Level 4 home care to Support at Home (2026 guide)
Andre Smith
Co-founder & CEO
Note: Home Care Packages were replaced by the Support at Home program on 1 November 2025. The former Level 4 package ($62,589/year, 2024-25 rate) no longer exists for new entrants. High-level care is now covered by Support at Home Classifications 7 ($58,148) and 8 ($78,106). This guide keeps the old Level 4 figures as history and explains the current equivalents.
Reviewed against myagedcare.gov.au and Services Australia on 2 July 2026.
Key points
- The former Level 4 home care package provided approximately $62,589 per year before 1 November 2025
- Under Support at Home, high-level care is covered by Classification 7 ($58,148) and Classification 8 ($78,106), the highest classification
- The highest level of home care, designed as an alternative to residential aged care
- Covers clinical care (daily nursing, allied health), independence services (personal care), everyday living services, home modifications, and respite
- Around 20 to 28 hours of support per fortnight depending on the service mix
- There is no basic daily fee under Support at Home; clinical care is free for everyone, with means-tested contributions for other services
- Existing Level 4 recipients are “no worse off,” keeping equivalent funding and arrangements
What was a Level 4 home care package?
Level 4 was the highest level of home care in Australia. It was designed for people with high-level, complex care needs who would otherwise need to move into a nursing home or residential aged care facility.
Home Care Packages were replaced by Support at Home on 1 November 2025, so the four levels no longer exist for new entrants. High-level care is now covered by Support at Home Classifications 7 and 8. Classification 8 provides $78,106 per year, more than the old Level 4 amount.
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 care plans are complex, often involving several different health professionals working together.
For many people and their families, high-level home care 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?
The former Level 4 package provided approximately $62,589 per year before 1 November 2025. Under Support at Home, high-level care is covered by two classifications:
| Classification | Annual budget |
|---|---|
| Classification 7 | $58,148 |
| Classification 8 | $78,106 |
Classification 8 is higher than the old Level 4 amount, reflecting the significant cost of keeping people with complex needs safely at home. Support at Home budgets are managed quarterly.
Provider fees reduce the amount available for direct care. A provider with lower care management and package management fees leaves more of your budget for actual support hours, so it pays to compare fees before you sign a service agreement. Over a year, the gap between a low-fee and high-fee provider can be the equivalent of many hours of personal care or nursing visits. Use our Home Care Package Calculator to model the difference.
What does high-level care cover?
High-level care (formerly 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 a high-level care budget (roughly $58,000 to $78,000 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 high-level care 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. This mix mirrors what we see through Carevo, where personal care is the most-requested support across aged-care and NDIS matches (855 recent inquiries), the same daily help that anchors most high-level care plans.
Who is high-level care for?
High-level care (formerly 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 high-level care:
- 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, the former Level 3 band (Classifications 4 to 6) might be sufficient. If high-level care is still not enough, residential aged care or a combination of high-level care 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 comprehensive assessment at home through the Single Assessment System (using the Integrated Assessment Tool)
- Receive your approval letter confirming your Support at Home classification
- Choose a provider when a place is assigned (you have 56 days, plus a 28-day extension)
- Start services after signing your service agreement
Assessment tips for high-level care:
- 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
Support at Home allocates places through a national priority system based on assessed need, rather than a single queue. Each person is given a priority category (Urgent, High, Medium, or Low). High-level care has historically faced the longest waits. Under the former Home Care Package system, Level 4 waits often ran 9 to 18 months. The national priority system is intended to make allocation more responsive to need.
Once a place is assigned, you have 56 days to choose a provider, plus a 28-day extension if you need more time.
What to do while waiting:
Access CHSP services. The Commonwealth Home Support Programme can provide basic services while you wait.
Ask about your priority category. If your situation is urgent (risk of hospitalisation, carer breakdown, safety concerns), ask My Aged Care whether you should be assessed as a higher priority.
Consider private top-up. If you can afford it, privately funded services can fill the gap while you wait for your place.
Costs and fees
Support at Home removed the basic daily fee and the old income-tested care fee that applied to Home Care Packages. Instead, you make service-based contributions based on the type of service and your means.
Service-based contributions
| Service category | Full pensioner | Self-funded retiree |
|---|---|---|
| Clinical care (nursing, allied health) | 0% | 0% |
| Independence (personal care, mobility) | 5% | up to 50% |
| Everyday living (cleaning, meals, gardening) | 17.5% | up to 80% |
Clinical care is free for everyone. Your rates for independence and everyday living services sit on a sliding scale between the full pensioner and self-funded rates based on your assessed means.
From 1 October 2026, personal care moves into clinical care and becomes fully government-funded, with no out-of-pocket contribution. The independence and everyday living figures in the table above apply until then, so treat them as current for the 2026 transition year rather than fixed.
Lifetime cap
Your total Support at Home contributions are capped at $135,318.69 over your lifetime (as at 1 November 2025, indexed twice a year). Once you reach the cap, you stop contributing. Existing Home Care Package recipients who moved across are “no worse off,” keeping their previous arrangements.
The value equation
High-level care provides up to $78,106 per year. The equivalent residential aged care can cost a similar amount once accommodation is included. For many people, staying home with high-level support is both preferred and cost-effective, and you get to stay in your own home, with your own things, on your own terms.
For current contribution rates, check myagedcare.gov.au (figures correct as at June 2026).
Support at Home changes
On 1 November 2025, the Support at Home program replaced home care packages. Level 4 now falls under Support at Home Classifications 7 ($58,148) and 8 ($78,106), covering high-level and complex care needs.
Classification 8 ($78,106 per year) is higher than 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
- The basic daily fee and income-tested care fee were replaced by service-based contributions (clinical care 0% for everyone), with a lifetime contribution cap of $135,318.69 (as at 1 November 2025, indexed twice a year)
- Services grouped into clinical care, independence, and everyday living
- The Single Assessment System (using the Integrated Assessment Tool, or IAT) replaced ACAT on 9 December 2024
If you held a Level 4 package before 1 November 2025, you are “no worse off.” Your services continue and you do not need to reapply.
For the full picture, read our Support at Home program guide. To see how the old levels map across, read Support at Home Classifications 7 and 8. If you held a package and are moving over, see switching from a Home Care Package to Support at Home.
High-level home care vs residential care
This is the comparison many families are wrestling with. Here is an honest look at both options.
| Factor | High-level care at home | Residential care |
|---|---|---|
| Annual budget | Up to $78,106 (Classification 8) | Government-funded, plus resident contributions |
| Out-of-pocket costs | Service-based contributions, lifetime cap $135,318.69 | Basic daily fee $66.80/day plus care and accommodation costs |
| 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 |
High-level care 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, high-level home care makes staying home possible, and that matters.
Frequently asked questions
How much was Level 4?
The former Level 4 package provided approximately $62,589 per year before 1 November 2025. Under Support at Home, high-level care is covered by Classification 7 ($58,148) and Classification 8 ($78,106).
How many hours is high-level care?
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 high-level care replace a nursing home?
For many people, yes. High-level Support at Home provides daily personal care, regular nursing, allied health, home modifications, and respite. It is 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?
Support at Home allocates places through a national priority system based on assessed need. Once a place is assigned, you have 56 days to choose a provider, plus a 28-day extension. Under the former Home Care Package system, Level 4 waits often ran 9 to 18 months. You can access CHSP services for basic support while you wait.
What if high-level care is not enough?
If your budget does not meet your needs, options include privately funding additional services, combining your funding with CHSP, or considering residential aged care. Classification 8 provides up to $78,106 per year, which may bridge the gap.
Can I get overnight care with high-level support?
High-level care can fund some overnight care, but it is limited within the budget. Most 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 high-level care provider
High-level 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.
Carevo 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.
Get matched with the right provider or call 1800 953 253 for help finding the right provider for complex care needs.
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Based on 938 aged care and Support at Home inquiries made through Carevo. See the full Support at Home Demand Report.
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About the author
Back to Blog Co-founder & CEO · Updated
Andre is the co-founder and CEO of Carevo. He holds a Bachelor of Commerce, majoring in Marketing, and a Bachelor of Arts from UNSW Sydney, where his majors were International Relations, Politics, Information Systems, and Media and Communications, graduating in 2014, and went through the UNSW 10x Founders accelerator in 2023.
