Level 4 home care package: $62,589 funding guide (2026)
Camila
Healthcare Expert
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Key points
- Level 4 home care packages provide approximately $62,589 per year in government funding
- The highest level of home care, designed as an alternative to residential aged care
- Covers daily nursing, personal care, allied health, home modifications, and respite
- Around 20 to 28 hours of support per fortnight
- Under Support at Home, replaced by Classifications 7 and 8 (up to $78,000/year)
- Longest wait times of all levels, typically 9 to 18 months
What is a Level 4 home care package?
Level 4 is the highest level of home care in Australia. It is designed for people with high-level, complex care needs who would otherwise need to move into a nursing home or residential aged care facility.
This level provides intensive, coordinated support across multiple areas: daily personal care, regular nursing visits, allied health, home modifications, equipment, and respite for family carers. The funding is substantial (over $62,000 per year), and the care plans are complex, often involving several different health professionals working together.
For many people and their families, Level 4 represents the answer to a question they have been dreading: “Do we need to look at a nursing home?” In many cases, the answer is no, not yet, and not if the right support is in place.
How much funding do you get?
Level 4 provides approximately $62,589 per year in government funding. That is $5,216 per month or $2,407 per fortnight.
Under the new Support at Home program (from November 2025), high-level care classifications 7 and 8 can provide up to $78,000 per year, reflecting the significant costs of keeping people with complex needs safely at home.
Provider fees still apply, but at Level 4, the impact is spread across a larger budget.
| Provider fee percentage | Amount for fees | Amount left for care |
|---|---|---|
| 15% | $9,388 | $53,201 |
| 20% | $12,518 | $50,071 |
| 25% | $15,647 | $46,942 |
| 35% | $21,906 | $40,683 |
Even at Level 4, a high-fee provider costs you over $12,500 more per year than a low-fee one. That is the equivalent of about 180 hours of personal care or 100 nursing visits. Choosing the right provider matters at every level.
What services does Level 4 cover?
Level 4 covers the full range of home care services. Your care plan will include a combination tailored to your specific medical conditions and daily needs.
Complex nursing care
- Daily or multiple-weekly nursing visits
- Wound management (complex wounds, pressure injuries)
- Catheter and stoma care
- Diabetes management and insulin administration
- Palliative care support
- Pain management
- Post-surgical care
- Chronic disease management (heart failure, COPD, renal conditions)
Extensive personal care
- Daily shower and bathing assistance
- Dressing, grooming, and skin care
- Toileting and continence management
- Transfers and mobility (bed to chair, chair to standing)
- Meal assistance (feeding support if needed)
- Overnight personal care
Allied health
- Regular physiotherapy (strength, balance, falls prevention)
- Occupational therapy (equipment assessment, home modifications)
- Speech pathology (swallowing assessment, communication)
- Podiatry
- Dietetics
- Psychology and counselling
- Social work
Home modifications (extensive)
- Bathroom renovations for accessibility
- Ramp construction
- Stair lifts or platform lifts
- Widened doorways
- Kitchen modifications
- Emergency call systems
- Smart home technology for safety
Assistive technology and equipment
- Hospital beds
- Pressure care mattresses
- Hoists and lifting equipment
- Wheelchairs and mobility aids
- Shower chairs and commodes
- Communication devices
- Personal alarms
Respite care
- Regular in-home respite for family carers
- Overnight respite
- Day respite at community centres
- Residential respite stays (usually up to 63 days per year)
- Emergency respite when carers are unwell or unavailable
Transport and social
- Transport to all medical and social appointments
- Accompanied outings
- Social engagement and community participation
- Carer support and education
How many hours per fortnight?
With $62,589 per year, after provider fees, you can expect around 20 to 28 hours of support per fortnight.
The mix of services significantly affects total hours. Clinical services cost more per hour, so a care plan with heavy nursing and allied health will have fewer total hours than one focused on personal care and domestic help.
A typical Level 4 fortnightly schedule:
| Day | Service | Hours |
|---|---|---|
| Monday | Personal care AM + PM | 2 hrs |
| Monday | Nursing visit | 1 hr |
| Tuesday | Personal care AM | 1 hr |
| Tuesday | Physiotherapy | 1 hr |
| Tuesday | Domestic help | 2 hrs |
| Wednesday | Personal care AM + PM | 2 hrs |
| Wednesday | Social outing | 2 hrs |
| Thursday | Personal care AM | 1 hr |
| Thursday | Nursing visit | 1 hr |
| Thursday | OT session | 1 hr |
| Friday | Personal care AM + PM | 2 hrs |
| Friday | Meal prep and shopping | 2 hrs |
| Saturday | Respite (carer break) | 4 hrs |
| Sunday | Personal care AM | 1 hr |
| Total | 23 hrs |
This schedule provides daily care visits, twice-weekly nursing, regular allied health, domestic help, social activities, and weekly respite for family carers. It is a comprehensive care plan that allows someone with significant needs to remain safely at home.
Who is Level 4 for?
Level 4 suits people who:
- Would otherwise need residential aged care
- Require daily personal care and nursing support
- Have multiple or complex chronic conditions
- Are living with moderate to advanced dementia
- Have significant physical disabilities or mobility limitations
- Need regular monitoring for safety
- Have family carers who need structured respite
- Are receiving palliative care at home
Common scenarios for Level 4:
- A person with advanced Parkinson’s disease who needs help with all personal care and has regular falls
- Someone recovering from a severe stroke with ongoing nursing, physiotherapy, and speech therapy needs
- A person with advanced dementia living with their spouse, who needs daily care and regular respite for the carer
- An elderly person with heart failure, diabetes, and limited mobility who wants to stay home rather than enter residential care
If your needs are primarily nursing and allied health without extensive daily personal care, Level 3 ($38,454/year) might be sufficient. If Level 4 is still not enough, residential aged care or a combination of Level 4 and private funding may be necessary.
How to apply
- Call My Aged Care on 1800 200 422 or visit myagedcare.gov.au
- Complete the initial screening
- Have your ACAT assessment at home
- Receive your approval letter confirming Level 4
- Choose a provider when your package becomes available
- Start services after signing your Home Care Agreement
Assessment tips for Level 4:
- The assessor needs to see that your needs are high-level and complex. Do not minimise anything.
- Have your GP or specialist write a supporting letter outlining your conditions and care requirements
- If you have a carer, have them describe the full extent of care they provide, including overnight and weekend
- Document any hospital admissions or emergency presentations, as these demonstrate the need for intensive home support
- If you have cognitive decline, have a family member present to provide the full picture
For a detailed guide to the assessment process, read our home care package eligibility guide.
The wait and what to do about it
Level 4 has the longest wait times of all home care packages. Waits of 9 to 18 months are common. This is a serious problem.
ABC News reported in February 2026 that the home care waiting list reached over 130,000 people by the end of December 2025. The long waits for high-level packages have contributed to approximately 3,100 aged care patients becoming stranded in hospitals, costing the healthcare system an estimated $1 billion per year.
What to do while waiting:
Accept a lower-level package. If you are approved for Level 4, you can accept a Level 1, 2, or 3 package while waiting. This gets some services in place immediately, and you move to Level 4 when it becomes available. The government encourages this approach.
Access CHSP services. The Commonwealth Home Support Programme can provide basic services while you wait.
Ask about priority access. If your situation is urgent (risk of hospitalisation, carer breakdown, safety concerns), ask My Aged Care about priority access to a higher-level package.
Consider private top-up. If you can afford it, privately funded services can fill the gap while you wait for Level 4.
Costs and fees
Basic daily fee
Providers may charge up to 17.5% of the single basic Age Pension, around $12.50 per day or approximately $4,560 per year.
Income-tested care fee
Calculated by Services Australia based on your income. Full pensioners do not pay this fee. Part pensioners and self-funded retirees may pay an additional amount, subject to annual and lifetime caps.
The value equation
Level 4 provides over $62,000 per year in care. The equivalent residential aged care can cost $60,000 to $100,000+ per year (including accommodation costs). For many people, staying home with Level 4 support is both preferred and more cost-effective.
Even with a basic daily fee and income-tested fee, your annual out-of-pocket costs for Level 4 are a fraction of what you would pay in a nursing home. And you get to stay in your own home, with your own things, on your own terms.
For current fee information, visit Services Australia.
Support at Home changes
Since November 2025, the Support at Home program has been replacing home care packages. Level 4 now falls under Support at Home Classifications 7 and 8, covering high-level and complex care needs.
The funding under Support at Home for high-level care can reach up to $78,000 per year, an increase from the old Level 4 amount of $62,589. The higher amount reflects the true cost of keeping people with complex needs safely at home.
Key changes for high-level care:
- Two classifications (7 and 8) replace the single Level 4 for more precise funding
- New fee structures including co-contributions for some service categories
- Services grouped into clinical care, independence, and everyday living
- New assessment tool (IAT) instead of ACAT
Existing Level 4 recipients continue receiving their current services during the transition.
For the full picture, read our Support at Home program guide.
Level 4 vs residential care
This is the comparison many families are wrestling with. Here is an honest look at both options.
| Factor | Level 4 at home | Residential care |
|---|---|---|
| Annual cost to government | ~$62,589 | ~$60,000-$80,000 |
| Out-of-pocket costs | $4,500-$10,000/year | $20,000-$50,000+/year (accommodation) |
| 24/7 care available | Only with private top-up | Yes |
| Independence | High | Limited |
| Social connection | Depends on support | Built-in community |
| Home environment | Your own home | Shared facility |
| Flexibility | High | Structured |
| Clinical capability | Good for most needs | Full clinical capacity |
| Overnight emergencies | Limited unless monitoring in place | Immediate response |
Level 4 at home is not the right answer for everyone. If you need 24-hour supervision, if your home cannot be safely modified, or if your carer is at breaking point, residential care might be the safer option. There is no shame in that decision.
But for many people, Level 4 makes staying home possible, and that matters.
Frequently asked questions
How much is Level 4?
Approximately $62,589 per year in government funding. Under Support at Home (from November 2025), high-level classifications 7 and 8 can provide up to $78,000 per year.
How many hours is Level 4?
Around 20 to 28 hours per fortnight. The exact hours depend on your service mix. A care plan heavy on nursing and allied health will have fewer total hours than one focused on personal care and domestic help, because clinical services cost more per hour.
Can Level 4 replace a nursing home?
For many people, yes. Level 4 provides daily personal care, regular nursing, allied health, home modifications, and respite. It is specifically designed for people who would otherwise need residential care. However, it does not provide 24-hour supervision, which some people require.
How long is the wait?
Typically 9 to 18 months. This is the longest wait of all levels. You can accept a lower-level package while waiting, and access CHSP services for basic support.
What if Level 4 is not enough?
If Level 4 does not meet your needs, options include privately funding additional services, combining Level 4 with CHSP, or considering residential aged care. Under the new Support at Home program, Classification 8 provides up to $78,000 which may bridge the gap.
Can I get overnight care with Level 4?
Level 4 can fund some overnight care, but it is limited within the budget. Most Level 4 recipients use personal alarms, monitoring technology, or family support for overnight safety. If you need regular overnight nursing, the budget may not stretch far enough without private top-up.
Resources
- My Aged Care - register and apply for home care
- Aged Care Quality and Safety Commission - provider quality ratings
- Services Australia: aged care fees - fee information
- Department of Health: Home Care Packages - official information
- Carer Gateway - support for family carers
Find a Level 4 provider
Level 4 care is complex. You need a provider with clinical expertise, experience managing high-level care plans, and the capacity to coordinate multiple services. Not every provider can handle this well.
MD Home Care connects you with aged care providers who specialise in high-level home care, so you can compare clinical capabilities, fees, and track records before committing.
Browse home care providers on MD Home Care or call 1800 953 253 for help finding the right provider for complex care needs.
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