We know that working out what your National Disability Insurance Scheme (NDIS) plan covers can be confusing, especially when you’re new to the Scheme, and sometimes it can be difficult to understand why the NDIS can’t fund a support you’ve requested.
To help you to better understand how the National Disability Insurance Agency (NDIA) makes decisions about what it will and won’t fund – and to explain the payments My Plan Manager can and can’t process – we’ve pulled together all the information and resources you need.
Would we fund it?
A great place to start is the NDIS ‘Would we fund it’ guidelines, which cover everything from assistive technology and consumables through to improved health and wellbeing and mainstream supports.
Is it reasonable and necessary?
Reasonable and necessary – these are words that come up a lot in the NDIS.
In order for supports to be funded by your plan, they must be a type that can, by law, be funded or provided, and they have to meet the NDIS reasonable and necessary criteria.
We’ve explained more about this here.
When working out whether a support is reasonable and necessary for you, the NDIS looks at the information you give and considers it alongside the funding criteria in this guideline about reasonable and necessary supports.
The ‘Would we fund it’ guidelines and the guideline on reasonable and necessary supports are designed to be read together.
What your NDIS plan support categories can fund
To paint a bigger picture of what your NDIS plan may fund, Kinora (My Plan Manager’s community of solutions) has created this fact sheet. The fact sheet breaks down the different NDIS support categories and what they may cover.
Processing payments
When it comes to processing payments for your supports, My Plan Manager follows a simple process, which we’ve explained in this 101 Provider Guide. This handy guide can be shared with your service providers, to make sure the payment of their invoices is simple.
We review every claim for reimbursement and every invoice to ensure they comply with the NDIA’s requirements and align with your NDIS plan.
The NDIA won’t make payment on quotes (only invoices), or process payments in advance of services being delivered, and My Plan Manager is unable to process invoices and reimbursements for amounts above those outlined in the NDIS Pricing Arrangements and Price Limits.
We hope these resources help to paint a clearer picture of what your NDIS plan will and won’t fund.
For your convenience, we’ve listed a summary of these resources here:
Don’t forget, you can also get in touch with us if you need guidance about the supports, services, and providers you can access with your NDIS plan funding.
We’re Australia’s largest (and leading!) NDIS plan manager, and we have a team of experts who can help you to maximise your plan and achieve the outcomes you’re looking for!
