NDIS and the health care system
Let’s face it, the NDIS is a complicated beast – there’s so much to remember and keep track of.
Everyone needs access to healthcare. When you have a disability, healthcare needs often become much more complex.
We receive a lot of questions around who funds which health services, so we’ve broken it down to help provide some clarity.
A general rule of thumb:
- The NDIS funds supports required due to the person’s disability.
- The health care system assists with clinical and medical treatment.
| What you might need | Who funds it |
|---|---|
| Aids and equipment like wheelchairs, hearing aids, adjustable beds etc. | NDIS |
| Medication | Health care system |
| Prosthetics and artificial limbs | NDIS |
| Clinical services and treatment of health conditions | Health care system |
| Hospital stays | Health care system |
| Visits to your GP | Health care system |
| Surgery | Health care system |
| Home modifications | NDIS |
| Disability support workers | NDIS |
| Palliative and geriatric care | Health care system |
| Dental costs | Health care system |
| Allied health and other therapy including physiotherapy, speech therapy and occupational therapy. | Some assessments and therapies may be covered by the NDIS – discuss your specific needs at your plan meeting. |
The grey areas
Allied health and other therapy including physiotherapy, speech therapy and occupational therapy.
Ask yourself – is this needed as a result of my disability, or is it needed as a result of an accident or injury that requires rehabilitation?
If it’s directly linked to your impairment and has been deemed a reasonable and necessary support – the NDIS may fund it.
If it’s part of your rehabilitation – keep reading.
Rehabilitation
Here’s what the NDIA says about rehabilitation:
“The Scheme and the health system will work closely together where a person needs rehabilitation following an accident or injury.
Where the initial rehabilitation is needed following injury, accident or other medical event, the support is the responsibility of the health system. This means that any surgery or treatment following an injury, accident or other medical event is not funded by the Scheme (i.e. the NDIS).
The health system would provide supports that enable a person to regain their maximum achievable level of functioning. This could include, for example, care in a rehabilitation unit after a spinal cord injury.
The Scheme assists the participant once the health system has provided these rehabilitation services. The supports offered by the Scheme may include:
- Home modifications, aids and equipment
- Personal care and domestic assistance to enable the participant to live independently in the community
- On-going allied health or other therapies to enable the participant to maintain their level of functioning.”