Aged care fees must be fair
Residents should have choice, but they should not be paying for services that were once free or they don’t need.
What residents should know about HELF
Higher Everyday Living Fees (HELF) are optional charges for services that go beyond the standard care to which every residential aged care resident is entitled.
Before agreeing to pay a HELF, residents should remember:
You cannot be forced to purchase optional services
A HELF cannot be agreed to before entering care, or made a condition of entering care
HELF must be covered by a separate agreement after you enter care
Bundled services must also be available individually
You should not pay for services you don't want or cannot use
You have a 28-day cooling-off period after signing a HELF agreement
Your agreement must be reviewed at least annually.
New fees in residential aged care are causing confusion and concern for many older Australians and their families, prompting an inquiry into the activities of some providers.
They have also led to a series of media reports canvassing complaints from residents and their families about being charged for services they can’t or won’t use, or having basic services removed and later offered as paid extras.
The Aged Care Quality and Safety Commission (ACQSC) is investigating complaints that Higher Everyday Living Fees (HELF) are being used in ways that are inconsistent with both the rules and residents’ rights.
HELF was introduced under the new Aged Care Act to replace previous Extra Service Fee and Additional Service Fee arrangements, from 1 November 2025.
It is intended to cover optional extras – services that go beyond the standard of care every resident is entitled to receive. Providers can charge for services above the minimum required under the Aged Care rules, but they cannot use HELF to charge for accommodation or basic care.
According to the Commission, investigations are examining allegations that some providers have required residents to pay for services that should already be included in standard residential aged care, charged residents for services they cannot or do not use, or presented optional fees as though they were mandatory.
Aged Care Quality and Safety Commissioner, Liz Hefren-Webb, has warned providers that the regulator will take strong action where it finds the rules have been breached.
“Higher Everyday Living Fees are optional. They are not an opportunity for providers to charge residents for services that should already be delivered as part of quality aged care,” she said.
The rules require, for example, that residents receive at least three meals a day of adequate variety, quality, and quantity to meet their individual nutritional and hydration needs.
Meals have become a particular focus of regulatory concern as providers introduce HELF-funded dining options while changing services that were previously available as part of standard care.
Ms Hefren-Webb said the Commission was closely monitoring these practices.
“We are very concerned about the use of HELF in relation to meals. The standards are crystal clear that providers must offer meals that meet the nutritional needs, goals, and preferences of residents. This is not optional. This is not an additional service. This is a minimum mandatory requirement,” she said.
National Seniors Australia (NSA) says residents should not be charged for a service they do not want, cannot use, or have not agreed to receive. There is more about our policy and advocacy later in this article.
Bundled services
One area causing particular concern is bundled services. These are packages where several services are grouped together for one price.
Residents and their families should check whether the services in a bundle are also available individually, and whether the resident will actually use them.
There are also concerns that some providers may seek to charge for services residents previously received at no extra cost.
Those concerns have been reinforced by examples already identified by the Commission during its investigations, including:
A provider that removed televisions from vacant rooms and intended to charge new residents to have them installed
A provider that removed basic services and attempted to charge residents to have them reinstated
A provider that planned to charge residents to watch volunteer performers who had previously entertained residents free of charge.
A recent media report highlighted the case of a woman who was charged for a daily alcoholic drink even though she is a teetotaller.
One provider reportedly attempted to introduce a two-tier HELF model that would have charged existing residents for services they had previously received at no additional cost.
Following scrutiny, the provider postponed implementation and advised residents they would continue receiving the services at no charge.
HELF agreements
HELF cannot be made a condition of entering care, keeping a room, or securing a place in a residential aged care home.
Before a provider can charge HELF, there must be a separate Higher Everyday Living Agreement entered into after a resident has moved into care. The agreement can only apply to higher-standard or additional services the resident has agreed to receive.
There is also a 28-day cooling-off period, and after that residents can generally cancel with 28 days' notice, although some longer arrangements may apply for ongoing subscriptions. Written HELF agreements must also be reviewed at least once a year.
Commissioner Hefren-Webb said residents and their families should be confident they are only paying for genuine additional services.
“Older people and their families must have transparency, fairness, and confidence that they are only being asked to pay for genuine additional services they have freely chosen and can use,” she said.
The Commission has warned that where providers are found to be using HELF inappropriately, it may require services to be reinstated and residents refunded for fees that were incorrectly charged.
National Seniors Australia’s position
NSA supports giving older Australians genuine choice to purchase additional lifestyle services in residential aged care where they provide value beyond the government’s standard care requirements.
However, these choices must never compromise equity, affordability, or the quality of everyday living that every resident should reasonably expect.
The HELF standards replace older, inconsistent models of “additional” and “extra” service fees, which often caused confusion among residents and families.
HELF ensures transparency. Residents clearly understand what their fees cover, and providers gain a structured framework to deliver high-quality services without ambiguity.
Furthermore, HELF prevents duplication by ensuring facilities do not charge additional fees for services already included in the daily rate. As a result, residents receive equitable services across all facilities.
Recent feedback from residents and families highlights growing concerns about confusion over what should be included as part of everyday care versus what can legitimately attract an additional fee. This uncertainty risks undermining consumer confidence.
NSA believes that HELF should operate under four key principles:
1. Standard care must remain genuinely a standard
Residents should never be expected to pay extra for services that are fundamental to quality of life, dignity, or social connection.
Items such as access to television, basic internet, and reasonable recreational activities and services that were previously provided as part of residential care should not gradually migrate to optional fee arrangements simply because a new charging mechanism exists.
2. Genuine consumer choice and informed consent
HELF must remain voluntary.
Residents and families should receive clear, plain-English information explaining:
What is included in standard residential care
What is genuinely optional
The cost of each individual service
The benefits provided
How services can be cancelled or changed.
No resident should feel pressured to purchase optional services or believe they are required to obtain quality care. Separate agreements and informed consent are essential consumer protections.
3. Transparency and fairness
Consumers should be able to understand exactly what they are paying for.
NSA supports:
Transparent pricing for every optional service
Clear disclosure of bundled services
The ability to purchase services individually
Protection from paying for services residents cannot use
Annual review of HELF agreements.
Consumers deserve confidence that fees represent genuine additional value rather than replacing services previously included in residential care.
4. Protecting affordability
Australia’s aged care reforms must not create a two-tier residential care system where quality of life depends on an individual’s financial capacity.
Older Australians already contribute significantly towards their accommodation and daily living costs. HELF should enhance choice, not increase financial pressure, or reduce equitable access to meaningful everyday living experiences.
NSA will continue advocating to ensure the implementation of HELF supports consumer choice while protecting older Australians from unnecessary costs and preserving confidence in the residential aged care system.
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