There’s a lot of jargon in the National Disability Insurance Scheme (NDIS) and it’s continually changing. If decoding the Scheme – from planning meetings to reassessments, reviews to variations (and everything in between) – stresses you out, we’ve got you!
Read our ultimate guide to the lifecycle of an NDIS plan to unpack the common terms and milestone moments in the NDIS journey.
To access the NDIS, you need to apply. This can be done verbally (just call the NDIS on 1800 800 110) or by completing and submitting an Access Request Form.
Once you’ve decided to apply, it’s time to get the ball rolling by gathering the supporting evidence you need to secure the funding you’re after. A great place to start is by talking to your GP, medical specialists and allied health professionals to ask for their help with preparing reports, which can be submitted with the Supporting Evidence Form.
There’s lots of information you need to include with your application, and you can find out more about stating your case for support in this article.
Once you’ve been granted access to the Scheme, you’re officially an NDIS participant – and you’ll soon hear from the National Disability Insurance Agency (NDIA), or an NDIA partner to set a date for your planning meeting.
During the meeting, you’ll have the chance to talk about the different areas of your life, as well as your disability and its impacts, and you’ll also get to discuss your goals and the supports you need to achieve them.
The NDIA will consider the information you provide and the evidence that supports it, and the Agency will make an assessment of what supports it considers to be reasonable and necessary for you. From there, your NDIS plan will be developed, and your funding will be allocated.
The decisions made by the NDIA will be informed by the information you present, so think about the evidence you can provide – such as medical and allied health reports, progress notes, assistive technology recommendations and quotes, and lived experience and carer statements.
You can contact the NDIA before your planning meeting to find out more and ensure you’ve provided the right documentation. You can also check out this information on the NDIS website.
If you do decide to call the NDIA before your planning meeting, some questions you might like to ask are:
1. What do I need to bring to my planning meeting?
Whether you’re meeting in person, online or by phone, the NDIA may recommend bringing (or referring to) reports from medical and allied health professionals, like specialist doctors, occupational therapists, speech pathologists and more.
2. Will my planning meeting be face-to-face, virtual or over the phone?
Be sure to lock in the details, so you know exactly where you need to be on the day of your meeting.
3. What will happen in my planning meeting, and what kind of questions will I be asked?
You can ask staff on the call to run through the planning meeting procedure with you.
4. Are there any resources I can use to prepare for my planning meeting?
Whether you’re speaking with NDIA staff or an NDIA partner, it’s important to ask them to direct you to all available resources. This page on the NDIS website is a great place to start.
When it comes to the planning meeting, don’t forget that you can bring a support person (like a relative or carer) – whether the meeting is conducted in person, online or by phone.
Once you have your first plan, you can start putting it into action, growing your capacity and achieving the outcomes you’re after!
The NDIA or an NDIA partner will check in with you near the end date of your current NDIS plan. You’ll be asked how you’re going with your plan and if your circumstances have changed during the plan period, and a date will be set for your plan reassessment meeting.
TIP: If you haven’t heard from the NDIA (or an NDIA partner) six weeks prior to the end date of your plan, call 1800 800 110 to discuss the next steps.
During the check in discussion, you might be asked:
It can be hard to remember everything you want to say during a check in discussion. That’s why it can be useful to keep a list of notes in your phone or tablet, in a notebook you carry with you, or on a piece of paper stuck on your fridge. Here’s some things you may want to note down:
If, after the check in, you all agree everything is working well, you may not require a plan reassessment, but if the check in reveals that your plan isn’t working, some changes (big or small) may be needed.
Every NDIS plan has a reassessment date built into it. A plan reassessment is when the NDIA looks at your plan with you and decides what’s needed to keep it up to date.
If your circumstances have changed, or you’d like a full reassessment, the NDIA will work with you to understand what information you may need to provide and how. If you have a support coordinator, they can also work with you to do this.
You can have your plan reassessment meeting face-to-face, over the phone, or even via a video call. You can also invite supports along to the meeting (they can attend the check in discussion too!), so think about whether you’d like your support coordinator, a family member or friend to join you.
During your plan reassessment, you’ll discuss your current goals, the supports you’ve been accessing, what’s been working well, and what hasn’t. The meeting is a great opportunity to talk about the progress you’ve made towards achieving your goals, new goals you’d like to set, and what changes you’d like to make to your plan.
Your goals are important because they relate to the supports and services you can access and the funding that will be provided in your plan. For more information about making your NDIS goals work for you, click here.
Tip 1: Get in contact with your providers and ask for end of plan progress reports, which you can take to your reassessment meeting. The end of plan reports should detail how supports have assisted you to work towards, or achieve, your goals.
The reports should also include the anticipated supports required for your new plan – including any assistive technology or home or vehicle modifications that will support you to progress towards achieving your goals. Your therapists will be able to provide you with any relevant assessments or quotes.
Remember to allocate funding from your current plan to pay your providers for the time spent preparing your end of plan progress reports.
Tip 2: If you’re not plan managed, you might want to make life a little less complicated by asking for plan management funding to be included in your new plan.
To do this, during your plan reassessment, let the NDIA or your NDIA partner know which plan manager you want to use.
They’ll record your plan manager’s name on your NDIS plan as a participant-endorsed provider, and you’ll be ready to start enjoying the benefits of plan managed life.
NOTE: The NDIA started rolling out its new PACE computer system at the end of October 2023, and under PACE, it’s a requirement for new participants (or participants new to plan management) to endorse a plan manager (like us!) if they want to be plan managed by them.
Those who are already plan managed by us, don’t have to do anything (it’s done automatically). But participants who want to switch to us from another plan manager need to let the NDIA know, and they need to endorse us as their new provider.
To endorse My Plan Manager, click here.
Tip 3: Prepare a weekly or fortnightly timetable that shows the schedule of supports you currently have in place. This is a good opportunity to reflect on your current plan and note the changes you’d like to make in your new plan.
Tip 4: Write down all the questions you want to ask during the plan reassessment meeting – it can be a good idea to note down a question as soon as you think of it (keep a notebook with you, start a draft email of questions, or use the notes app on your phone or tablet). That way, you won’t forget anything, and you can go through all the questions when you have the discussion.
It might also be worth taking an advocate or family member with you to act as another set of ears and a dedicated note taker.
Tip 5: Be prepared – have on hand multiple copies of your current plan, reports from providers, and recommendations and quotes for future supports. If your plan reassessment meeting is going to be held in person, bring print outs of any email communication you’ve had with the NDIA (including attachments), so you can demonstrate what you’ve sent, to whom, and when.
If neither you nor the NDIA believe there are any changes to be made to your plan, it may be automatically extended for up to 12 months.
This means the budget in your ‘extended’ plan will have the same amount of Core Supports and Capacity Building Supports funding as your current plan, but Capital Supports funding won’t be automatically extended – instead, you’ll retain the existing budget in your current plan, because Capital Supports funding is usually for one-off purchases that are deemed reasonable and necessary.
So, you’ve got a plan – what’s next?
Getting help at the start of your plan can set you on the right track and make your funding work for you. If you’re a My Plan Manager client, the good news is, we’re here to help. Alternatively, you can speak with your NDIA partner or a support coordinator (if you have one).
When you call us at the start of your plan, we can help you to maximise your funding. This might involve:
1. Having a conversation about what funding is available in your plan and how you want to use it
We’ll ask you about the supports you need (e.g., physiotherapy, support work etc) and how many hours of each support you think you’ll need each day/week/month/year.
By understanding your needs, and matching them to your budgets, we’ll have a better picture of how frequently you can access supports. We’ll also be able to help you plan for times when supports may be more expensive, like on weekends or public holidays. We can also support you to understand other factors that may impact how much support you can access, like provider travel costs.
Once your budgets are in place, you’ll know how much you can spend with the providers you choose to access.
2. Helping you to access My Plan Manager’s client portal and mobile app
Knowing what funding you have, how much you’ve spent, what you’ve spent it on, and how much is left in your budget – these are important parts of life for every NDIS participant.
That’s why we created our client portal and mobile app. It’s like having My Plan Manager’s team of experts right there with you – 24 hours a day, seven days a week.
We can help you to get set up, so you can view your NDIS plan budget, track your spending, submit invoices and claims for reimbursement, and so much more.
3. Working with you to lock in service agreements with the providers you choose
We encourage our clients to put service agreements in place with all their providers. A service agreement sets out what you can expect from a provider and the terms and conditions of their service. Usually, it will cover:
A service agreement is designed to protect both you and your provider, so the terms need to be fair and understood by all involved.
Your goals should inform all the supports you access. This is important, because down the line at your plan reassessment meeting, you’ll discuss your goals and the progress you’ve made towards achieving them, which will inform the development of your new plan and the funding allocated within it.
The right providers can make a huge difference to your NDIS journey and help you to live the life you want to live.
That’s why we created a checklist to help you engage the right providers (and avoid those who aren’t the right fit), so you can achieve the outcomes you’re after as quickly as possible, and save time, stress and distraction from your NDIS goals.
The checklist contains everything you need to know and ask before signing a service agreement, so you can avoid common mistakes – like engaging a provider who’s not qualified to support you.
NOTE: The NDIA started rolling out its new PACE computer system at the end of October 2023, and under PACE, participants with Agency managed funding will be able to record participant-endorsed providers – also known as ‘My Providers’ – on their plans.
For more information about PACE, click here.
Plan managed participants must record their plan manager on their plan. If you’d like to endorse My Plan Manager, complete this form and submit it to the NDIA.
When a participant endorses a provider, that lets the NDIA know the provider can make claims against the participant’s NDIS plan when they deliver a support, so the NDIA doesn’t have to check before making payments.
Participants and plan nominees can change their endorsed providers or tell the NDIA about new ones at any time by talking to their NDIA contact or calling the NDIA on 1800 800 110.
If you’re not happy with a decision reflected in your plan, you can request an internal review of a decision within three months of receiving the decision in writing.
In an internal review of a decision, the NDIA will check if it made the right decision under the law by looking at the facts and circumstances at the time. If the Agency needs more information to make its decision, an NDIA representative will contact you.
To ask the NDIA to review a decision, you can:
You can also send a letter with supporting evidence to:
Chief Executive Officer
National Disability Insurance Agency
GPO Box 700
Canberra ACT 2601
When you request an internal review of a decision, you can let the NDIA know:
Information to support your request may include reports or letters that detail your disability and how it impacts you on a day-to-day basis, a functional capacity assessment, lived experience and carer statements, and more.
The NDIA aims to complete all internal reviews within 60 days from the day after it receives a request. Sometimes the Agency may need more information and you’ll be contacted if further details are required.
If you’re not satisfied with the outcome of an internal review, you can ask the Administrative Appeals Tribunal (AAT) to conduct an external review of the NDIA’s decision.
You can request a plan reassessment at any time if your personal circumstances change and the NDIS supports you need are affected. This was previously known as a ‘change of circumstances’.
If you’ve missed the three-month window to request an internal review, or if things changed after three months, don’t worry – you can submit a change of details or change of situation form.
To let the NDIA know if your situation or details have changed, you can:
The NDIA will contact you within 21 days to confirm if your plan will be varied or replaced – or if the Agency has decided not to reassess your plan. The reasons for the decision will also be provided.
If you’re not happy with the outcome, you can ask the NDIA to undertake an internal review of the decision.
The NDIA’s new PACE computer system will help the Agency to vary plans faster. Until PACE is completely rolled out (the 18-month rollout started at the end of October 2023), participants who have their plans varied will receive a ‘new’ plan, which will have:
The NDIA will normally keep the new reassessment date as close as possible to the original date, but depending on your situation, the Agency may work with you to put a longer plan in place.
We know the NDIS is a complex beast, and we’re here to help. If you have any questions, you can call us on 1800 861 272 from 8am-6pm (SA time), Monday to Friday, or email us at [email protected].