What does the NDIS pay for?

What does the NDIS pay for?

The National Disability Insurance Scheme (NDIS) kicked off in 2013 and is a government initiative to support Australians with disabilities live a more independent life. Funding is made available within an NDIS Plan to assist with costs relating to a person’s disability.

How does the NDIS work?

Once signed up to the scheme a participant of the NDIS has access to a “Plan” which outlines the amount of funding they have available within certain categories, to be used for services/items relating to their disability. Below we explore how to know what can be covered within your NDIS funding and what cannot.

Let’s take a look at a breakdown of the 3 main categories you may see within an NDIS plan:

Core Supports Budget, Capacity Building Budget, Capital Support Budget.

All funded items will fall within one of these 3 main categories, watch the NDIS video below to learn more.

What can be funded from an NDIS plan?

In-home support

What might be funded:

Personal care such as showering, dressing, toileting, feeding

Help around the home with cleaning, gardening, laundry

Support to live more independently including assistance with grocery shopping, budgeting, making appointments etc.

What cannot be funded:

General living expenses and housing costs- groceries, rent, mortgage, water, power, and electricity bills

Community support

What might be funded:

A support worker can be funded to: attend and support participants at work, school, and further education.

Transport to and from work, training, or community activities

What cannot be funded:

Entry to cinemas, events, or other activities

Course fees

Consumable items 

What might be funded:

Continence items such as nappies and pads

What cannot be funded:

Everyday groceries

Toiletries such as toilet paper, deodorant etc.

Medicines

Support with your NDIS plan

What might be funded:

A support coordinator to help action a plan

A Plan Management provider to pay bills on the participant’s behalf

Assistive Technology

What might be funded:

Low-cost products such as smart devices, walking sticks, ramps, and walkers

Higher costing products such as electric beds, hoists, and wheelchairs- must have an OT report submitted for approval.

Repair and maintenance of the above items

What cannot be funded:

Household furniture and appliances that do not relate to a participant’s disability

Therapies/ Allied Health Services 

What might be funded:

Occupational Therapy, Physiotherapy, Counselling, Speech Therapy, Psychology etc.

What cannot be funded:

Local GP doctor’s or any other appointments which are covered by Medicare

Diagnosis appointments

Head to the new NDIS guidelines website for a detailed outline of the items considered reasonable and necessary and funded within an NDIS plan.

What does the NDIS not pay for?

The NDIS will not pay for a service/support or item if it:

X is not related to the participant’s disability

X is the same as other supports delivered under different funding through the NDIS

X relates to day-to-day living costs that are not related to a participant’s support needs

X is likely to cause harm to the participant or pose a risk to others

X can be more appropriately or effectively delivered by another system, such as health or education.

Why do we say “what might be funded”?

The NDIS focuses on maintaining choice and control for all its participants. This means, when deciding what can and cannot be funded it is assessed on an individual basis. If a service directly relates to their disability, cannot be funded through mainstream avenues, and links to one of their plan goals- it can generally be funded within their plan.

We understand how confusing it can be to know what items/services/supports you can engage with using your NDIS plan. Luckily our team are experts in the NDIS and are just a quick phone call away. If you are unsure about a particular service or item, we encourage you to contact us first on 1300 402 568. Our staff will ensure the item/service is in line with the NDIS guidelines and there is funding available within the correct category.

It is best to do this before accessing the service to avoid any payment issues once the service/item is delivered.

How does being Plan Managed help when it comes to understanding NDIS funding?

Having a Plan Manager like Budgetnet take care of your NDIS payments means you will have a team of funding experts available when you need them!

Find out more about how to manage my NDIS plan or the top 5 benefits of plan management.

Reach out to our team on 1300 402 568 or find out more about our plan management services.