For existing residents of residential aged care facilities, means tested care fees and/or accommodation contributions are determined through a quarterly fee reconciliation process.
The Department of Human Services (Centrelink) conducts a quarterly fee reconciliation process to determine ongoing care fees on 1st January, 1st July and 20th September each year.
The amount of means tested care fee and/or accommodation contribution payable is impacted by
• changes in the residents’ means tested amount
• changes in government subsidies payable to aged care facilities
• for means tested care fee only, residents reaching their annual or lifetime caps
As fees are adjusted quarterly, in some cases it can take several months for a residents fees to be adjusted for changes in circumstances.
Quarterly review
This process compares the means test care fee and/or accommodation contribution that should have been paid in the previous quarter with the amount actually paid by the resident. It also sets the fees to be paid for the next quarter.
Determining fees paid in the previous quarter:
Overpayments – where the resident has overpaid fees, such as where their means tested amount reduces during the previous quarter resulting in a reduction in means tested fees, the Department of Human Services will refund the overpaid amount. This refund is then paid to the aged care facility who must pass on the refund to the resident.
Underpayments – where the resident has underpaid fees, such as where their means tested amount increased during the previous quarter resulting in an increase in means tested fees, they will not be asked to pay arrears. However, they will receive notification that the higher level of fees is payable from the beginning of the next quarter.
Annual life and Lifetime caps
The quarterly fee reconciliation process also determines when residents means tested fees have reached their annual or lifetime caps.
However, it can take several months before the resident and the aged care facility are notified that a resident has reached their annual or lifetime cap. Therefore aged care residents will always overpay their means tested fees in this situation. A refund will then be issued through the quarterly fee reconciliation process.
Letters
The Department of Human Services issues a letter to the resident, and their nominee, when:
• a refund is due
• means tested fees or accommodation contributions for the next quarter have:
– increased by 10 cents or more per day; or
– decreased by 1 cent or more per day
Ad Hoc Reviews
Residents can request an ad hoc review if their circumstances change and they want their fees and charges reviewed outside the quarterly review process.
If a new fee is set after an ad hoc review, the new rate applies from the date the review takes place. This may be beneficial where the change in circumstances results in a fee reduction.
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