Home Care Package Denied in Australia? How to Appeal an Aged Care Decision

Home Care Packages (HCPs) are Australian Government-funded care packages that allow older Australians to remain living at home with support tailored to their needs. There are four levels of HCP — from Level 1 (basic care needs) to Level 4 (high care needs) — providing between $10,500 and $57,000 per year in funding.

When an older Australian is found ineligible for an HCP, or is assigned a level lower than their care needs require, it can have serious consequences for their independence, safety, and quality of life.

This guide explains the assessment process, why packages are denied or under-assigned, and how to challenge the decision.

How Home Care Packages Work

To access an HCP, an older Australian must:

1. Register with My Aged Care — online or by calling 1800 200 422
2. Have a comprehensive assessment — conducted by an Aged Care Assessment Team (ACAT) or Aged Care Assessment Service (ACAS) in Victoria
3. Be found eligible for an HCP at a particular level
4. Wait for assignment — due to demand, there may be a waitlist
5. Select an approved HCP provider — and begin receiving services

The assessment determines your eligibility and the level of package you need.

Why HCPs Are Denied or Under-Assigned

Not Found Eligible

The ACAT may determine that your care needs can be adequately met through lower-level Commonwealth Home Support Programme (CHSP) services, rather than an HCP. This may happen when:

• The assessor under-rates the complexity or severity of care needs
• The assessment does not capture the full picture of daily functional limitations
• The person being assessed understates their difficulties (as older Australians often do)
• Cognitive decline, dementia-related behaviours, or complex health conditions are not fully explored in the assessment

Assigned Too Low a Level

Even when found eligible, the ACAT may assign a Level 1 or Level 2 package when the person's care needs more closely match Level 3 or Level 4. Under-assignment means the funded care package cannot fully cover the services needed, leaving family members to fill the gap unpaid or forcing the person to pay out of pocket.

Waitlist Delays

Assignment to the HCP may be correct, but the wait for an available package at that level can be many months. While waiting, people may receive only basic CHSP services, which may be insufficient for complex needs.

Your Right to Request a Review

If you are dissatisfied with an ACAT decision — either a finding of ineligibility or the level assigned — you have the right to request a review. The review process involves:

Step 1: Request the Decision in Writing

Ask My Aged Care or the ACAT for a written record of the decision, including the reasons for the eligibility finding or the level assigned.

Step 2: Gather Additional Evidence

Work with your GP, specialist, and any allied health professionals (e.g., physiotherapist, occupational therapist, nurse) to gather:

• Medical reports documenting your health conditions, medications, and functional limitations
• An occupational therapist's report on activities of daily living (ADLs) and instrumental activities of daily living (IADLs)
• Evidence of falls, hospitalisations, or incidents at home
• A written account from family members or carers describing daily care needs and risks

Step 3: Request a Reassessment

You can request a reassessment through My Aged Care. A reassessment is a new ACAT assessment — ideally with different assessors — that takes into account new information or evidence not considered in the original assessment.

Contact My Aged Care at 1800 200 422 to initiate a reassessment request.

Step 4: Complain to the Aged Care Quality and Safety Commission

If you believe the assessment was conducted improperly, the assessors were dismissive, or your care needs were not properly evaluated, you can lodge a complaint with the Aged Care Quality and Safety Commission (ACQSC) at agedcarequality.gov.au or by calling 1800 951 822.

The ACQSC can:

• Investigate complaints about aged care services and assessments
• Direct the provider or assessor to take remedial action
• Refer systemic issues to the Department of Health, Disability, Regional Development and Education

Step 5: Seek an Internal Review of the ACAT Decision

The ACAT's decision about care needs assessment can be reviewed internally. Ask the ACAT coordinator to escalate your case for senior review or a second opinion assessment.

Step 6: Consider Commonwealth Review Rights

Under the Aged Care Act 1997 and the Aged Care Quality and Safety Commission Act 2018, there are formal review rights for certain administrative decisions. In complex cases — particularly involving residential aged care approvals — specialist aged care legal advisers may be able to assist.

Interim Options While Waiting

If you are waiting for an HCP or seeking a higher-level package:

• Commonwealth Home Support Programme (CHSP): Apply for entry-level services (domestic assistance, personal care, meals, transport) as a bridge
• Private care: Engage a private home care provider while waiting (HCP funding may later offset some costs)
• Carer support: Contact Carer Gateway (1800 422 737) for support services for family carers

Fight Back With ClaimBack

ClaimBack helps older Australians and their families prepare structured review requests, gather clinical evidence, and navigate the My Aged Care system when home care funding has been unfairly denied or under-assigned.

Start your home care package appeal with ClaimBack

Related Reading

• How to Write an Insurance Appeal Letter
• Internal vs External Insurance Appeal: What's the Difference?
• How to Use the Insurance Ombudsman