NDIS and the health care system – who funds what?

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.”

Other blogs and information you maybe interested in

Get ready for the NDIS with Map My World

A pre-planning booklet to help you to think about the supports you want and need – now and in the future – before meeting with your NDIA planner.

 

Discover guide to the NDIS

A practical, comprehensive guide to the NDIS, to help people understand the various components of the NDIS and how to access them.

 

NDIS FAQs and Glossary of Terms

A handy guide of NDIS FAQs and a glossary so you can familiarise yourself with NDIS language before your planning meeting.

 

NDIS tools and resources

Are you making any of these NDIS mistakes?

Transport under the NDIS