Hidden Aged Care Costs: 12 Fees Families Miss

Key Points

• Aged care in Australia involves more than just the basic daily fee and means-tested care fee
• Families routinely underestimate total costs by $2,000 to $5,000 per year because of overlooked extras
• Understanding each hidden cost helps you budget accurately and avoid financial stress
• Some extras can be reduced, negotiated, or covered through government subsidies or concession cards
• Always request a full fee schedule from any provider before signing an agreement

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Why So Many Aged Care Costs Catch Families Off Guard

When most Australian families start planning for aged care, they focus on the big-ticket items: the basic daily fee, the means-tested care fee, and the accommodation payment. These are the fees that government websites explain in detail and that aged care providers list upfront.

But there is a second layer of costs that rarely appears in the brochure. These are the day-to-day expenses that add up quietly over weeks and months. A $7 pharmacy co-payment here. A $15 hairdressing appointment there. A $40 physiotherapy gap fee every fortnight.

Individually, they seem small. Together, they can add thousands of dollars to the annual cost of care. And for families already stretching their budget, these unexpected expenses create real financial pressure.

This guide walks through 12 commonly missed aged care costs in Australia, explains how much each one typically adds to your bill, and offers practical ways to reduce the impact.

The 12 Hidden Aged Care Costs Most Families Miss

1. Pharmacy Co-Payments

Residential aged care facilities provide medications prescribed by the resident’s doctor as part of their care. However, this does not mean medication is free. Residents are typically required to pay Pharmaceutical Benefits Scheme (PBS) co-payments for each prescription.

As of 2025-2026, the PBS co-payment is $7.70 per prescription for concession card holders and $31.60 for general patients. If a resident takes five or more regular medications (which is common among older Australians), these co-payments can reach $40 to $160 per month.

Over-the-counter medications, vitamins, and supplements are usually not covered at all. If your parent takes daily fish oil, vitamin D, or glucosamine, expect to pay the full retail price.

What you can do:

• Ask the pharmacist about generic alternatives, which often have lower co-payments
• Track co-payments toward the PBS Safety Net threshold ($262.80 for concession card holders in 2025-2026), after which prescriptions are free or heavily discounted for the rest of the calendar year
• Review the medication list with the GP to remove any that are no longer clinically necessary

2. Incontinence Products

Government funding covers basic continence products in residential aged care through the National Continence Program. However, “basic” is the key word. The products supplied under this funding are functional but may not suit every resident’s needs or preferences.

If your family member requires a specific brand, a particular absorbency level, or more products than the standard allocation, the extra cost falls to you. Premium continence products can cost $50 to $150 per month depending on the type and quantity needed.

In home care packages, continence products can be funded through the package budget. However, this means the money comes out of the same pool that pays for personal care, nursing, and other services.

What you can do:

• Contact the National Continence Helpline (1800 33 00 66) to check eligibility for the Continence Aids Payment Scheme (CAPS), which provides an annual payment to help with costs
• Ask the facility what is included in the standard allocation before assuming everything is covered
• Compare product costs at pharmacies, supermarkets, and online suppliers

3. Hairdressing and Personal Grooming

Most residential aged care facilities offer hairdressing services, but these are almost never included in the standard fees. A basic wash and set typically costs $15 to $30, while a cut and colour can be $40 to $80 or more.

Monthly hairdressing appointments may seem like a luxury, but for many older Australians, maintaining their appearance is closely tied to their dignity and mental wellbeing. This is not something families should feel guilty about funding.

What you can do:

• Ask about the facility’s hairdressing schedule and pricing before admission
• Some facilities negotiate group rates with visiting hairdressers, which can be cheaper than external salons
• Family members can assist with basic grooming tasks during visits if the resident is comfortable with this

4. Outings, Activities, and Entertainment Fees

Aged care facilities organise social activities, outings, and entertainment to support residents’ wellbeing. While some basic activities are included in the daily care fee, many are not.

Bus trips to local markets, movie screenings, live music performances, craft supplies, and excursion entry fees can each carry a small charge of $5 to $25. A resident who participates in two or three activities per week could accumulate $50 to $100 per month in activity fees.

These charges are typically listed in the facility’s additional services schedule, but families often overlook them during the admission process.

What you can do:

• Request the full additional services and activities fee schedule during your facility tour
• Ask which activities are included at no extra cost
• Set a monthly activities budget with the facility and ask to be notified when the limit is approaching

5. Dental and Optical Care

Routine dental and optical care is not covered by standard aged care funding. This means the cost of dental check-ups, fillings, denture repairs, eye tests, and new glasses falls to the resident or their family.

Dental care for older Australians can be particularly expensive. A basic check-up and clean costs $200 to $350 at a private dentist. Denture repairs or replacements can run from $500 to several thousand dollars. New prescription glasses typically cost $200 to $600.

Many older Australians are eligible for public dental services, but waiting lists can be long. Some state and territory governments offer additional dental and optical subsidies for concession card holders.

What you can do:

• Check eligibility for public dental programs through your state or territory health department
• Ask whether the aged care facility arranges visiting dental or optical services, which may be more convenient and sometimes more affordable
• Look into health fund coverage or the Commonwealth Seniors Health Card for additional benefits
• The Department of Veterans’ Affairs covers dental and optical costs for eligible veterans

6. Physiotherapy and Allied Health Gap Payments

Aged care residents often need physiotherapy, occupational therapy, podiatry, or speech pathology. While some allied health services are funded through the aged care facility’s government subsidy, the allocation is limited.

If a resident needs more frequent sessions than the facility provides, additional appointments must be arranged privately. Medicare covers some allied health services under a GP Management Plan (up to five sessions per calendar year), but there is usually a gap payment of $20 to $60 per session.

Private physiotherapy without Medicare rebates costs $80 to $150 per session. For a resident recovering from a fall or managing chronic pain, weekly sessions can add $300 to $600 per month to the total cost.

What you can do:

• Ask the GP about a Chronic Disease Management Plan (formerly Enhanced Primary Care Plan) to access Medicare-funded allied health sessions
• Check whether the facility’s in-house physiotherapist can increase the frequency of sessions within the existing funding
• Look into whether a home care package could supplement residential care with additional allied health services

7. Personal Toiletries and Grooming Products

Residential aged care fees cover basic personal care, but they do not typically cover personal toiletries. Items like preferred shampoo, conditioner, moisturiser, razor blades, toothpaste, deodorant, and skincare products are the resident’s responsibility.

The facility may provide basic soap and shampoo, but many residents prefer their own products. This is a matter of personal comfort and routine. The monthly cost for toiletries can range from $30 to $80 depending on preferences.

What you can do:

• Buy toiletries in bulk during sales to reduce costs
• Label all products clearly with the resident’s name to prevent loss or mix-ups
• Ask the facility what basic toiletries they supply so you only purchase what is genuinely needed

8. Telephone and Internet Charges

Staying connected with family and friends is essential for aged care residents’ mental health, but communication costs are not included in standard care fees.

A basic phone line in a resident’s room (if available) can cost $30 to $50 per month. Mobile phone plans range from $15 to $50 per month. Some facilities offer Wi-Fi, but it may be limited to common areas, charge a monthly access fee of $20 to $40, or have restricted bandwidth.

For residents who use tablets or smartphones to video-call family, reliable internet access is important. Facilities with poor connectivity can make this difficult without a personal mobile data plan.

What you can do:

• Compare mobile phone plans for seniors, as many providers offer low-cost plans with unlimited calls to Australian numbers
• Ask the facility about Wi-Fi availability, cost, and whether it reaches individual rooms
• Consider a prepaid mobile broadband device if the facility’s internet is unreliable or expensive
• Check whether the Telstra Low Income measures apply

9. Transport to Medical Appointments

Aged care facilities provide day-to-day care, but they do not always provide transport to external medical appointments. When a resident needs to see a specialist, attend a hospital appointment, or visit an off-site allied health provider, transport must be arranged separately.

Options include ambulance transport for medical necessity (which may still incur fees depending on the state), community transport services, taxis, or private transport. Costs can range from $20 to $100 per trip depending on distance and the service used.

Regular specialist appointments can mean two to four trips per month, adding $80 to $400 in transport costs.

What you can do:

• Ask the facility if they provide or arrange transport to medical appointments and what the cost is
• Check eligibility for state or territory patient transport assistance schemes (e.g., PATS in Western Australia)
• Contact local community transport services, which often offer subsidised transport for older Australians and concession card holders
• Coordinate appointments to reduce the number of separate trips where possible

10. Equipment Hire and Purchase

Aged care residents may need specialised equipment that goes beyond what the facility provides. This can include custom wheelchairs, specialised pressure-relief mattresses, personal mobility aids, hearing aids, or adaptive eating utensils.

Hearing aids are a significant cost that surprises many families. A pair of hearing aids can cost $3,000 to $12,000 privately. The Australian Government Hearing Services Program provides subsidised hearing aids to eligible pensioners and veterans, but there may be waiting periods and the range of devices is limited.

Other equipment costs can include replacement walking frames ($100 to $300), customised seating ($500 to $2,000), and personal hoists or transfer aids ($1,000+).

What you can do:

• Check eligibility for the Australian Government Hearing Services Program
• Ask the facility what equipment is provided as standard and what requires a personal purchase
• Look into equipment loan programs offered by organisations like Independent Living Centres or state-based disability equipment programs
• Some home care packages and NDIS plans cover assistive technology costs

11. Premium Room Surcharges

In residential aged care, accommodation is classified by room type. Standard rooms (shared or basic single rooms) may have their costs fully or partially covered by government subsidies for residents who cannot afford to pay.

However, many families prefer a private room with an ensuite bathroom, a garden view, or additional space. These premium rooms attract a daily accommodation payment (DAP) or refundable accommodation deposit (RAD) that can be significantly higher than the standard rate.

The difference between a standard and premium room can be $20 to $80 per day, or $7,300 to $29,200 per year. Some facilities charge even more for rooms with special features like balconies, kitchenettes, or superior furnishings.

This is not technically a “hidden” cost, but the size of the premium often catches families off guard. It is easy to focus on the published maximum accommodation price without realising that the room you actually want may cost considerably more than the minimum.

What you can do:

• Ask for a clear breakdown of room categories and their associated costs during facility tours
• Consider whether premium room features are genuinely important to the resident or whether a well-located standard room might be just as comfortable
• Use our aged care fees calculator to model different accommodation scenarios
• Remember that the RAD is refundable when the resident leaves, while the DAP is a non-refundable daily rental payment

12. Exit and Administrative Fees

When a resident leaves an aged care facility, whether by choice, transfer to another facility, or after passing away, there may be exit-related costs that families do not anticipate.

These can include room cleaning and restoration charges, administrative processing fees, final account settlement fees, and charges for any unreturned equipment. Some facilities charge a room holding fee if a resident is temporarily absent (for example, during a hospital stay beyond the standard leave days).

Under the new Aged Care Act, which commenced in November 2025, consumer protections around exit fees and administrative charges have been strengthened. Providers must be transparent about all charges in the resident agreement, and certain types of exit fees may be limited or prohibited.

Despite these protections, it is still important to understand what you might be charged before you sign.

What you can do:

• Read the resident agreement carefully, including all schedules and annexures, before signing
• Ask specifically about exit fees, room restoration charges, and any holding fees
• Request a written estimate of all potential exit-related costs
• If you believe a charge is unfair, contact the Aged Care Quality and Safety Commission (1800 951 822) for advice

Hidden Costs Comparison Table

The table below summarises the 12 hidden costs, their typical monthly impact, and whether they apply to residential care, home care, or both.

Hidden Cost	Monthly Estimate	Residential Care	Home Care
Pharmacy co-payments	$40 - $160	Yes	Yes
Incontinence products	$50 - $150	Sometimes	Yes (from budget)
Hairdressing	$15 - $80	Yes	Yes
Outings and activities	$50 - $100	Yes	Less common
Dental and optical	$30 - $80 (averaged)	Yes	Yes
Physiotherapy gaps	$80 - $600	Yes	Yes (from budget)
Personal toiletries	$30 - $80	Yes	Less common
Phone and internet	$20 - $50	Yes	Less common
Transport to appointments	$80 - $400	Yes	Yes (from budget)
Equipment hire/purchase	Varies widely	Sometimes	Yes (from budget)
Premium room surcharges	$600 - $2,400	Yes	N/A
Exit and admin fees	One-off charges	Yes	Some providers

Total potential additional costs: $1,000 to $4,000+ per month (depending on room choice and individual needs)

How to Budget for Hidden Aged Care Costs

Step 1: Request a Complete Fee Schedule

Before committing to any aged care provider, request a full and detailed fee schedule. This should include the standard fees (basic daily fee, means-tested care fee, accommodation payment) as well as every additional charge the facility may apply.

Good providers will be upfront about these costs. If a provider is reluctant to share a complete fee schedule, consider that a warning sign.

Step 2: Create a Monthly Extras Budget

Based on the fee schedule and your family member’s known needs and preferences, create a realistic monthly budget for extras. Consider:

• Current medication list and approximate co-payments
• Personal grooming habits and preferences
• Social activity interests
• Communication needs (phone, internet)
• Ongoing medical appointments requiring transport
• Any specialised equipment needs

A good starting point is to budget an additional $200 to $500 per month for extras on top of the standard aged care fees, adjusting based on individual circumstances. For a detailed breakdown of all fees, try our aged care fees calculator.

Step 3: Review and Adjust Quarterly

Costs change over time. Medication needs shift. Activity preferences evolve. New health conditions may require additional allied health services. Review the extras budget every three months and adjust as needed.

Step 4: Build an Emergency Buffer

Unexpected costs will arise. A broken hearing aid, an urgent dental procedure, or a sudden need for specialised equipment can create a large one-off expense. Setting aside $1,000 to $2,000 as an emergency buffer helps manage these situations without financial panic.

7 Ways to Reduce Hidden Aged Care Costs

1. Maximise government concessions. Ensure the resident holds a Commonwealth Seniors Health Card, Pensioner Concession Card, or Health Care Card. These unlock discounts on pharmaceuticals, dental care, transport, and communication services.

2. Use Medicare-funded allied health. A GP Management Plan provides up to five Medicare-rebated allied health sessions per calendar year. This can significantly reduce physiotherapy and podiatry gap payments.

3. Compare providers on transparency. When choosing between aged care providers, ask each one for their full fee schedule. Providers who are transparent about additional costs are more likely to be trustworthy partners in your family member’s care. Use MD Home Care’s aged care directory to compare providers in your area.

4. Claim all available tax deductions. Some aged care costs may be claimable as medical expenses or through the net medical expenses tax offset (for eligible claims). Speak with an accountant who understands aged care finances.

5. Negotiate where possible. Some additional service fees are negotiable, particularly for long-term residents. Ask whether bundled pricing is available for regular services like hairdressing or activities.

6. Track spending carefully. Keep a simple spreadsheet or notebook of all additional charges each month. This makes it easier to spot unexpected increases and have informed conversations with the provider.

7. Seek financial advice early. An aged care financial adviser can help structure accommodation payments, manage assets and income, and identify ways to reduce the overall cost of care. This small upfront investment can save thousands over the course of a care journey. To understand the full picture of nursing home costs in Australia, professional advice is invaluable.

What the New Aged Care Act Means for Hidden Costs

The new Aged Care Act, which commenced on 1 July 2025, introduced stronger consumer protections around fees and charges. Key changes that affect hidden costs include:

• Greater fee transparency. Providers must clearly disclose all fees and charges before a resident signs an agreement, including additional service costs.
• Strengthened exit protections. Certain exit fees are now restricted, and providers must refund accommodation deposits within 14 days of departure.
• Improved complaints processes. If you believe you have been charged unfairly, the Aged Care Quality and Safety Commission has expanded powers to investigate and resolve disputes.
• Support at Home program. The new Support at Home program, replacing the existing Home Care Packages program, introduces reforms to pricing and budgeting transparency for home-based care.

These reforms do not eliminate all additional costs, but they do make it harder for providers to surprise families with unexpected charges.

March 2026: Ministerial Investigation Into Premium Service Fees

On 16 March 2026, the Aged Care Minister announced an investigation into claims that some aged care providers are charging premium fees for basic services that should be covered under standard care arrangements. The Minister specifically named Opal Healthcare as one provider under scrutiny, calling the practice “disgusting sidestepping” of aged care regulations.

While regulations provide absolute minimum standards, the Minister emphasized that Australians expect and deserve dignity in aged care, not exploitative pricing practices. The investigation will examine whether providers are inappropriately categorizing basic care activities as premium or extra services to justify additional charges.

This announcement reinforces the importance of carefully reviewing fee schedules before signing any aged care agreement. If you believe you are being charged for services that should be included in standard care, you can lodge a complaint with the Aged Care Quality and Safety Commission on 1800 951 822.

Source: ABC News, 16 March 2026

When Hidden Costs Signal a Bigger Problem

While some additional costs are a normal part of aged care, a pattern of unexplained or rapidly increasing charges can indicate a problem. Watch for:

• Charges that do not match the fee schedule you were given at admission
• Significant increases in additional service fees without prior notice
• Charges for services the resident says they did not receive or request
• Reluctance from the provider to explain or itemise charges when asked

If you notice any of these patterns, raise the issue directly with the facility manager. If the response is unsatisfactory, contact the Aged Care Quality and Safety Commission on 1800 951 822 or My Aged Care on 1800 200 422.

Frequently Asked Questions

What hidden costs are there in aged care?

Common hidden costs include pharmaceutical co-payments, incontinence products (especially premium brands), hairdressing, outings and activities fees, dental and optical care, physiotherapy gap payments, personal toiletries, newspaper and magazine subscriptions, telephone and internet charges, and premium room surcharges. These can add $1,000 to $4,000 or more per month to the standard fees.

Do I have to pay for medication in aged care?

The facility provides medications prescribed by the doctor, but you will typically need to pay PBS co-payments. These are $7.70 per prescription for concession card holders and $31.60 for general patients (2025-2026 rates). Over-the-counter medications, vitamins, and supplements are an additional cost paid by the resident or family.

Are incontinence products included in aged care fees?

Basic incontinence products are covered under government funding in residential aged care. However, if you prefer specific brands or higher-quality products, these may cost $50 to $150 per month extra. In home care, products may be funded through your package budget, but this reduces the amount available for other services.

What happens to unspent funds when you leave aged care?

In home care, unspent funds from your package are retained for up to 70 days after you leave a provider. If you transfer to another provider, the funds follow you. In residential care, your RAD (Refundable Accommodation Deposit) is refunded within 14 days of departure, minus any agreed deductions.

Do aged care facilities charge exit fees?

Some facilities may charge administrative fees when you leave, including room restoration charges and final account processing fees. Under the new Aged Care Act (commenced November 2025), exit fees and other consumer protections have been strengthened. Always read the resident agreement carefully before signing and ask specifically about exit-related charges.

How much should I budget for aged care extras?

A reasonable starting budget for additional costs in residential aged care is $200 to $500 per month, plus an emergency buffer of $1,000 to $2,000 for unexpected expenses like dental work or equipment replacement. The actual amount depends on the resident’s personal needs, preferences, and the facility’s fee structure.

Can I claim aged care costs on tax?

Some aged care costs may be tax-deductible or eligible for offsets. The rules are complex and depend on individual circumstances. It is worth consulting an accountant or financial adviser who specialises in aged care to ensure you are claiming everything you are entitled to.

Take Control of Aged Care Costs

Hidden aged care costs do not have to be a source of stress. The key is knowing what to expect, asking the right questions, and planning ahead.

Start by requesting a complete fee schedule from any provider you are considering. Use the comparison table in this guide to identify which additional costs are most likely to affect your family. Build a realistic extras budget, and review it regularly.

If you need help finding aged care providers who are transparent about their fees and committed to clear communication, MD Home Care connects families with trusted providers across Australia. Call 1800 953 253 or browse aged care providers in your area to get started.