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The National Disability Insurance Scheme (NDIS) and the Home Care Packages (HCP) program—soon transitioning to the Support at Home initiative—are pivotal Australian government programs designed to support Australian individuals with disabilities.
Whilst Government-funded support services like Australia’s are common globally, the structure, scale and accessibility of these programs do distinguish Australia as a world leader in such programs.
However, despite the fact that both programs are designed to enhance quality of life and promote independence of its participants, they differ significantly in funding, flexibility, self-autonomy, scope of services and financial hurdles faced by its participants.
The Origins of the NDIS
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The NDIS was designed to provide individualised, needs-based support to people under 65 with permanent and significant disabilities, giving them control over the services and supports they receive.
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It was born out of the 2011 Productivity Commission report, which found the existing disability system in Australia to be underfunded, unfair and fragmented.
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The NDIS began as a trial in July 2013 in select locations and was gradually rolled out nationwide between 2016 and 2020.
The Origins of Home Care
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Australia’s home care system evolved from earlier Commonwealth-funded programs like the Community Aged Care Packages (CACP), introduced in 1992.
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In 2013, the government introduced the Consumer Directed Care (CDC) model within HCPs, giving older Australians more choice and control.
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In 2017, Home Care Packages were assigned directly to individuals.
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The HCP will soon be superseded by the Support at Home Program in July 2025.
At a high level glance, the NDIS and Homecare are by design separate programs given the differences in the ages of the participants. Each of these programs have clearly stated target groups, as listed in the table below.
|
Category |
NDIS |
Home Care Packages (HCP) |
Support at Home (SaH) |
|
Target Group |
Under 65 with significant, permanent disability |
65+ (or 50+ Indigenous) needing home care |
65+ (or 50+ Indigenous) needing home support |
These differences may be assumed to be self-evident and justified on cursory overview, however on deeper reflection, troubling questions arise.
Why are over-65 y/o Australians living with a disability treated so differently to the under-65 y/o Australians who are also living with a disability, in terms of the support available?
Further, why are the Australians who are on a program that actually saves the Australian Government up to $6.8 billion dollars per year, exposed to services that are by design more financially onerous, more paternalistic, less flexible, and in light of the further restrictions due to be imposed by the new Support at Home program, more likely to force participants out of the program altogether?
Is it is case of pure Age-ism, or a more pragmatic political strategy of cutting funds to a vulnerable sector within the Australian community who have little voice, and even less political clout?
When one looks deeper into the differences between the NDIS and the Home Care Package program, and even further into the imminent Support at Home program, this question becomes even more pronounced.
An example of the further differences between these support programs are presented in the table below.
TABLE ON DIFFERENT FINANCIAL IMPACTS B/W PARTICIPANTS
|
Support Service |
Income/Asset testing |
Full Pensioner Contribution* |
Part-Pensioner/CHSC* |
Self-Funded Retiree (no CSHC)* |
|
NDIS
|
No |
$0 |
$0 |
$0 |
|
Home Care Packages (HCP) |
Yes, Income Tested. Assets not included |
Basic Daily Fee. Waived since July 2021 |
Up to ~$12/day (income-tested care fee) |
Up to ~$12,000/year |
|
Support at Home (from July 2025) |
Yes, Income & Assets tested (via Age Pension test) |
$0 for Clinical Services
5% contribution for all Independence services
17.5% for all Everyday Living services |
$0 for Clinical Services
5% to 50% contribution for all Independence services
17.5% to 80% for all Everyday Living services
|
$0 for Clinical Services
50% contribution for Independence services
17.5% to 80% for Everyday Living services
|
*NDIS participants who are on the NDIS prior to being 65 years of age can stay on the NDIS even after 65 years of age.
For new Support at Home, the following Services are defined as:
|
Clinical Services |
Independence Services
|
Everyday Living Services
|
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($0 contribution)
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(5% to 50% contribution of fees to be paid by participant): |
(17.5% to 80% contribution of fees to be paid by participant) |
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Clinical Services are defined as: |
Independence Services are defined as: |
Everyday Living Services are defined as: |
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Nursing Care · Physiotherapy · Occupational Therapy · Podiatry · Dietetics · Speech Pathology · Continence Assessment and Support · Medication Management · Allied Health Services
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· Carers · Assistance with Mobility · Transport Assistance · Social Support Services · Technology support · Allied Health (if aimed at maintaining function) – e.g., physiotherapy or occupational therapy focused on mobility or falls prevention. · Equipment and Aids (Low-Risk) – Such as walkers, shower chairs, and grab rails that assist daily living.
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· Domestic Assistance · Meal Preparation · Shopping Assistance · Gardening and Yard Work · Basic Home Maintenance · Unaccompanied Transport · Pet Support · Bills and Administration Help
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The Question of Why?
Looking at the above table, obvious questions arise.
Why are elderly Australians required to pay for such support services based on both an Income and Assets test, when NDIS participants can be multi-millionaires and not required to contribute at all?
Why are people on the full-pension required to contribute to almost all their support services, when they receive the pension precisely because they are financially struggling?
Given such questions, one could further ask why elderly Australians with Disabilities are forced to go on a Home Care Package instead of the NDIS, given such significant differences?
Below are further measures of contrast between these Australian government support programs.
|
Category |
NDIS |
Home Care Packages (HCP) |
Support at Home (SaH) |
|
Support Available |
Personal care, therapy, assistive tech, home mods, transport, employment, social supports |
Personal care, meals, transport, nursing, home mods, allied health |
All HCP services plus expanded clinical, independence, and everyday living supports |
|
Funding Amounts |
Based on individual needs (eg, can be $100k+ annually) |
Fixed by level: L1: ~$11k, L2: ~$19k, L3: ~$41k, L4: ~$61k |
Ten classifications (up to ~$78k/year for highest need); budgeted quarterly |
|
Spending Limits |
Funds tied to ‘reasonable and necessary’ disability supports; not for daily living costs (e.g. rent) |
Must be used for approved aged care supports; not for general living expenses. Unused funds can be carried over |
Must align with service list categories; carryover capped at $1,000 or 10% quarterly |
|
Restrictions (Detailed) |
Cannot fund: Rent, Groceries, Vacations, General household items |
Cannot fund: Mortgage/rent, Private medical services, Leisure activities, Overseas services |
Cannot fund: Private accommodation, Non-care-related expenses, Excessive home improvements |
|
Co-payment Requirements |
No co-payments; voluntary top-ups allowed |
User pays: Basic daily fee (up to $11.22), Income-tested fee (up to ~$12,600/year) |
More user pays |
|
User Pays (Income & Assets Based) |
Not income- or asset-tested |
Income-tested care fee: Singles above ~$32k/year, Max ~$12.6k/year, Lifetime cap ~$76k |
Assessed by Centrelink: Higher contribution fees for all clients, Clinical services free |
|
Annual Govt. Expenditure (2024–25) |
~$44 billion |
~$6.5 billion |
Replacing HCP (~$6.5B+); part of broader $4.3B aged care reform |
|
Participants (2024) |
~680,000 |
~284,000 |
~284,000 (initial transition from HCP/STRC); growth expected |
Flexibility and Scope of Services
NDIS:
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Flexibility: Participants have the autonomy to allocate funds across various support categories, adapting to changing needs without requiring formal approval.
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Services Covered: Includes therapies, assistive technology, home modifications, personal care, community participation, and transport.
Home Care Packages & Support at Home:
- Flexibility: Funding is more prescriptive, covering specific services such as personal care, domestic assistance, and certain equipment.
- Services Covered: Primarily offers support for aging, such as personal care, meal preparation, and home maintenance.
Home Care no More. Support at Home starts 1st July, 2025
Transition to Support at Home
The upcoming Support at Home program, set to commence on 1 July 2025, aims to consolidate existing in-home aged care programs, including the HCP and Short-Term Restorative Care (STRC) Program.
- New Classifications and Budget Levels: To better meet a person’s aged care needs.
- New Pricing: Standardized pricing for services
- Increased Focus on Early Interventions: Emphasis on proactive measures to maintain independence.
- Higher Levels of Care for Complex Needs:Enhanced support for individuals with more complex requirements.
Grandfathering Provisions for Existing HCP Recipients
Individuals who are receiving a Home Care Package as of 30 June 2025 will transition to the Support at Home program under “no worse off” arrangements.
This means that they will continue to pay the same or a lower amount in contributions compared to what they were paying under the HCP program, even if reassessed under the new system.
Under the forthcoming Support at Home program, participant contributions will be determined based on a means-tested assessment of income and assets, aligning with the Age Pension means test.
Hardship Provision
Existing hardship arrangements will continue under the Support at Home program.Participants facing financial difficulties can apply for hardship assistance to reduce their contribution obligations.
For more detailed information on the Support at Home program and its means testing arrangements, you can refer to the official resources provided by the Department of Health and Aged Care: