The Transition Care Program helps older people recover after a stay in hospital. It gives short-term care and support so you can regain independence and confidence, and possibly avoid needing longer-term care. This guide covers who can get transition care, how the assessment works, where care happens, how long it lasts, and what to ask before you leave the ward.
What transition care is
Transition care is short-term after hospital care, shaped around your needs and recovery goals. Depending on what you need, it can include nursing support, personal care, allied health care, social work, and help around the house with cleaning, shopping, laundry, meals and keeping your home safe.
A transition care provider coordinates all of it. They help you leave hospital, arrange your care, and help you move between settings as your needs change.
Who can get it
You may be able to receive transition care if you are an older person and you:
- are a patient in a public or private hospital
- have been told you are ready to leave hospital
- would benefit from services for a short period.
How you are assessed
Transition care starts with an assessment in hospital. An assessor visits you on the ward. You can ask hospital staff to arrange it, or contact My Aged Care yourself. If you are approved, you then connect with a transition care provider.
It helps to have a family member or friend with you for the assessment, especially if you are tired or still recovering. The guide to aged care assessments explains what assessors usually ask.
Where care happens
Care is delivered wherever suits your recovery best:
- In an aged care home, as a short stay, if you have high care needs and need support around the clock.
- At home and in the community, if your care needs are lower.
- A mix of both, moving from one setting to another as you improve.
How long it lasts
If you are eligible, you can currently be approved for up to 12 weeks (84 days) of transition care. In some cases this can be extended by up to 6 weeks (42 days), which needs another assessment.
There is no limit on how many times you can apply. If you need transition care again, even in the same year, you can be approved again if you are eligible.
What you may contribute
You do not need a means assessment for transition care. Providers can ask about your ability to contribute, within reason, and they set their fees with you. The government sets a daily maximum, worked out as a share of the single age pension, and the maximum is lower for care at home than for care in a residential setting. If you move between settings, where you stay overnight decides which maximum applies.
Your access to transition care does not depend on your ability to pay. The current maximum amounts are listed on the My Aged Care transition care page.
If you already receive aged care
- Living in an aged care home. You can go from hospital into transition care before returning, and your place in the home is held for you.
- Receiving Support at Home. If your transition care is at home, your Support at Home services can continue. Both providers must talk to each other so services are not doubled up. The guide to how Support at Home works covers that program.
- Receiving Commonwealth Home Support Programme (CHSP) services. Both can run at the same time, as long as they cover different parts of your care and are assessed separately.
- Receiving respite or restorative care. You cannot have transition care at the same time as either. The guide to respite care for older people explains how respite works.
Transition care vs the Restorative Care Pathway
The two are easy to mix up because both aim to restore function. Support at Home, which replaced the Short-Term Restorative Care Programme on 1 November 2025, includes a Restorative Care Pathway that provides up to 16 weeks of intensive allied health and nursing services.
The key difference is the starting point. Transition care begins in hospital, for people about to be discharged. The Restorative Care Pathway is part of Support at Home, which you reach through an aged care assessment.
Planning the discharge conversation
Discharge can move quickly. Questions worth asking the ward team:
- Do you think I would benefit from transition care, and can you arrange the assessment?
- Will my care start in an aged care home, at home, or a mix?
- Which provider will coordinate my care, and how do I contact them?
- What contribution might I be asked for, and can I have that in writing?
- What happens to my existing aged care services while I am in transition care?
Find in-home and nursing supports for the next step
Transition care is short by design, so it pays to think about what comes after. Provider24 lists businesses offering community nursing care, allied health and short-term restorative care. Compare a few, then contact them direct to ask about your situation.
This article is general information, not advice. The Department of Health, Disability and Ageing has more about the Transition Care Program.
Frequently asked questions
What is a transition care program?
The Transition Care Program provides short-term care for older people after a hospital stay, to help them regain independence and confidence. Care can be in an aged care home, at home, in the community or a mix.
How much does transition care cost?
There is no means assessment. Providers may ask for a contribution, set with you and capped at a government daily maximum. The current maximums are listed on My Aged Care.
Is transitional care free?
Not always. You may be asked for a contribution within the government maximum, but your access to transition care is not affected by your ability to pay.
How long does transition care last?
Up to 12 weeks, with a possible extension of up to 6 weeks after another assessment. You can apply again if you need it later.