The National Disability Insurance Scheme (NDIS) is designed to support those with assistive needs in accessing support programs, funded services and products to enable the freedom to live their life to the fullest. However, with so much information available online, the NDIS can become very confusing, with myths and misinformation becoming increasingly common. In this article, we’re debunking some widely held myths and about the scheme and its processes, so you can feel confident in understanding more about the NDIS and how you can get your funding to work harder for you.
1. How is the NDIS funded?
The scheme is funded via various avenues, including the Commonwealth, which provides a large portion of funding into the NDIS, while the Federal Government, states and territories also provide funding for the scheme. The Medicare levy, which was increased in 2014, is also used to cover some of the funding put towards the NDIS.
2. No, participants of the NDIS don’t have to use a registered provider
Participants of the NDIS only need to use a registered provider if they have elected to be agency-managed. If your plan is self-managed or plan-managed, you may use unregistered NDIS providers in most circumstances – providing your purchase is goal aligned, and reasonable and necessary (more on that a little later).
NDIS participants who are plan or self-managed must use registered NDIS providers for the following supports or services, including:
Specialist disability accommodation
Supports or services where there is or is likely to be a need to use a regulated restricted practice
Specialist behaviour supports that require a behaviour support assessment of the participant or developing a behaviour support plan for the participant
3. No, NDIS are not payments taxable
Funding received via the NDIS is tax-free and will not be taxed, meaning the full amount approved by the NDIS will be available to you. However, this does mean that you are ineligible to claim deductions for expenses or assets paid for by the scheme. All purchases made with your funding, whether that be clothing, home modifications or a support worker, cannot be claimed at the end of the financial year.
4. What does ‘reasonable and necessary’ mean for NDIS?
While applying to be a participant of the NDIS, you may have come across the term ‘reasonable and necessary’ as the cornerstone for using NDIS funding for your plan. However, as everyone’s plan is determined on an individual basis, it can be confusing to understand what ‘reasonable and necessary’ means for different people. As defined by the NDIS:
Reasonable: Is something that is fair
Necessary: Is something that you must have
Many times, what is deemed ‘reasonable and necessary’ for you and your plan will help you pursue your goals and aspirations, whether that’s having more independence, becoming more active in the community, or taking part in social activities and work. The framework for which the NDIS decides if a support is ‘reasonable and necessary’ is highly detailed and includes:
Is it related to your disability?
Will it help you achieve your goals and aspirations?
Will it help you partake in activities that increase both social and economic participation?
Is it value for money?
Is it effective and beneficial to you?
Does it complement other informal supports you have available, through evaluating what is reasonable for families, carers, informal workers and the community to provide?
Is it most appropriately funded by the NDIS or by another service system, agency, person or body etc.?
This framework helps the NDIS decide what supports, for your individual plan, goals and lifestyle, can be deemed both ‘reasonable and necessary’. Remember, that what is deemed ‘reasonable and necessary’ for one participant may be completely different for another participant. It’s all about getting the right funding for your situation – and that meets your goals - to help you lead an ordinary life.
5. No, the NDIS does not cover everything
When it comes to funding from the NDIS, the NDIA is very strict as to what you can use your funding for and there are a few things that the NDIS won’t cover, including:
1. Holidays: The NDIS won’t pay for you to go on holiday. However, if you need extra accessibility, support worker hours or similar supports, discuss with your plan manager how your funding can be used to help you better access your holiday.
2. Day to day living expenses: The NDIS won’t cover aspects of your day to day living expenses, which includes things like groceries, utility bills like water, electricity bills, or rent. Regardless of ability level, these are expenses we all incur. The NDIS won’t cover anything that is not attributed to or caused by your disability support needs.
This doesn’t mean that the NDIS won’t cover everyday products you need, like clothing and other sensory items, as long as these items are aligned with the goals set in your plan. It’s also important to note how the NDIS might support some of these items. For example, having a support worker assist with grocery shopping and making your meals is something the NDIS can fund, while the cost of the groceries is not covered.
6. Yes, you can appeal an NDIS decision
As a participant or nominee of a participant of the NDIS, you can request a change if you are unhappy with a decision or feel that your plan is missing something important. Always make sure to discuss your concerns with your planner during your plan meeting, or you can also request an internal review of the decision made.
This will mean that the NDIA will take a second look at their decision. When requesting an internal review, it’s important to make it very clear why you are requesting the change and provide a clear explanation, documentation and any proof to add to your request.
To request an internal review by the NDIA, you can either:
Mail a request directly to the NDIS
Talk to someone at the NDIA office
Call 1800 800 110
Send an email to: firstname.lastname@example.org
7. No, the NDIS does not cover dental
The NDIS does not cover any dental or dental procedures. This is because the NDIS is not designed to provide funding for services and supports that are already funded by the health care system including Medicare. Children aged between two and 17, and whose parents are receiving government payments, which includes if the child is receiving Disability Support Payments, may be eligible for the Child Dental Benefits Schedule.
For adults, you may be eligible to receive free publicly funded dental care. There are rules depending on which state you’re in and if you have one of the many pension, health care, or seniors cards, you may be eligible. Keep in mind that there may be long waiting lists to access public dental treatment.
8. No, NDIS funding does not go straight into your bank account
Receiving your NDIS funds all depends on your plan and how you’ve chosen to manage it and is strictly monitored by the NDIA to make sure that all funding is used appropriately. There are three ways to manage your plan including:
NDIS or agency-managed
Your plan may also be managed using a combination of these. Once you have agreed on your plan, you will be able to access your funding and make claims through your NDIS myplace portal using the Make a Payment Request option. You can either:
Submit a request for the funds you need with an invoice or quote, and then pay for your supports; or
Use your own money, get a receipt and then submit a request for reimbursement
NDIS funding cannot be used without uploading a tax invoice or receipt, so make sure you hold onto all paperwork once you have made a payment to any service or purchase of items deemed reasonable and necessary according to your plan.
9. No, the NDIS is not means-tested
Access to the NDIS is not based on means, so there will not be restrictions to funding based on income or other means already accessed by participants. This includes any Centrelink or disability support pension and carers allowance. When applying for the NDIS, you will not be required to show your income or monthly payments as an eligibility requirement to access the scheme.
10. No, the NDIS does not cover every disability
While the NDIS does cover a large majority of disabilities, there are a few instances that the NDIS will not cover.
The NDIS will not cover short term or non-ongoing conditions. This could include circumstances like a leg fracture, where mobility is impaired. However, as the bone will heal over time and you will gain your mobility back, then this doesn’t fit the NDIS criteria.
The NDIS will also not cover chronic health conditions that are not directly related to a person’s disability. This means that there must be a distinction between your disability and any chronic health conditions you may also have. For instance, the NDIS may fund disability supports for a person who had a lower limb amputated, while also living with diabetes, however, the NDIS won’t cover medication or medical care relating to that person’s diabetes.
Although the NDIS may seem confusing with so much information to digest, once you understand how the scheme works, you will be able to get the most out of your plan and funding. Discover the selection of NDIS claimable products like women’s and menswear, personal care and lifestyle and living available online at Averee.