This research evaluates the Home Equity Access Scheme (HEAS) versus downsizing for older Australians, factoring in elements such as means tests, health expenditures, taxes, and home maintenance. It builds on a utility approach, considering region-specific house prices and longevity risks. Findings reveal that HEAS enhances healthy ageing for healthy and mildly disabled retirees more than downsizing. This scheme benefits cash-poor but asset-rich retirees who have lower bequest motives, derive higher satisfaction from spacious homes, and prioritise long-term gratification. However, spatial disparities in housing prices and life expectancy decrease the uptake of HEAS, offering new perspectives on housing decisions among seniors in Australia.