What does NDIS pay for?
Have you recently received approval for access to the NDIS and are getting ready for your first planning meeting? When developing your goals for the next year or so within your NDIS plan, you need to consider how your NDIS funding works, and the most important question: what does the NDIS pay for, and how does that relate to your disability?
In this article, we’ll take you through the basics of NDIS funding structures, and how it can relate to your disability to make sure you’re getting the most out of your NDIS plan.
What does NDIS cover?
Unfortunately, NDIS funding is a bit more complicated than, “This is your disability, so what does NDIS pay for in relation to that disability?” When approaching your NDIS plan and the types of support the scheme funds, your LAC looks at the following factors when requesting access to funds or organising support coordination.
What is reasonable and necessary?
This is the main question asked by your LAC when it comes to support coordination. To be approved under the question, “what does the NDIS cover?”, the support you’re asking for must be: value for money, likely to be effective in supporting or improving your disability, as well as taking into account any other services you currently receive from the government.
Is it directly related to your disability?
Within that ‘reasonable and necessary’ category, NDIS may cover the following examples:
- Daily personal activities like cleaning or gardening services to help maintain your household (if this is something you struggle with)
- Transport to social activities or doctor’s appointments
- Workplace or home modifications – if you had to use a wheelchair and could no longer use stairs, or needed a specific type of laptop at work
- Mobility equipment and maintenance, such as a new walker, wheelchair or walking sticks
- Vehicle modifications, such as the lowering of your car’s height or the installation of a lift
- Employment training or connection with support services
- Access to community workers to help you attend social events safely
What are the main categories of NDIS funding?
Your NDIS funding generally falls into the following main categories, within capital and core support budgets (including supplementary funding for support coordination assistance):
- Choice and control – to help you receive assistance with plan management
- Daily activity – which is where you’ll fund your therapy supports through
- Employment support
- Health and wellbeing – exercise advice and assistance
- Home living – ensuring you have appropriate accommodation
- Lifelong learning – transitioning from secondary to tertiary education
- Relationships (and behaviour management)
- Social and community participation
What won’t the NDIS pay for?
Unfortunately, there are some things that will not be eligible for NDIS funding. These include supports that:
- Are the responsibility of another government/community service
- Are not related to your disability
- May cause harm to yourself or others
- Are outside the day-to-day living covered in your supports
What else to I need to know?
When developing your goals, it’s important to remember that what you consider ‘reasonable and necessary’ in supporting your disability may not be the same as other’s considerations. If you don’t make a good argument for this funding, chances are you may not receive the funding within your NDIS plan.
You must be prepared and have as much evidence from medical professionals, therapists and advocates as possible to improve your chances of receiving your requested funding.
Hopefully this article has given you insight into how NDIS funding works, and helped you determine what kind of supports will be covered by your plan.
If you need further clarification on your NDIS funding, or help with support coordination, contact our team today!
Frequently Asked Questions
Will the NDIS pay for home modifications?
Yes, if they are directly related to your disability and considered reasonable and necessary. This includes ramps, grab rails, and bathroom modifications. An occupational therapist assessment is usually required.
Does the NDIS cover medication?
Generally no. Medication is the responsibility of the health system. The NDIS may fund supports related to medication management but not the medication itself.
Can the NDIS fund a holiday?
Not the holiday itself. But NDIS funding can pay for a support worker to travel with you if you need assistance, and for support-related costs during travel.
