A younger person under 65 living in residential aged care may be eligible for the National Disability Insurance Scheme (NDIS). If a younger person is eligible for the NDIS, they may receive additional assistance with the cost of aged care. However, they may still need to contribute to accommodation costs, living expenses and care services.
When a younger person enters residential aged care, they will sign a residential agreement with the aged care home. This will set out the care and services they will receive and the costs.
To learn how the NDIS can assist with aged care fees and provide further support, see the NDIS Younger People in Residential Aged Care Operational Guidelines.
Entering aged care after 1 July 2014
The NDIS may pay some care fees for younger NDIS participants that enter aged care after 1 July 2014. The younger person’s NDIS plan will outline these amounts.
An NDIS planner or support coordinator will discuss aged care fees with the younger person when their NDIS plan is developed.
Lump Sum deposit
A lump sum deposit, such as a Refundable Accommodation Deposit (RAD) is not funded by the NDIS. However, the younger person can still choose to pay a lump sum for their accommodation. The aged care provider will refund the balance of the lump sum when a younger person leaves the aged care home, less any amounts that they have drawn down from the lump sum to pay other aged care cost while in the aged care home.
Daily Accommodation Contribution (DAC), a resident assessed as ‘low means’ is eligible for accommodation cost support. The NDIS will help the younger person with this payment. Providers may need to tell the younger person the DAC payment amount.
Daily Accommodation Payment (DAP), a resident without ‘low means’ status will pay the agreed room price. The NDIS will help the younger person with part of this payment – up to the value of the service’s eligible maximum accommodation supplement. Providers may need to tell the NDIS this amount. The amount above the service’s eligible maximum accommodation supplement is still payable by the younger person and will not be in their NDIS plan.
Basic daily fee
The basic daily fee covers the costs of daily living, such as meals, cleaning, laundry, heating and cooling. The younger person must pay this fee, as confirmed in their residential agreement. The NDIS does not fund daily living costs and therefore does not assist with funding for the basic daily fee.
Means-tested care fee
The NDIS may assist the younger person with the means-tested care fee. Providers should advise the younger person of their current fee.
Additional service fees
If the younger person chooses to access additional service fees, often ‘hotel-type’ services, the younger person will be responsible for paying this fee. The NDIS does not assist with this fee.
More information on aged care fees can be found on the aged care home costs and fees webpage.
Entered aged care prior to 1 July 2014
Younger people who entered aged care before 1 July 2014 will receive some assistance from the NDIS with their aged care fees. These amounts will be included in the younger person’s NDIS plan.
The NDIS planner will discuss how these aged care fees are paid when developing the NDIS plan.
Accommodation bond or charge
The accommodation bond, based on the type of accommodation and level of care needs, will not be NDIS-funded.
The NDIS will assist the younger person with the accommodation charge payment, applied in a residential aged care home providing high-level care.
Income tested fee
The NDIS will support the younger person with their income tested fee. The income tested fee cannot be more than the amount as detailed and tested by Services Australia. If the younger person’s income is above the threshold, the provider can ask the resident to pay an income tested fee.
Additional service fees
The NDIS will only fund disability related supports that are approved in the younger person’s plan.
If a younger person chooses to access additional service fees, such as ‘hotel-type’ services, the NDIS will not provide funding. The younger person will be responsible for paying this fee.
Read more information on aged care costs if you entered care before 1 July 2014.
Cross billing payments for residential aged care subsidies and supplements
For NDIS participants in residential aged care, their NDIS plan will also include the item ‘Cross billing payments for residential aged care subsidies and supplements’. They do not need to do anything with this item. The NDIA will manage this item, as it is for the cost of subsidies and supplements that the government pays for residents in aged care.
For more information, see the NDIS Younger People in Residential Aged Care Operational Guideline.