The federal government would need to spend an additional $2-2.5 billion a year to get the waiting times to a reasonable level, the aged care royal commission heard on Friday.

More people are waiting for care and support at their assessed level of need than are receiving the home care packages, senior counsel assisting the commission Dr Timothy McEvoy QC said.

"The waiting times to which older Australians have been subjected, in between being assessed as needing home care packages and actually receiving funding for care, are severe and unacceptable," Dr McEvoy said.

"This has caused great suffering and continues to do so.

"Long waiting lists are cruel, unfair, disrespectful and discriminatory against older Australians."

Health department data suggests people will wait for a year or longer for all but the lowest level of home care package.

Dr McEvoy said the waiting time for the highest level of need was almost two years.

"The waiting time between assessment and the allocation of the funding must be reduced as closely as practicable to zero," he told the Adelaide hearing.

Dr McEvoy said 212, 860 people appeared in the national prioritisation system during the 2017/18 year, more than 16,000 of whom died waiting for a package they never received.

Fiona Buffinton, who heads up the health department's In Home Aged Care division, conceded the program is not effectively meeting the in-home care needs of senior Australians.

"I absolutely acknowledge that the unprecedented demand has led to unprecedented growth of the wait list and therefore wait times," she said.

Ms Buffinton said the government put an additional $1 billion into the home care program in the last two years, taking funding to about $2.6 billion a year, and announced increased investment to make more places available over the next four years.

"In answer to your question will this be sufficient to get wait times to a reasonable level? It will need additional investment to that," she said.

About 92,000 people received services under home care packages as at June 2018, up from 64,000 two years earlier.

But there are currently 128,500 people either on the waiting list or not receiving their approved level of care.

Getting all people on the waiting list attached to home care within three months would require about $800 million extra a year, Ms Buffinton estimated.

But getting them the actual level of home care at which they had been assessed would require an additional $2-2.5 billion per annum, she said.

Dr McEvoy said the government's recent announcements of an additional 20,000 home care packages did not come close to meeting current or projected demand.

Australian Associated Press