If you or someone in your family is living with a disability, you may have heard the term NDIS and wondered: What exactly is it, how does it work, and how can someone get support?
So, how does the NDIS work?
The National Disability Insurance Scheme (NDIS) is an Australian government scheme that provides funding to eligible people with disability so they can access support and services related to their disability. The aim is to help people with disabilities manage everyday life, build independence, participate in their community and work towards their personal goals.
In simple terms, the process generally works like this:
- Check your eligibility
- Apply
- Become an NDIS participant
- Create your plan
- Receive funding
- Choose suitable supports and providers
- Use your funding
- Review or reassess your plan.
However, there is more to each step than this simple summary. So, let’s break everything down.
What Is the NDIS?
NDIS stands for National Disability Insurance Scheme.
It is designed for Australians with permanent and significant disability, as well as some people who meet the early intervention requirements.
One important thing to understand is that the NDIS is not simply a payment that everyone with a disability automatically receives.
There are specific eligibility requirements. If you meet those requirements, the NDIS may provide funding for supports that are considered appropriate under NDIS rules.
The NDIS is operated by the National Disability Insurance Agency (NDIA). The NDIS is the scheme itself, while the NDIA is the organisation responsible for running it.
Who Can Access the NDIS?
This is one of the first questions people usually ask.
Not everyone with a disability automatically qualifies for the NDIS. There are eligibility requirements covering age, residence and disability or early intervention requirements.
Let’s look at these one by one.
1. Age Requirements
Generally, you need to be under 65 when you apply for the NDIS.
There are also specific arrangements for young children and early childhood supports, so families with young children should check the relevant NDIS pathway rather than assuming the standard adult process applies.
2. Residence Requirements
You generally need to:
- live in Australia and spend most of your time here; and
- be an Australian citizen, permanent resident or Protected Special Category Visa holder.
These are legal requirements used when determining NDIS eligibility.
3. Disability Requirements
This is where things become a little more detailed.
Generally, the NDIS looks at whether a person’s disability is caused by an impairment that is, or is likely to be, permanent.
The impairment must also substantially affect everyday activities and participation, such as working, studying or taking part in social life. The NDIS also considers whether the person is likely to need NDIS support for their lifetime.
This means having a medical condition or disability by itself does not necessarily mean that someone will qualify.
The NDIS looks at how the impairment affects the person’s life and what long-term support they are likely to need.
What About Early Intervention?
There is another pathway known as the early intervention requirements.
Early intervention is intended to provide support where doing so may reduce the person’s future need for disability support.
For example, some children may be able to access the NDIS through early intervention arrangements.
Young children with developmental delay may also have specific pathways under the NDIS early childhood approach.
Because eligibility can depend on individual circumstances, families should avoid relying on a simple checklist alone. The NDIA makes the final eligibility decision.
Step 1: Check Whether You May Be Eligible
Before starting an application, it is useful to understand the eligibility requirements.
You may also be able to speak with an NDIS partner for assistance.
An NDIS partner can help people understand their options, connect with community support and, where appropriate, help them connect with the NDIS application process.
If you’re unsure whether you qualify, don’t assume that you are either definitely eligible or definitely ineligible. Getting guidance can save time and make the process easier.
Step 2: Gather Your Evidence
If you are applying for the NDIS, evidence about your disability and how it affects your everyday life is important.
You may need information from a doctor, specialist or another treating professional.
The evidence should help explain things such as:
- what your impairment is;
- whether it is permanent or likely to be permanent;
- how it affects your daily activities;
- how it affects work, study or social participation;
- what support you currently need; and
- what support you are likely to need in the future.
The NDIS uses the evidence you provide when making an eligibility decision.
A helpful tip
Don’t focus only on the name of a diagnosis.
What matters is also how the impairment affects your everyday life.
For example, someone might need assistance with communication, personal care, mobility, learning, social participation or other everyday activities. Evidence should explain those practical impacts clearly.
Step 3: Submit Your NDIS Application
Once you have the relevant information and evidence, you can complete your application.
The current NDIS application process includes connecting with an NDIS partner, working with your treating health professional to gather evidence, completing the application and submitting it for a decision.
The NDIA then considers your application and evidence.
You will receive an access decision telling you whether you have become an NDIS participant.
Step 4: Your First NDIS Plan
If your application is approved, the next major step is creating your NDIS plan.
Think of an NDIS plan as a personalized roadmap.
It is based on your circumstances, disability-related support needs and goals.
Your plan can identify the types of NDIS support and funding you have available.
The NDIS says plans are individual, meaning there isn’t one standard amount of funding that everyone receives. The amount of funding depends on the person’s situation, evidence, supports and needs.
What Are NDIS Goals?
Goals are an important part of the planning process.
Your goals might relate to areas such as:
- becoming more independent;
- developing everyday skills;
- participating in community activities;
- improving your ability to study;
- working towards employment;
- improving communication;
- managing daily activities; or
- participating in social activities.
Your goals help explain what you are trying to achieve and why particular disability-related supports may be useful.
Step 5: Understand Your NDIS Funding
This is one of the most important parts of understanding the NDIS.
Your NDIS plan can contain different support budgets.
Under the current NDIS structure, the four support budgets are:
1. Core supports
2. Capacity building supports
3. Capital supports
4. Recurring supports
Not every participant necessarily has funding in every budget. Your plan is based on your individual needs.
Let’s look at what these mean.
Core Supports
Core supports are generally focused on helping with everyday activities and participation.
Depending on the person’s plan, they may include assistance with things such as:
- personal care;
- household tasks;
- daily living;
- community participation; and
- other everyday disability-related activities.
For example, a participant may receive support from a worker to help with certain daily tasks or participate in community activities.
Capacity Building Supports
Capacity building supports are focused on developing skills, independence and longer-term outcomes.
Depending on the plan, these can include supports such as therapy or other services designed to help a person build their abilities.
Examples can include occupational therapy, speech-related supports or behaviour supports where they meet NDIS requirements.
The basic idea is:
Core supports often help with what you need to do today, while capacity building supports can help you develop skills and independence for the future.
The exact supports available depend on the participant’s individual plan.
Capital Supports
Capital supports relate to higher-cost items and certain equipment, technology or modifications.
Depending on the circumstances and the plan, this can include assistive technology or home and vehicle modifications.
Capital funding can also cover certain specialist disability accommodation costs where applicable.
Recurring Supports
Recurring supports are another type of budget that can appear in an NDIS plan.
These are generally used for support that is provided or funded on a recurring basis.
Whether you receive this type of funding depends on your individual circumstances and plan.
What Can NDIS Funding Be Used For?
This is an area where beginners often become confused.
Having money in an NDIS plan does not mean you can spend it on anything you want.
NDIS funding can only be used for supports that meet the relevant NDIS rules.
The support generally needs to be:
- an NDIS support;
- related to your disability; and
- in line with your plan.
The NDIS currently provides lists and guidelines explaining what can and cannot be funded.
A simple way to think about it
Don’t ask only:
“Do I have money in my NDIS plan?”
Also ask:
“Is this an NDIS support, and can I use my funding for it under my plan?”
If you use NDIS funding for something that isn’t an appropriate NDIS support, you may be required to repay the money.
Step 6: Choose Your Providers
Once your plan is approved, you can begin arranging the supports included in your plan.
Depending on how your funding is managed and what support you need, you can choose providers that are suitable for you.
A provider might offer services such as:
- support workers;
- therapy;
- assistance with daily living;
- community participation;
- specialised equipment; or
- other approved disability-related supports.
One of the important principles of the NDIS is that participants have choice and control over the supports and providers they use, subject to the relevant rules and their plan.
What Does “Plan Management” Mean?
Another term you may hear is plan management.
NDIS funding can be managed in different ways.
The main arrangements include:
- NDIA-managed funding
- plan-managed funding
- self-managed funding
The management method affects how providers are paid and how you manage your NDIS funding.
For example, with self-management, the participant has greater responsibility for managing payments and records. With plan management, a plan manager helps manage the financial side of the plan.
The appropriate arrangement depends on the participant’s circumstances and preferences.
What Is My NDIS Contact?
Once you become an NDIS participant, you may have a NDIS contact who can help you understand your plan and navigate the NDIS.
The NDIS also offers a plan implementation meeting after a new plan is approved. This is intended to help participants understand their plan and get started.
You don’t necessarily have to figure everything out by yourself.
If your plan is confusing, asking questions early can make it much easier to use your funding correctly.
Step 7: Start Using Your NDIS Plan
Once your plan has been approved, you can start purchasing the NDIS support included in your plan.
This is where your plan moves from being a document to something you actually use in everyday life.
For example, depending on your approved supports, you may arrange services that help you:
- complete daily activities;
- develop skills;
- participate in the community;
- access appropriate assistive technology; or
- work towards your individual goals.
The important thing is to keep your spending connected to the supports and rules in your plan.
How Much NDIS Funding Does Someone Get?
There isn’t one fixed amount of NDIS funding for everyone.
The amount depends on the person’s individual circumstances, evidence, support needs and the supports included in their plan.
This is why comparing two participants and expecting them to receive identical funding can be misleading.
Two people may have similar diagnoses but very different functional needs.
The NDIS looks at the person’s individual situation rather than simply giving everyone with the same diagnosis the same amount.
Does the NDIS Pay You Cash?
Not in the simple sense of giving every participant unrestricted cash to spend however they like.
The funding is connected to approved NDIS support and is managed according to the relevant funding arrangement.
Participants use their funding to purchase appropriate support and services.
So, it is better to think of NDIS funding as funding for approved disability-related supports, rather than as ordinary income.
What Happens If Your Needs Change?
Your circumstances can change over time.
Your support needs may increase or decrease, your goals may change, or the supports in your plan may no longer work as expected.
The NDIS can review or reassess plans so that support continues to reflect a participant’s circumstances and needs.
If something important changes, it’s better to understand the relevant NDIS process rather than simply changing your spending without checking the rules.
What If Your NDIS Application Is Not Approved?
Not being eligible for the NDIS does not mean that you cannot receive any disability support.
Australia has other systems and services that can support people with disability, including mainstream and community services.
NDIS partners can help people understand other options if they don’t meet the NDIS eligibility requirements.
Depending on the circumstances, these alternatives may include community, health, education, employment or other government services.
Common NDIS Terms You Should Know
If you’re new to the NDIS, the terminology can feel overwhelming.
Here are some of the most common terms in simple language.
NDIS
The National Disability Insurance Scheme, which provides funding for eligible people with disability.
NDIA
The National Disability Insurance Agency, the organisation that runs the NDIS.
Participant
A person who has been accepted into the NDIS.
NDIS Plan
A personalised plan that outlines the participant’s goals, supports and available funding.
NDIS Funding
Money included in an NDIS plan to pay for approved NDIS support.
Provider
A person or organisation that delivers an NDIS support or service.
Core Supports
Funding generally focused on assistance with everyday activities and participation.
Capacity Building
Support designed to build skills, independence and capacity.
Capital Supports
Funding for certain equipment, assistive technology and modifications.
Plan Manager
A person or organisation that can help manage the financial administration of NDIS funding.
NDIS Partner
A local organisation that can help people understand the NDIS, connect with supports and navigate relevant processes.
A Simple Example of How the NDIS Works
Let’s imagine someone named Sam.
Sam has a permanent disability that significantly affects everyday activities.
Step 1: Sam checks eligibility
Sam checks the NDIS requirements for age, residence and disability.
Step 2: Sam gathers evidence
Sam works with relevant health professionals to collect information explaining how the disability affects everyday life.
Step 3: Sam applies
Sam completes and submits an NDIS application.
Step 4: Sam becomes an NDIS participant
If the application is approved, Sam becomes an NDIS participant.
Step 5: Sam develops a plan
Sam discusses personal circumstances, goals and support needs.
Step 6: Funding is included in the plan
The NDIS determines the appropriate funding for the approved supports.
Step 7: Sam chooses suitable providers
Sam arranges services and supports that are appropriate under the plan.
Step 8: Sam uses the supports
Sam uses the approved support to work towards everyday goals and greater independence.
Step 9: The plan is reassessed when needed
The NDIS reviews the plan as appropriate to make sure the supporters continue to meet Sam’s needs.
That’s the basic NDIS journey.
7 Common Mistakes Beginners Should Avoid
Understanding the NDIS is much easier when you know what mistakes to avoid.
1. Assuming every disability automatically qualifies
The NDIS has specific eligibility requirements.
A diagnosis alone does not automatically guarantee access.
2. Treating NDIS funding like ordinary money
NDIS funding is intended for approved NDIS support.
Before purchasing something, make sure it is allowed under the relevant rules and your plan.
3. Focusing only on a diagnosis
Your diagnosis is important, but the NDIS also looks at how your impairment affects everyday life and what support you are likely to need.
4. Not keeping track of spending
Understanding your available funding and monitoring how you use it can help prevent unpleasant surprises later.
5. Choosing a provider without asking questions
Before starting with a provider, consider things such as:
- What exactly does the service include?
- How much does it cost?
- How often will the service be provided?
- Does the provider understand your needs?
- What happens if you want to stop the service?
Taking a little time to understand the arrangement can make the experience much smoother.
6. Being afraid to ask questions
The NDIS can be complicated, especially when you’re seeing terms like funding categories, support budgets and plan management for the first time.
If something isn’t clear, ask.
Understanding your plan is an important part of using it properly.
7. Relying on outdated information
The NDIS continues to evolve, and official guidance can change.
For important decisions about eligibility, funding or support, always check the latest information from the NDIS rather than relying on an old blog post or social media comment.
How Long Does the NDIS Process Take?
There isn’t one simple timeframe that applies to every person’s journey.
The process can involve:
1. checking eligibility;
2. gathering evidence;
3. submitting an application;
4. waiting for an access decision;
5. creating a first plan if accepted; and
6. arranging supports.
The NDIS currently states that a first plan must be approved within 56 days after a person becomes a participant.
However, individual circumstances and stages of the process can vary.
Is the NDIS Free?
The NDIS itself is a government-funded scheme, but that doesn’t mean every service a person might want is automatically free.
NDIS funding is allocated for approved disability-related supports.
There may also be everyday expenses that are the person’s own responsibility because they are ordinary living costs rather than disability-specific supports.
This is why understanding the difference between NDIS supports, mainstream services and ordinary living expenses is so important.
What Makes the NDIS Different?
One of the biggest differences between the NDIS and older models of disability support is its focus on individualised funding.
Instead of providing exactly the same service to everyone, the NDIS aims to provide funding based on an eligible person’s individual circumstances, goals and support needs.
This can give participants more choice and control over how they arrange appropriate support.
At the same time, having greater choice also means participants need to understand their plans, budgets and responsibilities.
A Beginner’s NDIS Checklist
If you’re just getting started, here’s a simple checklist to keep nearby:
Before applying
- Check the age requirements.
- Check the residence requirements.
- Understand the disability or early intervention requirements.
- Speak with an NDIS partner if you need help.
- Start gathering supporting evidence.
During the application
- Provide accurate information.
- Explain how your impairment affects everyday life.
- Include relevant professional evidence.
- Keep copies of important documents.
After approval
- Understand your NDIS plan.
- Learn what each funding budget means.
- Understand how your funding is managed.
- Learn which supports you can purchase.
- Research suitable providers.
- Keep track of your spending.
During your plan
- Use funding only for appropriate NDIS support.
- Keep your goals in mind.
- Monitor your budgets.
- Ask for help when something isn’t clear.
- Tell the NDIS about important changes when required.
- Prepare for plan reassessment when appropriate.
Conclusion
The NDIS Doesn’t Have to Be as Confusing as It First Seems
The NDIS can look complicated when you first encounter terms such as eligibility, access decisions, plans, support budgets, providers and plan management.
But the basic idea is fairly straightforward:
The NDIS provides individualised funding to eligible people with disability so they can access appropriate disability-related supports and work towards their goals.
The journey usually starts by checking eligibility. If you may qualify, you gather evidence and apply. If you’re accepted, you work through the planning process, receive funding for approved supports and then arrange those supports with suitable providers.
The most important thing to remember is that every NDIS participant’s situation is different. There is no single plan, funding amount or combination of services that works for everyone.
If you’re starting your NDIS journey, take it one step at a time. Learn what your plan means, understand your funding, ask questions when you’re unsure and keep checking the latest official NDIS guidance.
The official NDIS website is the best place to confirm current eligibility requirements, funding rules and application processes because these rules can change over time.
FAQs
1. What is the NDIS in Australia?
The National Disability Insurance Scheme (NDIS) is an Australian government scheme that provides funding to eligible people with permanent and significant disability. The funding helps participants access appropriate disability-related supports and work towards their personal goals.
2. Who is eligible for the NDIS?
Generally, a person must meet certain requirements relating to age, residence and disability or early intervention. For the disability requirements, the impairment generally needs to be permanent and significantly affect the person’s ability to take part in everyday activities.
3. How do I apply for the NDIS?
You can start by checking the NDIS eligibility requirements and gathering relevant evidence about your disability and support needs. You can then complete an NDIS application and provide the required information and supporting evidence for the NDIA to assess your application.
4. What can NDIS funding be used for?
NDIS funding can generally be used for approved disability-related supports that meet the relevant NDIS rules and are included or allowed under your plan. It cannot simply be used for any everyday expense or item you choose.
5. How much NDIS funding can I receive?
There is no standard funding amount for every NDIS participant. Funding is based on individual circumstances, support needs, goals and the supports considered appropriate under the NDIS. Two people with similar disabilities may therefore receive different levels of funding.
