The fee layer most families miss: extra service, additional services, and the new Higher Everyday Living Fee

For Australian families navigating residential aged care, the standard discussion of fees usually covers three core components: the basic daily fee, the means-tested care contribution(s), and the accommodation contribution. At many premium facilities there is a fourth layer that often receives less scrutiny than it deserves. Under the Aged Care Act 2024 reforms (effective 1 November 2025) the structure of this fourth layer has changed materially — and anyone making a placement decision today, or reviewing a long-standing agreement, needs to understand both the legacy framework and the new replacement.

What was the legacy extra service and additional services framework?

Under the prior framework (Aged Care Act 1997), premium amenities and services beyond the standard government subsidy were funded by extra service fees (at facilities classified as "extra service" by the Department) or additional services fees (charged by other facilities for specific premium inclusions). Both were unsubsidised — the resident paid the full amount from their own resources. Pricing typically fell into rough bands: $10 to $50/day at the lower end, $50 to $200/day at premium private facilities, and above $200/day at top-tier or specialist facilities. Cumulative numbers matter: at $150/day, a four-year residency adds $219,000 to total cost.

What changed on 1 November 2025 with the Higher Everyday Living Fee?

From 1 November 2025, the Aged Care Act 2024 introduced a new Higher Everyday Living Fee (HELF) as the replacement vehicle for premium-amenity charging (My Aged Care, https://www.myagedcare.gov.au/news-and-updates/new-aged-care-act-and-your-aged-care-home-fees). Key transition rules:

• Existing extra service / additional service agreements continue to operate for up to 12 months from 31 October 2025, lapsing no later than 31 October 2026.
• During the 12-month transition, residents on legacy agreements can switch to HELF voluntarily at a time agreed with their provider — useful where the new structure offers better value or transparency.
• After 31 October 2026, all premium-amenity charging operates through HELF; legacy agreements no longer apply.
• Providers may increase legacy extra/additional service fees during the transition — they're not locked at pre-reform amounts.

HELF is optional for residents who want services that go beyond what aged care homes are required to provide under the new Aged Care Act and the Aged Care Quality Standards. The resident pays the full amount; no subsidy applies.

What are the new transparency requirements for aged care fees?

The 2024 reforms introduced stronger pricing-disclosure obligations. Providers must publish standard prices online and share details of what residents are paying for (Department of Health, Disability and Ageing). Support at Home providers had to publish standard service prices online within 7 days and report initial pricing to the System Governor by 8 November 2025. For residential care, similar transparency obligations apply to HELF pricing — families now have meaningfully more pricing information available pre-admission than they did under the pre-reform framework, which is a real improvement.

What do HELF and legacy extra service fees cover?

The underlying concept across both frameworks is consistent: charges for premium amenities or services beyond what the standard government subsidy and standard resident fees support. Common inclusions:

• Premium accommodation: larger rooms, ensuite bathrooms, balcony or garden access
• Enhanced dining: higher-quality meals, menu choice, beverages with meals, restaurant-style service
• Recreational and lifestyle services: organised excursions, in-house hairdressing, concierge support
• Enhanced care features: higher staff-to-resident ratios, dedicated personal care attendant time
• Hospitality facilities: library, computer access, premium social spaces, in-house cinema

The specific inclusions are defined in the resident agreement (HELF agreement post-reform; extra service agreement under legacy) which the resident or their authorised representative signs at admission.

What questions should families ask about premium aged care fees?

Will the resident genuinely use and benefit from the included services? A resident with significant mobility limitations may not benefit from garden walks or excursions. A resident with advanced cognitive decline may not engage with concierge services or in-house cinema. The fee should reflect the resident's actual capacity to benefit, not the family's aspirations for the kind of care their loved one deserves. Premium facilities paid for by family guilt are the most expensive form of aged care decision-making.

Is the fee genuinely optional or a condition of access to a preferred facility? Some premium facilities operate exclusively at the HELF/extra-service level — admission requires accepting the fee. For families with a strong preference for a particular provider (proximity, specialist care expertise, prior connection), declining the premium fee may not be a real option; the choice is between this facility with its fee and a different facility entirely. Other facilities offer the premium tier as opt-in, with a standard tier available within the same facility. Ask the question explicitly at admission.

Is the fee sustainable over the full expected residency? A premium facility decision should be made with explicit modelling of multi-year total cost, not just the manageable-seeming daily figure. Whether $150/day is affordable depends on the resident's overall financial position: superannuation balance, non-super investments, proceeds from the sale of the family home, and whether family members will contribute. A position that supports $150/day for two years may not support five.

What should you check in the resident agreement before signing?

The agreement (HELF or legacy) should specify:

• What is included in the premium tier — itemised, not generalised
• The daily fee amount
• Conditions for indexation (annual? CPI-linked? capped?)
• Notice periods for proposed fee changes
• Process for disputes
• Exit/withdrawal terms if the resident or family decides to step down to standard tier

Request and review the agreement before the day of signing, not at signing. The combination of family stress, time pressure, and document complexity at admission day is the worst possible context for evaluating a multi-year financial commitment.

How do premium-tier fees affect the Age Pension and Centrelink?

Premium-tier fees (HELF or legacy) do not affect the Age Pension or the means-tested care contribution(s). They are a personal consumption expense of the resident. They do not reduce MTCF/contribution calculations, do not affect deeming, and are not deductible from any Centrelink assessment.

Where one partner of a couple is in residential aged care while the other remains at home, the illness-separated couple status applies — both partners are assessed separately and at the single Age Pension rate, which can partly offset the cost of care (DSS Guide on illness-separated couples; see also the related aged-care-costs-pension-interaction article). But the premium fee itself is borne entirely by the resident's own resources.

Case study: comparing the multi-year cost of a HELF facility

Consider Margaret, 82, single, recently widowed, sells the family home for $1.1M. She is choosing between two facilities:

• Facility A: standard tier, no HELF, $66.80 basic daily fee + means-tested contribution + RAD $580k. Total non-RAD daily: ~$80/day.
• Facility B: HELF facility, larger room with ensuite + premium dining + concierge, $66.80 basic + HELF $130/day + means-tested contribution + RAD $620k. Total non-RAD daily: ~$210/day.

The daily HELF differential is $130. Multi-year math:

• 3-year residency: extra cost $130 × 365 × 3 = ~$142,000
• 5-year residency: ~$237,000

She also needs to find the extra $40k for Facility B's higher RAD. From her $1.1M home-sale proceeds, both options are affordable for the typical 3-5 year residency, but Facility B reduces her residual estate to her children by ~$140-240k. The decision turns on: how much does Margaret value the premium amenities vs. estate value to her children, and is she likely to genuinely use the concierge/premium dining given she still has good mobility and cognition? Both choices are defensible — the conscious comparison is the point.

Case study: reviewing a legacy extra service agreement during the transition

Consider David, who entered care in 2021 with a $90/day extra service agreement. He is now 86 with declining cognition. His daughter (his nominated representative) reviews the situation in early 2026:

• The legacy agreement remains in force until 31 October 2026 unless a switch is made.
• Provider has signalled a $20/day fee increase mid-2026 (allowed during transition).
• David no longer attends the organised excursions, no longer uses the in-house café, and his dining preferences have simplified to a basic menu the provider includes in the standard tier.

The daughter requests review with the provider. Two options on the table: (1) switch to HELF at a lower daily rate that excludes the recreational components David no longer uses ($60/day), or (2) move to standard tier with no HELF ($0). She models the savings:

• Switch to HELF $60: saves $30/day = $11,000/year.
• Move to standard tier: saves $90/day (legacy fee) = $32,800/year, plus avoids the mid-2026 increase.

The standard-tier choice depends on whether the provider offers a standard tier in the wing David occupies (some HELF-only buildings don't) and whether moving rooms within the facility is workable for David's cognitive state. The active review and request — by an authorised representative, with documented declining engagement — is the leverage point. Annual review of premium-fee value is one of the highest-impact aged care decisions families can make but is rarely undertaken.

Why should families review premium aged care fees annually?

For residents in care for some time, a review of whether the premium fee still reflects actual use and benefit is worthwhile. A resident whose mobility, cognitive capacity, or social engagement has declined significantly may no longer be drawing value from the services for which the fee is charged. At facilities where the premium tier is genuinely optional, requesting a change is a legitimate option, and the savings over subsequent years can be material. The transition to HELF before 31 October 2026 is a natural moment for that conversation if the resident is on a legacy agreement.

Sources

• My Aged Care — New aged care act and your aged care home fees
• My Aged Care — Improving australias aged care system
• challenger.com.au — Whats changed with 1 November 2025 aged care reforms
• agedcarequality.gov.au — Rb 2023 20 additional fees residential aged care