If you have just been told you might be eligible for the NDIS, or you are helping a family member through the application process, the language alone can feel like a barrier. Acronyms, funding categories, planning meetings, partner organisations — none of it is everyday vocabulary. This is the explainer we wish someone had handed us when we first started in this sector.
What the NDIS Actually Is
The National Disability Insurance Scheme is a federal government programme that funds disability supports for eligible Australians. It replaced a patchwork of state-based programmes in 2013 and has been rolled out progressively across the country. In Queensland, every region is now covered.
The NDIS is run by the National Disability Insurance Agency (NDIA). The NDIA is the body that decides who is eligible, how much funding each participant receives, and what that funding can be used for. They do not deliver services themselves — that is what providers like us do.
The NDIS works on what is called an ‘insurance model’. The premise is that lifelong, individualised support is cheaper and better than the previous reactive approach. Whether that is true in practice is debated, but the funding model itself is built around the idea that investing in capacity early reduces long-term costs.
Who Is Eligible
To access the NDIS, a person must:
- Be aged under 65 when they first apply
- Be an Australian citizen, permanent resident, or hold a Protected Special Category Visa
- Live with a permanent and significant disability that affects their ability to take part in everyday activities
‘Permanent’ means it is expected to last for life. ‘Significant’ means it substantially reduces functional capacity in at least one of the following areas: mobility, communication, social interaction, learning, self-care, or self-management.
Children under 9 access early intervention through a separate pathway. People aged 65 and over generally access aged care instead, with some exceptions for participants who entered the NDIS before turning 65.
How Funding Is Structured
Once a person is approved as a participant, they have a planning conversation with the NDIA (or with their Local Area Coordinator). The output of that conversation is an NDIS plan — a document that lists their goals and the funding allocated to support those goals.
Funding falls into three main categories:
- Core Supports — everyday assistance. Personal care, household tasks, community participation, transport, consumables. The most flexible category.
- Capital Supports — one-off funding for assistive technology (wheelchairs, communication devices), home modifications, and Specialist Disability Accommodation. Tied to specific items.
- Capacity Building — skill development. Includes support coordination, Improved Daily Living, employment supports, and therapy. Each sub-category is usually fixed.
Three Ways To Manage Funding
Participants choose how their funding is managed:
- NDIA-managed — the NDIA pays providers directly. Limited to NDIS-registered providers.
- Plan-managed — an external Plan Manager handles invoices and payments. Allows registered and non-registered providers.
- Self-managed — the participant handles invoices and record-keeping. Most flexible, most administrative work.
Most participants in Queensland are plan-managed because it offers the broadest choice of providers without the administrative load of self-management.
What The NDIS Does Not Cover
The NDIS funds disability-related supports. It does not fund:
- Day-to-day living costs (rent, groceries, utilities, holidays)
- Health services that should be covered by Medicare, Health Queensland, or private health insurance
- Mainstream services like mainstream education, public transport, or general counselling
- Income support — that is what the Disability Support Pension is for
How To Apply
Call the NDIA on 1800 800 110 to make an Access Request. You will need evidence of your disability — usually reports from your GP, specialist, or allied health team. The NDIA reviews the evidence and decides whether you meet the criteria. If approved, you go to a planning meeting.
Most people benefit from help during this process — from an Local Area Coordinator (Carers QLD or EACH in most Queensland regions), a support coordinator if one is funded, or an advocate. Doing it alone is possible but often produces plans that miss things.
What To Expect Once The Plan Starts
Plans run for one to three years. During that time, you find providers, set up Service Agreements, and use the funding to access supports. Towards the end of the plan, you have a review where you talk through what worked, what did not, and what the next plan should fund.
The system has flaws. Plans get under-funded, providers fail to deliver, communication is patchy. But it is also a more individualised, more participant-controlled system than what came before. Used well — with the right providers and ideally a good support coordinator — it can make a real difference.
FAQs
Q1. How long does it take to get an NDIS plan?
From Access Request to plan approval, typically two to four months. The NDIA aims for 56 days after access is granted, though it often takes longer in practice.
Q2. Can I appeal an NDIS decision?
Yes. If your Access Request is rejected or you disagree with your plan, you can request an internal review. If you still disagree, you can appeal to the Administrative Appeals Tribunal (AAT).
Q3. Does the NDIS pay for medications?
No. Medications are funded through Medicare, the Pharmaceutical Benefits Scheme (PBS), or private health insurance — not the NDIS.
Q4. Who decides what is in my plan?
The NDIA, based on the planning conversation and the evidence about your disability and goals. You can request changes if you disagree with what is funded.
Q5. Can family members be paid as my support workers?
Generally no, except in specific circumstances. Most participants use external providers like us for funded supports.
