All supports we fund under the NDIS need to be value for money. This means the cost of the support is reasonable, when we consider the benefits of the support and the cost of other supports.
Making sure that your supports are value for money is one of the ways we keep the NDIS financially sustainable. This means we make careful decisions about funding so that we make sure the NDIS exists for future generations. It’s also one of our principles.
When we decide if the support is value for money, we consider:
- if other supports would achieve the same result at a substantially lower cost – this means there should be a real or material difference in cost
- if there’s evidence that the support will substantially improve your life stage outcomes and benefit you in the long term
- if the support will likely reduce the cost of other supports over time
- how the cost compares to other supports of the same kind in your area
- if the support will make you more independent, and mean you won’t need as many supports in future, for example, in some circumstances home modifications may reduce the need for home care.
When we consider the likely cost of supports, we consider the cost over the long term. We consider if the support will help you to achieve milestones at different ages or stages of your life, and have long term benefits.
For example, some supports such as home modifications may be expensive now, compared to other supports. But getting these supports now may mean you need much less support in a few years, or later in life. Or, it may delay the need for other more costly supports.
When we determine the cost of the support, we consider:
- the prices for NDIS supports in the NDIS Pricing Arrangements and Price Limits
- supports suggested by the Typical Support Package
- quotes for specific or high risk supports.
It’s important we consider the cost of the support. This will be the level of funding we include in your plan, if we decide the support is reasonable and necessary.
When we fund equipment or modifications, we also need to consider:
- how the cost of buying the equipment or modifications compares against the cost of renting them
- if it’s appropriate to fund the equipment or modifications you want, based on your circumstances and any expected changes in technology.
Elias needs a shower commode.
He got an assessment and sent us a quote for one that will suit his needs. As part of the process to work out if we can fund it, his planner considers other similar shower commodes.
There’s a second commode that’s $5,000 cheaper than the one Elias has asked for. But it won’t meet Elias’ needs, as it won’t provide enough back support. That is, it won’t achieve the same result as the one Elias has asked for.
Finally, there’s a third commode that’s $1,000 cheaper. The planner contacts his occupational therapist who confirms the cheaper commode will meet Elias’ needs.Elias’ planner decides to fund the commode that’s $1,000 cheaper. It’ll deliver the same result at a substantially lower cost.