Key Takeaways
- Setup fees, exit fees, and package activation fees are banned under SAH, but they sometimes reappear under different names.
- Travel charges, kilometric rates and 'administration overheads' can be material, often $1,000-$3,000 per year if not questioned.
- Cancellation fees are sometimes legitimate (booked workers can't be redeployed), sometimes punitive, read the fine print.
- Equipment hire should usually go against your AT pool, not your operating budget. If it doesn't, you're being double-charged.
- After-hours surcharges and weekend penalty rates are where some providers quietly recover margin, check the multipliers.
The headline reform of Support at Home was capping care management at 10% per quarter. That was always going to push providers to find other places to recover margin, and they have. The good ones are transparent about it; the less good ones aren't.
This post is the consolidated list of hidden costs we see on real SAH statements, what they look like, and how to challenge them.
Banned fees that still appear
Three categories of fee are explicitly banned under SAH:
- Setup fees (sometimes called "package establishment" or "onboarding")
- Exit fees (any charge for leaving the provider)
- Activation fees (any charge tied to commencement of services)
These should never appear on a price list or invoice. If they do, push back. The provider must remove them or you can escalate to the Aged Care Quality and Safety Commission.
What we see in practice: these fees occasionally re-appear under different names. Watch for:
- "Initial care plan development fee"
- "Service commencement charge"
- "Closure administration fee"
- "Final reconciliation fee"
If any of these appear, ask whether they fall under the banned categories. The honest answer is yes; ask for them to be removed.
Travel and kilometric charges
In most urban service delivery, travel between visits is part of overhead and shouldn't be passed on. But some providers, particularly those covering large geographic areas or rural clients, do charge for travel.
What's reasonable:
- A flat per-kilometre rate (around $0.80-$1.00 per km) for journeys with you in the vehicle (e.g. medical transport)
- No charge for the worker's commute between client homes
What's not:
- Charging the worker's drive time as a service hour
- Per-visit travel surcharges in normal urban areas
- Travel charges that aren't clearly itemised on statements
Annual cost if you don't push back: $400-$1,200 per year for a moderate-needs client.
Cancellation fees
These are partly legitimate. If a worker has been rostered, paid for, and you cancel at short notice, the provider has a real cost. Some cancellation charge is fair.
What's reasonable:
- 24-48 hours notice required
- Charge equivalent to one hour of the service rate ($60-$95) for a missed visit
- Waived if cancellation is due to genuine emergency or hospital admission
What's punitive:
- 72-hour notice required (excessive)
- Charge of full visit length ($150-$300+)
- No waiver provisions for emergencies
- Charges that apply even if the provider can re-deploy the worker
A typical participant might cancel 6-10 visits a year due to illness, weather, or family events. Punitive cancellation policies cost $600-$3,000 a year.
Equipment and consumables
Under SAH, assistive technology (rails, ramps, hoists, walkers) is funded from a separate AT pool, not from your operating budget. Consumables (cleaning sprays, gloves) are a grey area.
What's reasonable:
- Worker-supplied consumables included in the hourly rate (the worker brings their own gloves, the provider absorbs cost)
- Equipment hire from the AT pool (no impact on your operating budget)
- Documented equipment purchases through approved suppliers
What's not:
- Charging consumables as line items against your operating budget
- Charging equipment hire against your operating budget
- Marking up equipment supplied through the provider
Annual cost if not challenged: $300-$800 a year on consumables; equipment can be more.
After-hours and weekend surcharges
Penalty rates for support workers on evenings and weekends are real (under the SCHADS award and related instruments). Providers reasonably reflect those in their hourly rates. But some go further than the underlying penalty rates require.
The award structures roughly imply:
- Weekday after 8pm: ~1.15x base rate
- Saturday: ~1.5x
- Sunday: ~1.75x
- Public holiday: ~2.5x
If your provider's price list shows multipliers materially higher than these (especially at 2x for Saturday or 3x for public holiday), they're recovering margin on top of penalty rates. Ask why. Reasonable answers exist (payroll overheads, scheduling difficulty); unreasonable ones are also common.
Annual cost difference between aggressive and reasonable multipliers: $500-$2,000 for clients with regular weekend services.
Care plan reviews charged separately
Care plan reviews should be inside care management, not separate line items. If you're being charged a "care review fee" or "annual planning fee," that's a duplicate charge, you're already paying care management.
Push back; this should be removed from invoicing.
Allied health booking fees
Allied health visits (physio, OT, podiatry) are 100% government-funded. Some providers charge a "booking fee" or "coordination fee" for arranging the visit on top of the visit itself. This is usually inappropriate, coordination is part of care management.
If you see such a fee, ask whether it's covered by your existing care management percentage. If so, it should be removed.
"Administration overheads"
The catch-all line item. Should already be inside care management (10% cap) and package management (10% cap). A separate "administration" charge is almost always a duplicate of one of those.
How to audit your statement
A practical, 30-minute exercise to do once a quarter:
- Pull up your last quarterly statement.
- List every distinct line item.
- Group them into: core service hours, care management, package management, basic daily fee, other.
- Tally the "other" category. What does it total?
- For each "other" line item, ask: is this banned, duplicate, or legitimate?
- Send a one-paragraph written query to your provider for any line you can't justify.
The legitimate response time is 5 business days for a written query of this kind. Quality providers will produce a clear explanation; lower-quality ones will hedge or delay.
When to escalate
If a provider can't or won't justify a charge:
- Lodge a complaint through their internal process (gives them 30 days to resolve).
- Escalate to the Aged Care Quality and Safety Commission (1800 951 822) if unresolved.
- The Older Persons Advocacy Network (OPAN, 1800 700 600) can support you through complaints.
Most situations are resolved at the provider's internal complaints stage.
Don't pay what you don't owe
The single most important habit: read your quarterly statement carefully, every quarter. Hidden charges accumulate quietly. A provider who has been adding $50/month in unjustified fees costs you $600 over a year, and once you stop checking, that grows.
Use the price comparison tool to see hourly rates and care management percentages before you commit, and our price list reading guide to spot issues during onboarding.
If you suspect you're being over-charged and you've already raised it without resolution, the OPAN advocates are independent and free.