Aged care means assessment 065-09000000

A means assessment is the assessment of a care recipient’s income and/or assets. It determines the type and level of contribution a care recipient must make towards their aged care costs.

For home care:

• a means assessment is an income assessment
• determines the care recipient’s contributions to their care costs
• applies to care recipients commencing home care on or after 1 July 2014, or
• a pre 1 July 2014 care recipient opting in to the post 1 July 2014 assessment rules

For residential care:

• for care recipients assessed under post 1 July 2014 schemes, a means assessment is a combined assets and income assessment
• for care recipients assessed under pre 1 July 2014 schemes, a means assessment is done via separate assessments for income and assets
• the means assessment determines the care recipient’s contributions to their accommodation and care costs

Assessments are completed in the Customer First system. If a care recipient or their nominee contacts to request a calculation of their cost of care, they can do this in one of the following ways:

• Automatically
• Customer First can complete a means assessment automatically where the care recipient has commenced care and the required information is available in the system
• As a verbal assessment
• Can be undertaken where the information is available in the system and any outstanding information can be obtained verbally
• Via lodgement of a form. Depending on care type the form will be one of the following:
• Home Care Package Calculation of your cost of care (SA456)
• Residential Aged Care Calculation of your cost of care (SA457), or
• Residential Aged Care Property details for Centrelink and DVA customers (SA485)

The Resources page contains links to forms.

Signature requirements for Aged Care Calculation of your cost of care differ from Social Security forms. Unlike Social Security forms, if an Aged Care Calculation of your cost of care form is:

• signed by a care recipient or authorised third party anywhere on the form, the form can be accepted.
• unsigned, it can be accepted following verbal contact in some circumstances

See Aged care means assessment - preliminary checks for information regarding means assessment validity periods.

The Aged Care Calculation of your cost of care forms are located on the Services Australia website. They are available as paper forms. The Resources page has a link to the forms and an explanation of which forms are required.

Encourage applicants to access the forms from the website themselves, where possible. The applicant can print and complete a paper form (SA456, SA457 or SA485). If an applicant is unable to access the form online, issue the form using the Customer First Mail Forms Guided Procedure.

SA456 (home care) and SA457 (residential aged care) forms:

• are required when a care recipient does not receive a means tested payment from Centrelink or Department of Veterans’ Affairs (DVA)
• request all income and asset information required for the completion of a means assessment
• The SA456 form was previously titled Aged Care Fees Income Assessment and the SA457 was previously titled Permanent Residential Aged Care - Request for a Combined Assets and Income Assessment

SA485 (residential aged care property details) form:

• may be used when a care recipient receives a means tested payment from Centrelink or DVA and owns or part owns their home, including retirement villages, if a verbal assessment is not able to be completed
• is shorter than the SA457 form, and only collects information related to the principal home

There is a change to the request for information (RFI) process for carers and close relatives when assessing Aged Care Calculation of your cost of care forms (SA457 and SA485). The Aged Care Carer or close relative assessment (SA483) form replaces the decommissioned questionnaire. Links to forms are available on the Resources page.

Home care providers are responsible for aged care means assessments for home care recipients assessed under pre 1 July 2014 schemes. Care recipients who commenced a package prior to 1 July 2014 are not required to complete a new income assessment, unless there is a break in care of greater than 28 days.

The agency (or the Department of Veterans’ Affairs (DVA)) undertake home care means assessments for care recipients assessed under post 1 July 2014 schemes and who commenced:

• a new package, or are considering commencing a new package, on or after 1 July 2014
• a package prior to 1 July 2014 and after a break in care of greater than 28 days have commenced a new package, or are considering commencing a new package, on or after 1 July 2014
• a package prior to 1 July 2014 and are seeking an estimate of fees as they are considering opting in to the post 1 July 2014 assessment rules (no break in care)

When is a Home Care Package – Calculation of your cost of care (SA456) form required?

An SA456 is required for care recipients who:

• are self-funded retirees (includes care recipients who receive a foreign pension)
• receive a Centrelink non-means tested income support payment
• examples include Age Pension (Blind), Disability Support Pension (Blind), Carer Allowance and Mobility Allowance
• however, if they have a partner who receives a Centrelink means tested income support payment and/or rent assistance they may not need to lodge a form
• receive a Department of Veterans’ Affairs (DVA) non-means tested payment
• for example, a War Widow(er)’s Pension (without an Income Support Supplement)

When is an SA456 not required?

An SA456 is not required for care recipients who:

• receive a Centrelink means tested income support payment
• examples include Age Pension and Disability Support Pension
• receive a DVA means tested income support payment
• examples include Age Service Pension, Invalidity Service and Income Support Supplement
• receive Age Pension (Blind) or Disability Support Pension (Blind) from Centrelink and have a partner who receives a Centrelink means tested income support payment/rent assistance

If an SA456 is not required:

• the means assessment will complete automatically when the care recipient enters care
• where the care recipient has not yet entered care, it is not possible for the means assessment to complete automatically:
• where a means assessment is requested prior to entry to care it will need to be undertaken online, verbally or via an SA456

A residential care means assessment is required for care recipients who:

• enter or are considering entering permanent residential care for the first time after 1 July 2014
• re-entered permanent residential care after a break in care of more than 28 days on or after 1 July 2014, or
• enter permanent residential care prior to 1 July 2014 and are considering opting in to a post 1 July 2014 assessment scheme

The Residential care means assessment determines:

• the daily means tested care fee, and
• liability for accommodation costs

Liability for accommodation costs

The care recipient’s status, set at the date of permanent entry to care, determines liability for accommodation costs. The status will be either low means or not low means.

A low means care recipient is eligible for assistance with their accommodation costs. They can be asked to pay either:

• an Accommodation Contribution. This is a partial contribution towards the accommodation cost (the government will pay the remainder)
• no accommodation costs. The government will pay the full accommodation cost

A not low means care recipient is not eligible for government assistance with their accommodation costs. They must pay an Accommodation Payment (that is, the accommodation price they agree to with the service provider). The accommodation price must be agreed to before entry to care.

The care recipient’s status will not change following entry to care, even if there are changes to their circumstances.

For low means care recipients, a change in circumstances after entry to care:

• may affect the amount of accommodation contribution and/or means tested fee payable
• will not make them liable for an accommodation payment while they remain in the same facility

For not low means care recipients, a change in circumstances after entry to care:

• may affect the amount of means tested fee payable
• will not affect the accommodation price that was agreed to prior to entering care

A previously low means care recipient may be reassessed and found to be not low means at date of entry to care. Any accommodation supplement paid to the provider is recovered and the care recipient asked to pay an accommodation payment.

Note: if the means assessment was incorrect at the date of entry, any review of the means assessment may be backdated.

The Resources page contains:

• calculation examples of Residential Aged Care means assessments
• fee calculation worksheets for manual calculation of residential care fees, and
• links to Department of Health and Aged Care’s Schedule of Fees and Charges for home care and residential care - Pre and Post 1 July 2014 assessment schemes

When is a Residential Aged Care – Calculation of your cost of care (SA457) form required?

An SA457 must be lodged for care recipients who:

• are self-funded retirees (includes care recipients who receive a foreign pension)
• receive a Centrelink non-means tested income support payment
• examples include Aged Pension (Blind), Disability Support Pension (Blind), Carer Allowance and Mobility Allowance
• home owners who have a partner who receives a Centrelink means tested income support payment will need to provide principal home details verbally
• non home owners who receive rent assistance or who have a partner who receives a Centrelink means tested income support payment will need to provide principal home details verbally
• receive a Department of Veterans’ Affairs (DVA) non-means tested payment, for example a War Widow(er)’s Pension (without an Income Support Supplement)

When is a Residential Aged Care Property details for Centrelink and DVA customers (SA485) form required?

For care recipients who receive a Centrelink or DVA means tested income support payment:

• where the care recipient has entered care:
• for non-home owners, the means assessment will complete automatically
• for home owners, principal home details will need to be provided verbally or via an SA485
• DVA care recipients should contact DVA to discuss if they are required to complete an SA485 form or can lodge a verbal assessment
• where the care recipient has not yet entered care and has requested a pre-entry assessment:
• an automatic means assessment cannot be triggered and needs to be undertaken verbally or by completing the online application, or an SA485 form

When is an SA457 or SA485 not required?

An SA457 or SA485 is not required for care recipients who receive:

• a Centrelink means tested income support payment (examples include Age Pension and Disability Support Pension); and are non home owners
• a Centrelink non means tested income support payment (for examples include Age Pension (Blind) or Disability Support Pension (Blind)); and receive Rent Assistance or have a partner who receives a Centrelink means tested income support payment:
• have already provided income and asset details to Centrelink
• will be required to provide principal home details if they are a home owner
• these assessments will need to be completed manually as they are not eligible for auto completion
• a Centrelink means tested income support payment, has not yet entered care and has requested a pre-entry assessment:
• an automatic means assessment cannot be triggered and needs to be undertaken verbally or by completing the online application
• DVA care recipients should contact DVA to discuss if they are required to complete an SA485 form or can lodge a verbal assessment

Prior to 1 July 2014, a means assessment was known as a Residential Care Assessment (RCA). The RCA covered 2 different types of assessment:

• Residential Care Income Assessment (RCIA), and
• Residential Care Assets Assessment (RCAA)

Income Assessments

Aged Care Income Assessments (previously known as RCIA) are applicable for care recipients who:

• first entered permanent residential care after 1 March 1998 and prior to 1 July 2014, and
• have not had a break in care of greater than 28 days since 1 July 2014

The income assessment determines the daily income tested fee amount. If no means assessment is completed, care recipients are liable for the full cost of their care. An income assessment could be completed at the time of entry or a care recipient could subsequently choose to complete an income assessment at a later date.

Assets Assessments

Aged Care asset assessments (previously known as RCAA) are required for care recipients who first entered permanent residential care after 1 July 2005 and prior to 1 July 2014, and have not had a break in care of greater than 28 days since 1 July 2014.

Applying for an assets assessment is voluntary. It is compulsory where the care recipient wishes to claim either concessional, assisted, or supported resident status. Assets assessments can be completed either prior to, or after entry into care.

Prior to 1 July 2005, the service provider completed these.

The assets assessment determines the amount payable for accommodation costs. The care recipient will be liable for one of the following:

• Accommodation Bond:
• For those in low level care and extra service places
• Amount payable is dependent on the assets assessment
• Can be paid as a daily amount or as a lump sum
• Accommodation Charge
• For those in high level care
• Can only be paid as a daily amount
• Depending on the date that the care recipient first entered care, different rules regarding this charge apply. Further information regarding these rules is available on the Resources page linking to the Department of Health and Aged Care – Residential Care Fees and Charges for residents that entered care before 1 July 2014

Form options for pre 1 July 2014 residential care recipients are:

• SA456 for an income assessment
• Advise the care recipient to disregard the instructions on the form that state they are not to be used for residential care. This only applies to care recipients who first entered care on or after 1 July 2014
• SA485 for an assets only assessment where the care recipient is in receipt of a Centrelink means tested income support payment
• See below note regarding information about debts
• SA457 for an assets only assessment where the care recipient is a self-funded retiree or is not in receipt of a Centrelink means tested income support payment
• see below note regarding information about debts
• SA457 to obtain an estimate of fees if they are considering opting in to the post 1 July 2014 assessment rules

The Resources page has links to forms.

Note: pre 1 July 2014 residential care recipients cannot complete an online Aged Care calculation of cost of care.

Care recipients assessed under pre 1 July 2014 schemes can deduct the value of debts from their assessable assets. Further information regarding any outstanding debts, other than a mortgage on their principal home, need to be provided in addition to the information requested on the SA457 and SA485.

Debts include:

• Credit card debts
• Personal loans
• Utility bills
• Medical bills

Specific details required include:

• The amount owing
• The name of the creditor
• The care recipient’s percentage of share in the debt
• Their partner’s percentage of share in the debt

It may be possible to obtain this information verbally but in most cases a Request for information letter will need to be sent.

A care recipient who chooses not to have their means assessed is not eligible for government assistance with their fees except in the circumstances of annual and lifetime caps. They are deemed to be means not disclosed (MND) and are liable for the maximum care fee based on the cost of their care. Residential care recipients who are MND are also liable for an Accommodation Payment.

MND Letters

Where a care recipient has:

• commenced care and does not have a valid means assessment:
• An MND initial letter is sent requesting they lodge an Aged Care Calculation of your cost of care form
• If no response is received following the MND initial letter, an MND reminder letter is sent (unless the care recipient advises that they do not wish to disclose their means)
• If no response is received following the MND reminder letter (or if the care recipient has advised that they do not wish to disclose their means), the MND final letter is sent. The letter advises that they are now deemed to be MND and are liable to pay the maximum fees for their level of care
• not commenced care and has advised they do not wish to disclose their means:
• MND letters are not sent before the care recipient has commenced care
• When care has commenced, the MND final letter is sent. This advises that they are deemed to be MND and are liable to pay the maximum fees for their level of care

Details of MND letter types are available in the Aged care letter codes and descriptions.

Where a calculation of your cost of care application has commenced, but documentation required to complete the assessment is not received, a written request for information will be issued. The care recipient is deemed to be MND if they fail to provide the requested information.

MND and responsible department/agency

For care recipients who entered care prior to 1 July 2019, the agency managed the MND process for all care recipients.

For care recipients entering care from 1 July 2019, the department/agency responsible for completing the means assessment, for example, Services Australia or Department of Veterans’ Affairs (DVA) manages the MND process.

Care recipients may commence home or residential care with the DVA as the responsible department, and during their care period, the responsibility may change to Services Australia. Where change of responsibility occurs Customer First will receive an entry event to create an RCA/HOM or RCA/NCL. The date of entry on RCIRC will display the date the responsible department changed not the actual date of entry into care. The change in responsibility date is the date of event for coding a means assessment.

A care recipient may elect to opt into post 1 July 2014 assessment rules if moving to a new service provider and currently assessed under a pre 1 July 2014 scheme. To opt in, the care recipient:

• must be moving into the same service type (home care to home care or residential care to residential care)
• if the move is from home to residential care (or vice versa), the care recipient will automatically be assessed under post 1 July 2014 rules
• must be moving into a new service
• they cannot opt in if they remain with the same service (as determined by the Service/RACS ID)
• must lodge an AC022 (Continuing Care Recipient opting into the New Aged Care Arrangements from 1 July 2014 form):
• the ACO22 must be lodged with the new service provider before moving to the new service
• the service provider will then send the form to the Aged Care Payments Team (Health Service Delivery Division) who process this form
• see the Resources page for a link to this form

Care recipients who are outside of care (other than on approved leave) for more than 28 days after leaving their former home or residential care service are automatically subject to post 1 July 2014 assessment rules if they later re-enter care.

Once the care recipient has opted in, they cannot choose to return to their former fee arrangements. For more information see Opting into the post 1 July 2014 aged care means assessment arrangements.