The National Disability Insurance Scheme

Not all types of support required by a person living with a disability fall under the responsibility of the NDIS.

Some supports are funded by other areas of government (e.g. state health systems) or existing public/community services.

In general, the NDIS will fund reasonable and necessary supports that help a person living with a disability enjoy an ordinary life.

These supports and services fall into three categories.

A support that assists with activities of daily living.

A support for an investment, such as assistive technologies; equipment and home or vehicle modifications; or funding for capital costs (e.g. to pay for Specialist Disability Accommodation).

A support that helps build independence and skills.

Common examples of supports provided or funded by the NDIS include:

• Help with personal care activities and/or household tasks
• Home and vehicle modifications
• Assistive technology, aids and mobility equipment, including set up and training by skilled personnel
• Transport to enable participation in community, social, economic and daily life activities, e.g. workplace, gym or places of learning
• Support to find and keep a job
• Therapeutic supports like occupational therapy, speech therapy and behaviour support
• Health-related supports (as long as they are a regular part of your patient’s life and the need for them arises from a disability), e.g. continence, diabetic management, dysphagia, epilepsy, nutrition, podiatry, respiratory and wound and pressure care supports.

If you are uncertain if the supports your patient requires are funded by the NDIS, refer the patient to a Local Area Coordinator for further advice before proceeding with an Access Request, as other public or community services may be more appropriate. 

 The NDIS is not designed to fund supports 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. 

The Disability Support Pension along with other income supports and payments such as the Carer Payment, Carer Supplement, Carer Allowance and Child Disability Assistance Payment are entirely separate to the NDIS.

These payments will not be affected if a patient qualifies for NDIS funding (the exception to this is the Mobility Allowance from Centrelink, which may be replaced if your patient’s NDIS plan includes transport-related funded supports).

It’s important to note that someone who is receiving the Disability Support Pension is not automatically eligible for NDIS funding and supports.