Five Things They Don't Tell You About Full-Service Home Care Providers

1. The Coordination Markup Is Structural, Not Optional

Every full-service home care provider takes your Support at Home funding and applies a coordination markup before any care is delivered. They roster the worker, send the invoice, handle the admin, and bill that work back to your funding as a percentage on top of the worker's actual hourly rate.

The markup is rarely shown to you cleanly. Some providers fold it into the hourly rate (a much higher headline rate per hour). Others split it into a separate Care Management fee and admin charge (a percentage on every dollar processed). Either way, the maths is the same. A meaningful slice of your funding goes to the provider's internal operations rather than to your support worker.

2. The Workers Are Usually From the Same Local Pool

Here's the part the marketing doesn't lean on. In most metro and regional Australian postcodes, the cleaners, personal-care workers, and nurses available to full-service providers are the same people available to self-managed clients. Australia has a single home-care workforce. Providers do not own their workers.

If you're self-managing on Support at Home and you book a cleaner through one of the staffing platforms, the same individual might rotate through a full-service provider's roster the next day. Same person, same skills, same hour of work. The difference is how much of your funding goes to them versus to the layer between you and them.

There are exceptions. Some full-service providers do employ a stable internal team, especially in regional areas or for clinical care. Worth asking the question explicitly: 'Is this worker your direct employee, or are they contracted in?'

3. After-Hours and Weekend Surcharges Add Up Fast

Headline rates on a provider's brochure are almost always for the cheapest possible visit, a Tuesday morning standard personal care. Real care doesn't fit that mould. People need showers on weekends, medication checks at night, and respite over Christmas.

Common surcharge structures on a full-service arrangement:

• Saturday: usually 25 to 50 percent above standard
• Sunday: usually 50 to 75 percent above standard
• Public holiday: often double the standard rate
• Evening (after 6pm): typically a 25 to 40 percent loading
• Last-minute booking (under 24 hours notice): 10 to 25 percent loading

Ask any provider for their complete surcharge schedule before you sign. If they only quote you the weekday daytime rate, you don't have the information you need to compare.

4. The Care Management Fee Sits on Top of an Already Marked-Up Rate

Under Support at Home, the separate package management fee that existed under Home Care Packages no longer applies. What remains is a Care Management fee, around 10% of your quarterly budget, that everyone pays. The catch with full-service is that this fee sits on top of an already marked-up hourly rate, so the two costs stack.

How the stacking works on a mid-range quarterly budget:

• The Care Management fee (around 10% of the budget) comes off the top before any care is booked.
• The remaining budget then buys care at the full-service hourly rate, which is marked up well above the self-managed rate for the same worker.
• Two effects compound: less budget reaches care, and each hour of care costs more.

On a self-managed Support at Home arrangement, the same Care Management fee applies, plus a self-management fee (the provider's overhead, capped at 10% of the service cost under the program rules). Even with that, the lower hourly rate means the same budget delivers materially more care hours per quarter. That's the source of the savings, fewer layers between you and the worker. Across published provider price lists, full-service everyday rates typically sit 50% to 100% above the matching self-managed rate.

5. You Can Switch Without Leaving Support at Home

The funding the government allocates under Support at Home belongs to you, not to your provider. If you started with a full-service provider and want to move to self-managed (or to a different full-service provider), you can, and you don't lose your Support at Home eligibility.

The typical process:

1. Give written notice to your current provider. Most agreements require 14 to 28 days.
2. Choose your new provider (or self-manage with a self-managed Support at Home provider).
3. My Aged Care moves the funding allocation to the new provider, with no reassessment needed.
4. Any unspent funds in your account transfer with you (some providers attempt to claw these back via 'exit fees', so read your agreement before signing initially).

Trilogy Care, like other self-managed providers, supports the transition. If you're currently on a full-service arrangement and feeling the pinch, the switch typically pays for itself in extra care hours within the first quarter.