If you are new to the NDIS, the system can feel overwhelming very quickly.
You may hear people talking about plans, funding, Core Supports, Capacity Building, plan managers, Support Coordinators, providers and the NDIA, often before anyone has explained how all of these pieces fit together.
This guide is designed as a starting point.
Rather than going deeply into every rule, I want to explain the basic structure of the NDIS in plain language so that the terminology starts to make sense.
What does NDIS stand for?
NDIS stands for the National Disability Insurance Scheme.
It is Australia’s national scheme for people with disability.
The NDIS provides funding to eligible people with disability for supports that can help them with everyday life, independence and their individual goals.
It can also help connect people with disability to community and mainstream services, even where a person is not an NDIS participant.
What is the difference between the NDIS and the NDIA?
This is one of the first things that confuses many people.
The NDIS is the scheme.
The NDIA, or National Disability Insurance Agency, is the government agency that runs the NDIS.
A simple way to think about it is:
NDIS = the system
NDIA = the organisation that administers the system
The NDIA is responsible for decisions such as whether someone is eligible for the NDIS and what NDIS supports are included in a participant’s plan.
Who is the NDIS for?
Not every person with disability automatically becomes an NDIS participant.
To access the NDIS, a person must meet eligibility requirements.
In general, this includes age, residency and disability or early intervention requirements.
A person normally needs to:
- be younger than 65 when they apply
- live in Australia
- be an Australian citizen, permanent resident or hold a Protected Special Category Visa
- meet the disability requirements, early intervention requirements, or both
For disability access, the impairment generally needs to be likely to be permanent and significantly affect daily life, work or study.
There are also early intervention pathways, including for some young children with developmental delay.
Eligibility can become more detailed depending on a person’s individual circumstances, so this is an area I will cover separately in a future guide.
What is an NDIS participant?
A person who applies to the NDIS is initially an applicant.
If the NDIA decides that the person meets the eligibility requirements, they become an NDIS participant.
Participants can then receive an individual NDIS plan.
What is an NDIS plan?
An NDIS plan describes the participant’s NDIS supports and the funding available to pay for those supports.
Every plan is individual.
Two people with the same diagnosis may have very different plans because the NDIS looks at individual circumstances, support needs and goals.
An NDIS plan may include funding for things such as:
- assistance with daily activities
- personal care
- support workers
- social and community participation
- therapies
- assistive technology
- home or living-related supports
- supports that build independence and skills
Exactly what is funded depends on the individual plan and the NDIS funding rules.
How is NDIS funding organised?
Current NDIS plans can contain up to four main support budgets:
- Core Supports
- Capacity Building Supports
- Capital Supports
- Recurring Supports
Not every participant will have funding in every budget.
Core Supports
Core Supports generally help with everyday activities and participation.
This can include things such as:
- help with personal care
- assistance with household tasks
- support to participate in the community
- some everyday disability-related items
Capacity Building Supports
Capacity Building funding is generally aimed at building a participant’s skills, independence and ability to achieve their goals.
Depending on the plan, this may include supports such as:
- occupational therapy
- speech therapy
- behaviour supports
- employment-related supports
- support coordination
Capital Supports
Capital Supports are generally for higher-cost items or modifications.
Examples can include:
- assistive technology
- equipment
- home modifications
Recurring Supports
Recurring Supports are another type of support budget that may appear in a participant’s plan.
These provide funding for particular recurring NDIS supports.
The exact categories and flexibility within each budget can be more complicated, so I will explain the different funding categories in a separate article.
What are funding periods?
Newer NDIS plans may also use funding periods.
A funding period controls when part of a participant’s total funding becomes available.
For example, a funding component may be released in intervals rather than the participant receiving access to the full amount at the beginning of the plan.
Funding periods do not reduce the total amount of funding in the plan.
They affect when that funding becomes available to use.
How can an NDIS plan be managed?
There are three main ways NDIS funding can be managed:
- Self-managed
- Plan-managed
- NDIA-managed
A plan can also use a combination of these options.
Self-managed
With self-management, the participant, nominee or representative manages payments and financial records.
This generally offers the greatest flexibility, but it also comes with more responsibility.
Plan-managed
With plan management, a registered plan manager helps manage the participant’s funding.
The plan manager can:
- receive and pay provider invoices
- submit claims
- keep financial records
- provide spending reports
- help the participant keep track of their budget
NDIA-managed
With NDIA-managed funding, the NDIA manages provider payments and financial records.
You may also hear this called Agency-managed funding.
The management type affects how providers are paid and which providers may be used, but it does not change the basic requirement that funding must be spent on NDIS supports that are in line with the participant’s plan.
What is an NDIS provider?
An NDIS provider is a person or organisation that delivers supports or services to NDIS participants.
Providers can include:
- support worker organisations
- therapists
- plan managers
- assistive technology suppliers
- cleaning or household support services
- community participation providers
Some providers are registered with the NDIS Quality and Safeguards Commission and some are unregistered.
Whether a participant can use an unregistered provider can depend on how that participant’s funding is managed and the type of support involved.
What is a Support Coordinator?
A Support Coordinator is different from a plan manager.
A plan manager mainly manages funding, payments and financial records.
Support Coordination is generally about helping a participant understand and use their plan, connect with supports and build their ability to navigate the NDIS.
Because Support Coordination is currently going through reform, I will cover this role in more detail in a separate article.
What does “choice and control” mean?
Choice and control is an important principle within the NDIS.
In simple terms, it means participants should be supported to make decisions about their own supports and how they use their plan.
This can include choosing providers, deciding how supports are delivered and being involved in decisions about their own goals.
There are still NDIS rules about what funding can be used for, but participants should remain central to decisions about their supports.
Does the NDIS pay for everything a person with disability needs?
No.
The NDIS does not replace every mainstream or community service.
Australia also has other systems responsible for areas such as:
- health
- education
- housing
- employment
- transport
- community services
NDIS funding is for supports that meet the NDIS funding rules.
This is why a support that may be helpful to someone is not automatically something the NDIS will fund.
Why does the NDIS feel so complicated?
Part of the difficulty is that the NDIS has its own language.
A new participant may suddenly need to understand terms such as:
- participant
- nominee
- NDIA
- provider
- plan manager
- Support Coordinator
- Core Supports
- Capacity Building
- Capital Supports
- stated supports
- flexible supports
- service agreements
- plan reassessment
- plan variation
Trying to learn all of these at once can make the system feel much harder than it needs to be.
That is one of the reasons I created the Understanding the NDIS section of this blog.
The goal is to break these concepts down one at a time and build a practical library that people can return to when a term or process is unclear.
Where should a beginner go next?
If you are completely new to the NDIS, I suggest learning the system in roughly this order:
- What is the NDIS?
- Who can access the NDIS?
- How does an NDIS plan work?
- Understanding NDIS funding categories
- Self-managed vs Plan-managed vs NDIA-managed
- What does a Plan Manager do?
- What does a Support Coordinator do?
- What are NDIS providers?
- What can NDIS funding be used for?
- What happens when a plan needs to change?
I will continue adding guides on each of these topics to this section.
A practical way to think about the NDIS
If all of the terminology is still confusing, the simplest starting point is this:
The NDIS is a system that provides eligible people with disability with an individual plan.
That plan may include funding for disability-related supports.
The participant then uses that funding, within the NDIS rules and their plan, to access the supports they need.
Different people and organisations may help along the way, including NDIA planners, NDIS partners, providers, plan managers and Support Coordinators.
Once you understand who does what, the system becomes much easier to follow.
Official sources
NDIS – Guide to getting started
NDIS – Guide to using your funding
NDIS – Guide to your management options
NDIS – What are NDIS support budgets
This article is for general information only and is designed as a beginner-friendly introduction to the NDIS. NDIS rules, legislation and processes can change, and individual circumstances differ. Always check current information with the NDIS for decisions relating to your own circumstances.