When we work with you to create your plan, we decide what supports meet the reasonable and necessary criteria. If a support meets all the criteria, including that it’s an NDIS support for you, we’ll include it in your plan.
If you already have a plan, you may be able to use your funding for the NDIS supports you need.
This means you might not need a plan change to buy specific types of supports.
Learn more about what supports you can buy with your NDIS funding.
How can we help you get support from a mainstream or community service?
We’ll help you link to mainstream and community services that can help you pursue your goals. This is often the best way to work towards your goals, as it helps you connect with and be part of your community.
Your early childhood partner, local area coordinator or support coordinator can tell you about mainstream and community services that could help you build your independence and take part in your community.
They can also help you connect to these services, and coordinate the supports you get from us and other services.
Local area coordinators and early childhood partners also work with mainstream and community services to help them be more inclusive of people with disability. For example, they can help mainstream services better understand and meet the needs of people with disability.
To find out more, talk to your planner, early childhood partner, local area coordinator, support coordinator, or contact us for advice.
What if a support can be funded by both the NDIS and another service?
There are some supports that can be funded or provided by both us and other services. For example, some therapies may be available both under Medicare and under the NDIS for some participants.
When we work out who is more appropriate to fund or provide the support, we think about why you need the support.
For example, if you need physiotherapy to recover from surgery, this is probably a Medicare service. We can’t include physiotherapy in your plan for this reason.
But we may include physiotherapy in your plan if:
- you need it due to the regular impact of your disability, and not for a health condition, and
- it meets all the reasonable and necessary criteria.
Many Australians also need clinical treatment like psychology to help with mental health issues like schizophrenia, anxiety and depression. You can get these services through Medicare and the mental health system.
We don’t fund clinical services for mental health treatment purposes. Your treating health professional can give you advice on the types of treatments available.
However, we may fund supports that focus on your functional ability and long-term recovery.
For example, we may fund psychology or occupational therapy supports that help you go about your daily life, study, work, and take part in your social life and community.
We focus on supports that are directly related to helping you manage or reduce the functional impact of your disability.
This could include social and communication skills development, regular help with medication and symptoms, and behaviour intervention and support.
In rare situations, you may be eligible for the same support under both the NDIS and another service. If so, there are a couple of things to remember:
- If you claim a support from another service, you can’t use your NDIS funding to claim the same support as well.
- It doesn’t matter whether you use the support funded in your plan first, or the support from another service first.
What if you don’t agree with our decision?
If a support is not an NDIS support because it’s appropriately funded or provided by a mainstream or community service, we can’t include it in your plan.
There are lots of ways we might be able to help though, so talk to us if you’re in this situation. We can help you at any time. For example, we can consider if a different support is more appropriate before we approve your plan.
If another government service should provide the support, we can help you connect with that service.
We’ll give you written reasons why we made the decision. You can contact us if you’d like more detail about the reasons for our decision.
If you don't agree with a decision we make, you can ask for an internal review of our decision.
You’ll need to ask for an internal review within 3 months of getting your plan.
Learn more about reviewing our decisions.