Understanding your home care bills

Key points:

• Home care bills can be quite confusing to read, especially if you don’t know what you are being charged for
• There are generally three sections to your home care bill: the overview, the summary, and the itemised list
• If you are concerned that you are being charged for services you never received, ask for clarity from your provider or contact a financial advocate for assistance

Not understanding a home care bill is a common complaint or concern of home care clients and often they have to call advocates, like the Older Persons Advocacy Network (OPAN) or Aged and Disability Advocacy (ADA) Australia, to get help.

Financial advocate for ADA Australia, Heidri Brook, says that there is no set standard for home care bills, which is why sometimes they can be so confusing for home care clients.

You may even come across charges you never knew about, like fees for processing invoices or brokerage fees for using an external party from your regular provider.

Ms Brook explains that it can be hard to keep track of what is being charged and what portion is for direct care services.

“With the fees and things like that on home care bills, it can be a bit confusing. People at the very start [of their services] can sign up at time of crisis and they pick a service straight away and it might not be always the best fit,” says Ms Brook.

“Or they might not have understood fees at the very start because things were happening as they were in a time of crisis.

“People should not feel nervous to ask their provider to sit down again and go through the pricing and go through their statements again. It is something they can do and is a part of their rights to understand their care and services and what they are being charged.”

So what is on your home care bill and how can you ensure that everything on your bill is right?

What's on your bill?

When you start receiving care and services through the Federal Government Home Care Package (HCP) program, you will generally receive a monthly statement showing you all the services you received, how much it cost, the contribution by the Government, your contribution, and how much funding is left over in your HCP budget.

This information is all important, because it can tell you if there are unspent funds, how your current package is tracking, how much money you are spending for care and whether you are being charged for the care that was delivered.

There are usually three areas within your bill that you can expect – an overview, a summary, and an itemised list.

The bill is provided in this way so you have a good breakdown of how your HCP funding is being spent. Additionally, it allows you to compare your own notes or previous bills to what is in your latest statement.

• Overview or account summary

The overview should be the first page of your statement and is a quick snapshot of the last month and its services, including:

• Your package balance
• The Government and client contribution over the month
• The total of services and items you received over the month
• The remaining balance

This section shouldn’t hold anything too complicated and is not too in-depth compared to the rest of the bill.

• Summary of your income and expenses

This section is a further breakdown of your home care expenses for the last month.

You can expect this section to be separated into:

• A quick overview summary of your HCP balance and the subsidy and client contribution total during this time
• An outline of the Government subsidy, including:
  • Your HCP basic subsidy
  • Any primary supplements or top ups your receive, such as dementia and cognition supplement or veterans supplement
  • If you have compensation payment reductions
  • Other supplements, such as enteral feeding, hardship, or viability
• A breakdown of your client contributions, including:
  • Your basic daily fee
  • Your income tested care fee
  • Additional service fees you pay
• An overview costing of your equipment and items, and then costs broken down into services, including:
  • The cost of the equipment and item rentals and purchases
  • Costs of your services in categories, such as personal care, nursing and health services, cleaning and household tasks, etc
  • Any other package services you have received, like carer management fees or package management fees
  • An adjustments section – this would be for any charges that were incorrect or missed from your last bill
  • Your remaining HCP balance

• Detailed expense information or an itemised list

This will be your full rundown of every single service you received for the month, this should include:

• The date you received services
• Who provided the services (your provider or a third party contractor)
• The type of service, for example, personal care, nursing care, or wheelchair purchase
• What the rate is, for instance, this could be a ‘per day’ rate for renting an item or a ‘per hour’ rate if this was for nursing care
• How many hours you received of this service or item, which may be logged as a ‘unit’
• The cost per ‘unit’ or hours
• The complete cost of individual services

This should be a day-by-day breakdown of the services you received, and may be divided into an equipment and items section, services section, other package services section, and adjustments or refunds section.

• Other information

You may find there is a little bit extra at the bottom of your home care bill, this may be another basic breakdown of your HCP balance, including your unspent client contributions and unspent subsidy.

There may also be extra information listed about your client fees and contributions, such as your agreed basic daily fee, your assessed income tested care fee, and your agreed additional services contribution.

To look at an example of a home care bill, you can view a monthly statement example for a Home Care Package on the Department of Health and Aged Care website.

Problems you may come across

Your provider may not have a sophisticated accounting system that provides you with a good breakdown of your services.

Ms Brook says it is not uncommon for some providers to pool all your services into the one slot rather than breaking it down. For example, you received three gardening services of one hour over the month, but your gardening is just put down to three hours for one day.

In these cases, you can request for your home care bills to be set out more clearly by your provider.

Additionally, if you have found that you don’t understand your home care bill, you can always ask your case manager or provider to go through your bill with you.

This could mean a couple of sessions with your provider to make sure you wrap your head around understanding your bill.

Noticing when something is not right

If you are looking at your bill and noticing that some of your services don’t add up, it can be beneficial to call up your provider or case manager and ask what is going on in your bill.

For example, if you only received two hours of cleaning services over the month, but you have four hours on your bill.

“Most people don’t know what their hourly rates are but if you are seeing a really large hourly rate, going back to your provider and asking what this is about and why is it this much [is important],” explains Ms Brook.

Ms Brook suggests circling the charges on your statement you are unsure about before going to your service provider to ask.

She says if you don’t feel comfortable going to your service provider directly to ask about the odd charges, you can always ask an advocate to come in and assist.

Advocacy groups like ADA Australia and OPAN have financial advocates available, who will go through your statement with a “fine-toothed comb” to make sure everything is looking okay.

To make raising a complaint about your bill easier, tracking your services on a calendar, diary or notebook can be really beneficial.

Ways to ensure your bill is always correct

If you are concerned about being overcharged or receiving unnecessary extra charges, you should keep a track of what services and care you do receive.

Ms Brook says there are two fool-proof ways to ensure that you have accurate records so you can ensure you are being charged appropriately by your provider.

1. Keep a logbook

It is not uncommon for home care clients to have a sign-in book for the different people that come into their home.

It can be hard to track who comes and delivers care and services, as you may have people that come in your actual home to assist, whereas a gardener may come around and be outside the whole time so you don’t notice them.

This sign-in system ensures that everyone is accounted for, as they sign in and out, and you also have an accurate record of when people were on your property.

2. Tick off services in your calendar or diary

If you have quite a few appointments coming up, you can tick off the services you utilise from day to day by keeping track in your calendar.

Having a calendar or diary in place means you are aware when someone is coming over beforehand, but also ensures you are across the period that they delivered your care and services.

So when you go back through your bill, you can cross-check to make sure that the services and care you received aligns with your own calendar.

Whatever method you have for tracking your services, keeping a record can make a big difference when disputing any odd charges.

To get assistance or help with your home care bills, or support bringing up an issue with your provider, you can contact OPAN on 1800 700 600 or visit their website for more information.

Do you check your home care bill statement every month? Tell us in the comments below.

Related content:

Home care services and your rights
How much can home care cost?
Why choose private home care?
How to have “the home care talk” with your parents