What Is the NDIS?

A plain-English guide to the National Disability Insurance Scheme — what it is, who it’s for, and how to access it.

If you or someone you care about has a disability, you’ve probably heard the NDIS mentioned by a doctor, a social worker, a friend, or in the news. It’s the main way disability support is funded in Australia, and it can make a real difference to everyday life. But the language around it can be confusing, and it isn’t always obvious where to start.

This guide explains the NDIS in plain terms: what it stands for, who’s eligible, what it pays for, how to apply, and what happens once you have a plan.

What does NDIS stand for?

NDIS stands for the National Disability Insurance Scheme.

It’s a national program, funded by the Australian Government, that provides money for supports and services to people with a permanent and significant disability. It began rolling out in 2013 and now supports more than 700,000 Australians.

You’ll also see the letters NDIA used, and the two are easy to mix up:

• NDIS — the National Disability Insurance Scheme. The program itself, and the funding it provides.
• NDIA — the National Disability Insurance Agency. The government agency that runs the scheme, assesses applications, and approves plans.

In short: the NDIA is the organisation, and the NDIS is what it delivers.

How the NDIS works

The idea behind the National Disability Insurance Scheme is straightforward, even if the process around it isn’t always. Rather than funding disability services in blocks and asking people to fit into whatever is available, the NDIS gives funding to the individual, so you can choose the supports that suit your life and the providers you want to work with.

The scheme is built around a few core principles:

• Choice and control. You decide which providers deliver your supports, and you can change providers if a service isn’t working for you.
• Individual funding. Your funding is based on what you need, not on a fixed package level or a queue.
• A focus on goals. Your plan is built around what you want to achieve, such as living more independently, working, studying, staying connected to your community.
• Lifetime approach. The scheme is designed to invest early, on the basis that the right support now often reduces the need for more intensive support later.

It’s worth understanding that the NDIS is not a welfare payment and it doesn’t replace Medicare, the disability support pension, or the health system. It sits alongside them, funding the disability-related supports those systems don’t cover.

Who is eligible for the NDIS?

To access the NDIS, you generally need to meet four requirements. The NDIA assesses each of these when you apply.

Age

You need to be under 65 when you first apply. If you’re already an NDIS participant when you turn 65, you can choose to stay on the scheme as you won’t be moved off it automatically. We’ve covered this in more detail in our guide to what happens to your NDIS plan when you turn 65.

Residency

You need to live in Australia and be an Australian citizen, a permanent resident, or hold a Protected Special Category Visa.

Disability

You need to have a disability caused by a permanent impairment. This can be intellectual, cognitive, neurological, sensory, physical, or psychosocial. “Permanent” means the impairment is likely to be lifelong, though it doesn’t have to be unchanging.

Support needs

Your impairment needs to substantially reduce your ability to carry out everyday activities (things like communicating, moving around, socialising, learning, or managing self-care) such that you require support from another person or from assistive technology.

There’s also an early intervention pathway for people who don’t meet the standard disability requirements but where early support is likely to reduce their future needs. This is often relevant for young children.

If you’re not sure whether you meet the criteria, apply anyway. Eligibility is assessed on individual circumstances, and plenty of people who assumed they wouldn’t qualify do. The NDIA also has a checklist on its website you can work through first.

What does the NDIS cover?

NDIS funding pays for supports that are related to your disability, help you pursue the goals in your plan, and represent value for money. The scheme groups these into three budget categories.

Core supports

Day-to-day assistance. This is the category most participants use most heavily, and it includes:

• Help with personal care — showering, dressing, grooming, and personal hygiene
• Domestic assistance — cleaning, laundry, and help around the home
• Meal preparation
• Social and community participation
• Transport and help getting to appointments
• Consumables like continence aids

Capital supports

Higher-cost items and modifications, including assistive technology (wheelchairs, communication devices, vehicle modifications) and home modifications such as ramps or bathroom rails. Capital funding is generally tied to specific approved items.

Capacity building supports

Supports that help you build skills and independence over time, such as therapies, employment support, help with daily living skills, and support coordination.

What the NDIS doesn’t cover

The scheme won’t fund everyday living costs that aren’t related to your disability (rent, groceries, general utilities), supports that another system is responsible for, such as medical treatment through Medicare or the public health system, or anything likely to cause harm. If you’re ever unsure whether something can be funded, your plan manager or support coordinator can tell you.

How to apply for the NDIS

The application process has a few steps. It can take some time, so it’s worth starting early and gathering your evidence before you begin.

1. Check the eligibility requirements. Work through the four criteria above, or use the NDIA’s eligibility checklist.
2. Gather your evidence. You’ll need reports from your treating health professionals confirming your disability, how permanent it is, and how it affects your daily life. This is the part that most often causes delays. The more specific and recent the evidence, the smoother the process.
3. Submit an Access Request. Call the NDIA on 1800 800 110 or complete an Access Request Form. You can be helped with this by a family member, carer, or advocate.
4. Wait for a decision. The NDIA aims to decide within 21 days of receiving a complete request. If more information is needed, they’ll ask for it.
5. Attend your planning meeting. If you’re found eligible, you’ll meet with an NDIA planner or Local Area Coordinator to talk through your goals, your current supports, and what you need.
6. Receive your plan. Your approved plan sets out your funded supports and budgets, and you can start using it.

If your application is declined, you can ask for an internal review. A decline isn’t necessarily final. Many successful participants were knocked back the first time, usually because the initial evidence didn’t fully capture the day-to-day impact of their disability.

Your NDIS plan and how it’s managed

Your NDIS plan is the document that sets out your goals, your funded supports, and how much funding sits in each budget category. It usually runs for 12 months, though longer plans are becoming more common where someone’s needs are stable.

How your funding is managed determines which providers you can use and how invoices get paid. There are three options, and you can use a combination of them.

Self-managed

You receive the funding and pay providers directly. This gives you the most flexibility. You can use both registered and unregistered providers but it also means handling invoices, records, and claims yourself.

Plan-managed

A plan manager handles the financial administration on your behalf. You still choose your own providers, including unregistered ones, but you’re not doing the paperwork. The plan manager’s fee is funded separately and doesn’t come out of your support budget.

NDIA-managed (agency-managed)

The NDIA pays your providers directly. This involves the least administration, but you can only use registered NDIS providers.

None of these options is better than the others in the abstract. It depends on how much administration you want to take on and how much flexibility you want in choosing providers.

What is an NDIS provider?

An NDIS provider is any person or organisation that delivers the supports and services funded in your plan, such as a support worker, a cleaner, a physiotherapist, a nursing service, a transport service.

Providers fall into two groups:

• Registered providers have been approved by the NDIS Quality and Safeguards Commission and audited against the NDIS Practice Standards. Anyone can use a registered provider, regardless of how their plan is managed.
• Unregistered providers haven’t gone through that process. They can still deliver quality support, and many do, but they can only be used by self-managed and plan-managed participants.

You’re free to choose your own providers and to change them if something isn’t working. You don’t need permission from the NDIA to switch, though you should check any notice period in your service agreement.

Absolute Care & Health is a registered NDIS provider delivering in-home and community supports across Melbourne. You can read more about the NDIS services we provide, or about how we work with NDIS participants and support coordinators and plan managers.

Frequently asked questions about the NDIS

What does NDIS stand for?

NDIS stands for the National Disability Insurance Scheme. It’s the Australian Government program that funds supports and services for people with a permanent and significant disability.

What’s the difference between the NDIS and the NDIA?

The NDIS is the scheme itself. The funding and the supports.

The NDIA, or National Disability Insurance Agency, is the government agency that runs it, assesses applications, and approves plans.

Who is eligible for the NDIS?

You generally need to be under 65 when you apply, live in Australia as a citizen or permanent resident, have a permanent impairment causing significant disability, and need support from another person or assistive technology for everyday activities. There’s also an early intervention pathway for people who don’t meet the standard criteria but would benefit from early support.

How much funding will I get?

There are no set funding levels. Your budget is based on what the NDIA assesses you as reasonably and necessarily needing to pursue your goals, so two people with the same diagnosis can receive very different amounts.

How long does an NDIS application take?

The NDIA aims to make an access decision within 21 days of receiving a complete request. Gathering supporting evidence from health professionals beforehand usually takes longer than the decision itself, so it’s worth starting there.

What happens if my NDIS application is rejected?

You can request an internal review within three months of the decision. Many applications are declined initially because the evidence didn’t fully demonstrate the day-to-day functional impact of the disability rather than because the person wasn’t eligible.

Does the NDIS affect my Centrelink payments?

NDIS funding is not income and doesn’t reduce the Disability Support Pension or other Centrelink payments. We’ve explained this further in our guide on what happens to Centrelink payments when you receive an NDIS plan.

Can I get cleaning through the NDIS?

Household tasks including cleaning can be funded where your disability means you can’t do them yourself. It’s funded from your Core supports budget. There’s more detail in our article on getting a cleaner through the NDIS.

What happens to my NDIS plan when I turn 65?

If you’re already a participant, you can stay on the NDIS after 65. You’re not transferred to aged care automatically. You do have the option to move to the aged care system if you’d prefer. Our guide on NDIS plans after 65 covers the choice in detail.

Can I change my NDIS provider?

Yes. Choice and control is a core principle of the scheme, and you don’t need NDIA approval to change providers. Check the notice period in your service agreement, and it’s usually worth arranging the new provider before ending with the old one so your support isn’t interrupted.

Need help using your NDIS plan?

Understanding the scheme is one thing; finding the right people to deliver your supports is another. Absolute Care & Health is a registered NDIS provider offering personal care, domestic assistance, community participation, nursing and more across Melbourne.

If you’d like to talk through what support might look like, get in touch or call us on 1300 030 032. There’s no obligation — we’re happy just to answer questions.