What is the NDIS? Eligibility, plans & budgets explained

1. What the NDIS actually is

The National Disability Insurance Scheme funds supports that are reasonable and necessary because of a permanent and significant disability. It is not income support and it does not replace health, education or housing systems.

Funding is individual: two people with the same diagnosis can receive very different plans, because plans are built around function — what you can do, with how much help, on an ordinary day.

2. Who is eligible

You generally need to be under 65 when you first apply, live in Australia as a citizen or permanent resident (or hold a Protected Special Category Visa), and meet either the disability requirements or the early intervention requirements.

• Permanent and significant impairment affecting daily activities such as mobility, communication, social interaction, learning or self-care.
• Or early intervention: support now would reduce your future need for support.
• Children under 6 are supported through the early childhood approach, which does not always require a diagnosis.

3. Applying — the access request

Call 1800 800 110 or submit an Access Request Form. The evidence you attach does most of the work.

• Confirmation of identity, age and residency.
• Evidence of impairment from a treating professional — diagnosis, permanence and functional impact.
• Functional assessments (OT, speech, physio, psychology) describing help needed in each area of life.
• A written description of a typical day and a typical bad week.

4. Your first planning conversation

This meeting sets your goals and budgets. Prepare like an interview, and bring someone with you.

• Describe a full 24 hours, including nights, and the worst weeks — not your best day.
• Bring 3–5 concrete goals with a measurable outcome.
• Say what support you need for each goal, and how often.
• Ask for plan management and support coordination explicitly if you want them.

5. How your budgets work

Plans separate funding into Core (everyday supports), Capacity Building (skills and independence) and Capital (equipment and home changes). Under the new framework, plans state a total amount with flexible and stated components released across funding periods.

• Flexible funding can be moved between most day-to-day supports.
• Stated funding is locked to a named purpose, such as SIL or assistive technology.
• Capital funding cannot be reallocated to other supports.
• Funding periods control when each instalment becomes available to spend.

6. Who manages the money

There are three options and you can mix them across categories.

• Agency-managed: the NDIA pays providers; you must use registered providers.
• Plan-managed: a plan manager pays invoices; you can use registered and unregistered providers. Funded on top of your plan.
• Self-managed: you pay providers and keep records; maximum choice, most admin.

7. Using your plan well

• Sign a service agreement with every provider: rates, notice periods, cancellation terms.
• Check a statement monthly so a shortfall never surprises you.
• Keep a simple diary of supports that worked and supports that did not.
• Ask therapists for goal-linked progress reports every year.

8. Preparing for reassessment

Reassessment decisions follow evidence. Start collecting it three months out.

• Current functional assessment (ideally under 12 months old).
• Therapy progress reports tied to each goal.
• A roster of care if you are seeking SIL or higher support hours.
• Quotes for any capital items you need.
• A short written summary of what changed since the last plan.

9. If you disagree with a decision

• Request an internal review within 3 months of the decision.
• If still unresolved, apply to the Administrative Review Tribunal.
• Free advocacy is available through state and territory advocacy services.
• Complaints about provider conduct go to the NDIS Quality and Safeguards Commission on 1800 035 544.