What supports are funded by your NDIS plan?
The NDIA funds support services that are reasonable and necessary. This means, the NDIA will only fund a support if it meets ALL the following criteria:
1. The support is related to your disability.
2. The support will assist you to achieve your goals as outlined in your NDIS Plan.
The support will help the participant to:
- pursue their goals, objectives, and aspirations.
- increase their independence.
- increase community and workplace participation, and
- develop their capacity to actively take part in the community.
4. The support represents value for money.
5. The support will be effective and beneficial for you.
6. The support considers and complements the informal supports you have available.
7. The support is most appropriately funded or provided by the NDIS.
Read more about the Reasonable and Necessary Supports Guidelines.
What supports are not funded by the NDIA?
The NDIA will not fund a support if:
1. It consists of sexual services and sex work, alcohol, or drugs.
2. It is income replacement.
3. It is likely to cause harm to you or others.
4. It is not related to your disability.
5. It is considered a day-to-day living cost (for example, rent, groceries, utility costs like your water bill, tickets to events or costs for a holiday).
6. Providing the support would be against the law.
7. It is more appropriately funded or subsided by another service system, agency, person, or body. Different services systems are designed to complement each other to form a government safety net. NDIS participants continue to have access to these systems. The NDIA will not fund a support if it’s the responsibility of another service system, such as the education system or the health system.
Learn more about NDIS Reasonable and Necessary Supports.
How are supports funded through my NDIS Plan?
NDIS participant budgets are allocated to three separate support purposes:
- CORE – Supports that enable participants to complete activities of daily living.
- CAPACITY BUILDING – Supports that enable a participant to build their independence and
skills. - CAPITAL – Investments, such as assistive technologies, equipment, home or vehicle
modifications.
Within the three support purposes there are many support categories which outline the types of supports that the NDIS fund for participants. This has changed a bit under the new PACE system – view our PACE Summary Update to understand PACE and what is going to change with this new billing system.
| Support Purposes | Support Categories | Examples of Support Services |
|---|---|---|
| Core | Assistance with Daily Life | In home support work, house cleaning, house/yard maintenance, respite. |
| Assistance with Social, Economic and Community Participation | Community support work, social and recreational activities, group-based activities. | |
| Transport | Personal travel related costs (e.g., taxi fees, uber). | |
| Consumables | Low-cost assistive technology and disability related products (e.g., incontinence items). | |
| Capital | Assistive Technology | Mobility aids (e.g. wheelchairs, hoists/slings), rental and maintenance of equipment. |
| Home Modifications and Specialised Disability Accommodation (SDA) | Design, construction, installation of equipment or non-structural components of the building to enable independence and safety. | |
| Capacity Building | Improved Daily Living | Allied health professionals/therapy supports (e.g., Occupational Therapy, Physiotherapy, Psychology, Speech Pathology) Early Childhood Supports Training for carers and parents |
| Improved Health and Wellbeing | Physical Wellbeing Specialists (e.g., Personal Training, Exercise Physiology, Dietetics). | |
| Improved Relationships | Specialist Behaviour Intervention Support Individual Social Skills Development. |
|
| Increased Social and Community Participation | Assistance in Coordinating or Managing Life Stages, Transitions, Supports Development of Daily Living and Life Skills Innovative Community Participation. |
|
| Finding and Keeping a Job | Employment Related Assessment and Counselling Workplace assistance School Leaver Employment Supports. |
|
| Improved Living Arrangements | Assistance with Accommodation and Tenancy Obligations. | |
| Improved Learning | Transition through School and to Further Education. | |
| Support Coordination | Support Coordinators Psychosocial Recovery Coaches |
|
| Improved Life Choices | Plan Management |
Does the NDIS cover health and medical costs?
Does the NDIS cover the cost of medical care like diagnostic assessments, treatment, medication, hospital/GP visits or Medicare gap fees?
The NDIS is not designed to fund supports which are more appropriately funded or provided by the health system. Assessment, diagnosis, and treatment of health conditions, along with medications and hospital care, remain the responsibility of the health system.
As a general guide, the following health-related services and supports are not provided or funded through the NDIS:
- Items and services covered by the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS), nor Medicare gap fees.
- Treatment, services or supports delivered by a doctor or medical specialist, including diagnosis and assessment of a health condition.
- Items and services provided as part of diagnosis, early intervention, and treatment of health conditions, including ongoing care of chronic health conditions.
- Medically prescribed care, treatment or surgery for an acute illness or injury including post-acute care, convalescent care, and rehabilitation.
- Sub-acute care including palliative care, end of life care and geriatric care.