with strong family caregiver support, an accessible home environment + a clear advance care plan. Level 4 provides daily professional support but is not 24-hour staffing. The decisive factors are night-time safety, caregiver sustainability + clinical complexity. Many families use Level 4 with regular residential respite blocks (4–8 weeks/year) to manage caregiver burden. End-of-life care at home with Level 4 + community palliative-care input is increasingly common.
How long is the wait for a Level 4 package?
Historically 4–12 months from approval to commencement, though recent reform funding has shortened the queue. Until your assigned package starts you can access an interim Level 3 package + CHSP services to bridge the gap. ACAT-priority cases (caregiver in crisis, post-hospital discharge with high needs) can start materially faster.
Can a Level 4 package cover 24/7 in-home care?
No – Level 4 funds ~10–13 hours/week of direct care, not 168 hours. Continuous 24/7 in-home staffing would cost $400,000–$700,000/year depending on workforce + complexity, well beyond any HCP level. Families seeking continuous in-home support typically combine Level 4 with private-pay support (live-in companion + privately-engaged carers) or transition to residential care where 24/7 staffing is included in the federally-funded model.
Can I get end-of-life care at home on a Level 4 package?
Yes – Level 4 supports palliative care + end-of-life care at home, coordinated with your local community palliative-care team (a Medicare-funded specialist service in every state). Around 30% of Australians die at home or in a care residence rather than hospital; Level 4 + family caregiver + community palliative team is the typical pathway for at-home death. Advance care directives should be lodged + understood by all involved well in advance.
What happens if I have a Level 4 package + then need residential placement?
Your HCP eligibility transfers – the residential aged-care provider takes over funding (through AN-ACC) once you sign the permanent residency agreement. Any unspent HCP funds are returned to the Commonwealth (with the package management fee applied as per your agreement). The transition can happen at any time; many families use this pathway when a Level 4 home setup becomes unsustainable, particularly around caregiver burnout or a clinical deterioration.
Compare across levels