NDIS Frequently Asked Questions
NDIS Provider Group — Your Guide to Understanding the NDIS
Navigating the National Disability Insurance Scheme (NDIS) can raise a lot of questions, whether you’re a new participant, a family member, or a carer. Below, we’ve answered 30 of the most common questions we hear from participants across Sydney and beyond. If you can’t find what you’re looking for, our team at NDIS Provider Group is always happy to help.
About the NDIS
1. What is the NDIS?
The National Disability Insurance Scheme (NDIS) is an Australian Government scheme that provides funding to eligible people with disability to access supports and services that help them live more independently and achieve their personal goals.
2. Who runs the NDIS?
The NDIS is administered by the National Disability Insurance Agency (NDIA), while the NDIS Quality and Safeguards Commission oversees the quality and safety of registered providers and the conduct of NDIS workers.
3. Is the NDIS the same across all Australian states and territories?
Yes, the NDIS operates nationally, though specific services, providers, and community resources will vary depending on your location within Australia.
4. What’s the difference between the NDIA and the NDIS Commission?
The NDIA manages participant plans, funding, and access decisions, while the NDIS Quality and Safeguards Commission regulates provider conduct, investigates complaints, and enforces quality and safeguarding standards.
Eligibility and Applying
5. Who is eligible for the NDIS?
Generally, you must be under 65 years of age, an Australian citizen or hold a Permanent Visa or Protected Special Category Visa, and have a permanent and significant disability that affects your ability to take part in everyday activities.
6. How do I apply for the NDIS?
You can start the process by contacting the NDIA directly, calling 1800 800 110, or visiting a local NDIS office. You’ll need to complete an Access Request Form along with supporting evidence of your disability.
7. What evidence do I need to provide when applying?
You’ll typically need reports or letters from treating doctors, specialists, or other health professionals confirming your diagnosis, the permanence of your condition, and how it affects your daily functioning.
8. How long does the NDIS application process take?
Processing times vary, but the NDIA aims to make an access decision within 21 days of receiving a complete Access Request. Delays can occur if additional information is needed.
9. What happens if my NDIS application is rejected?
If your application is rejected, you have the right to request an internal review of the decision. You can also seek advocacy support or legal advice if you believe the decision was incorrect.
10. Can children access the NDIS?
Yes, children with developmental delay or disability can access the NDIS, including through the Early Childhood Early Intervention (ECEI) approach for children under 9.
Understanding Your NDIS Plan
11. What is an NDIS plan?
Your NDIS plan outlines your goals, the supports you’re funded for, and the budget allocated across different funding categories to help you achieve those goals.
12. What are the main NDIS funding categories?
The three main categories are Core Supports (everyday activities), Capacity Building Supports (building skills and independence), and Capital Supports (equipment, home, and vehicle modifications).
13. How often is my NDIS plan reviewed?
Plans are typically reviewed every 12 months, though this can vary. You can also request an early plan review if your circumstances or support needs change significantly.
14. Can I request changes to my NDIS plan before my scheduled review?
Yes, if your circumstances change significantly, you can request an unscheduled plan review or a change of circumstances review through the NDIA.
15. What does “reasonable and necessary” mean in relation to NDIS funding?
This is the test the NDIA applies when deciding what supports to fund. Supports must relate to your disability, represent value for money, and be likely to be effective and beneficial for you.
Plan Management Options
16. What are the different ways to manage my NDIS plan?
You can choose to be NDIA-managed (the NDIA pays providers directly), plan-managed (a plan manager handles your funding administration), or self-managed (you manage the funding and payments yourself).
17. What is the benefit of plan management over NDIA-managed funding?
Plan management gives you the freedom to use both registered and unregistered providers, while still having the administrative burden of invoicing and claims handled on your behalf.
18. Can I use unregistered providers under the NDIS?
Yes, if you are plan-managed or self-managed, you can use unregistered providers. If you are NDIA-managed, you generally need to use registered providers.
19. Does plan management cost extra out of my funding?
No, plan management is funded separately by the NDIA and does not reduce the funding available for your other supports.
Finding and Using Providers
20. How do I find a registered NDIS provider?
You can search the NDIS Provider Register through the NDIS Commission website, ask your Support Coordinator for recommendations, or research local providers directly, such as through their websites.
21. What’s the difference between a registered and unregistered NDIS provider?
Registered providers have been independently audited against the NDIS Practice Standards, while unregistered providers have not undergone this formal audit process, though they may still deliver quality services.
22. Can I change providers if I’m not happy with my current one?
Yes, you are free to change providers at any time. It’s a good idea to review your service agreement for any notice periods required.
23. What is Support Coordination and do I need it?
Support Coordination helps you understand and implement your NDIS plan, connecting you with the right providers and building your capacity to manage your supports. Not all plans include funding for this, depending on your individual needs.
Costs and the NDIS Pricing Guide
24. What is the NDIS Pricing Guide?
The NDIS Pricing Arrangements and Price Limits document sets out the maximum prices registered providers can charge for various supports, ensuring consistency and fairness across the sector.
25. Do prices for NDIS supports change over time?
Yes, the NDIA reviews and updates pricing arrangements periodically, usually on 1 July each year, though updates can occur at other times as well.
26. Can providers charge more than the NDIS price limits?
Registered providers must not charge above the specified price limits for supports covered under the NDIS Pricing Arrangements. Always check current pricing with your provider directly.
Supports, Carers, and Community
27. What support is available for family members and carers?
While NDIS funding is provided to the participant rather than the carer directly, supports such as respite care, Support Coordination, and capacity building can help ease the demands on family carers.
28. Can I get NDIS support if I live in a rural or regional area?
Yes, the NDIS is available nationally, though the range of available providers may be more limited in rural and regional areas compared to major cities.
29. What should I do if I’m unhappy with my NDIS provider’s service?
Start by raising your concerns directly with the provider. If the issue isn’t resolved, you can lodge a complaint with the NDIS Quality and Safeguards Commission on 1800 035 544.
30. Where can I get help understanding my NDIS plan and options?
You can seek help from a Support Coordinator, Local Area Coordinator (LAC), NDIS-funded advocacy services, or a trusted provider like NDIS Provider Group, who can help explain your plan and connect you with suitable supports.