What Does the NDIS Not Cover? What You Must Know About NDIS Funding
Unsure about what NDIS funding covers? We explore three key areas where funding does notapply.
Is this funded by the NDIS?
In all our time helping people navigate the National Disability Insurance Scheme (NDIS), this is the most common question we are asked.
Rightly so. It can be difficult to understand what is funded and what is not.
At the heart of all NDIS funding is the ‘reasonable and necessary’ criteria, but even with this in place, confusion remains.
To help clear up the confusion, we delve into three broad areas where funding is commonly thought to apply but in reality, it does not.
1. Supports Already Provided by the Government
The NDIS exists to provide critical services that other government departments do not deliver.
But as the NDIS operates alongside several of these government services, there is crossover.
So, if you have a disability, it can be tricky to know where to get funding and support.
There are three main government services that typically add to this confusion:
- The healthcare system.
- The education system.
- Centrelink.
Let’s explore each of these services in more detail.
The Health Care System and the NDIS
You might have read or heard the statement that ‘the NDIS is the biggest social reform in Australia since Medicare’.
Medicare was here first, so generally speaking, anything covered by Medicare is not covered under the NDIS.
That said, grey areas exist, so it pays to ask questions about what funding opportunities might be available in this field.
A note on medication…
Unfortunately, the NDIS does not cover or help subsidise the cost of medication.
Medication subsidies are available only through the healthcare system.
Further reading: The NDIS and the healthcare system.
The Education System and the NDIS
There is constant confusion between what the education system funds and what the NDIS covers.
Importantly, you cannot claim school fees under the NDIS. So, anything covered by your school fees will not be funded by the NDIS.
The education system and the NDIS often work closely together. This is good news because it means that schools are generally well-versed at helping students and their parents to navigate NDIS funding related to the education system.
Additionally, the NDIS has a handy school education section on its website.
Centrelink and the NDIS
Many NDIS participants receive payments from Centrelink. The most common payment is the Disability Support Pension (DSP).
A recurring question we get in this space is, ‘Will the NDIS affect my Centrelink payments?’.
The answer to this question is no – the NDIS will notaffect your Centrelink payments.
Any funding the NDIS provides is not considered as income.
2. Daily Living Costs
Mostgeneral day-to-day costs are not covered by the NDIS.
This includes such items as groceries, phone bills, event tickets and general living expenses.
The reasoning is that people withoutdisability buy these things from their own money, and the NDIS exists to cover the gap between having a disability and not having a disability.
So, as a general rule, if someone without disability would purchase a particular item from their own money, chances are that item will not be funded by the NDIS.
The top two questions we are asked in this space relate to smartphones and holidays.
Of course, like most things with the NDIS, it is not always black and white. The NDIS considers individual needs and circumstances to decide the level of funding you need and what that funding should be used for.
3. Things Not Related to Your Disability
This sounds straightforward but there is nuance to it.
The NDIS will not cover supports that they do not regard as being related to your disability.
But – and this part is critical – your needs are open to interpretation by the NDIS.
The bulk of the detail will be determined in your planning meeting.
In these meetings, the NDIS generally does a good job of understanding your needs and asking key questions, but it pays to be prepared for your planning meeting.
Even if the NDIS doesfund a particular support, it does not always mean that you can access it.
Different funding categories allow for your budget to be spent in particular ways. These avenues can be flexible, but they can also be prescriptive.
Is There Any NDIS Funding for Parents and Carers?
Often, we are asked what NDIS services and supports are available to participants’ parents or carers.
Currently, there are not any specific supports available to parents and carers. They are all based on the person with disability and what their needs are.
Looking for Support?
Navigating the NDIS can be challenging, but we are here to help.
Among our expert team are NDIS specialists who are on hand to guide participants and their families through this complex scheme.
What is more, these specialists regularly advocate for improved NDIS funding outcomes for our clients and have even created their own escalation pathways with the National Disability Insurance Agency (NDIA).
Contact us to see how we can help you.