If you’ve recently been moved from self management to plan management by the NDIS, you might be wondering what this means for you. For some people, this change happens at the request of the NDIS, not the participant, which can be unexpected and a little confusing.
While the way your supports are paid will change, you can still choose the providers you want to work with, as long as your supports comply with the NDIS rules and align with your plan.
Understanding what’s different can help you feel confident and in control as you settle into plan management.
What changes when you move to plan management?
The NDIS can make this change at any time, but often happens during a plan rollover or reassessment.
When you move to plan management, you no longer pay provider invoices yourself or claim funds back from the NDIS. Instead, your plan manager manages claims and payments on your behalf.
Invoicing processes.
Providers send invoices directly to a plan manager (such as Leap in!) rather than to you. If you’re plan managed with Leap in! you’ll also receive a monthly statement.
The NDIA requires your plan manager to check the invoice matches your NDIS Plan, submits the claim to the NDIA and pays the provider on your behalf once the claim is approved by the NDIA.
You don’t need to log into the myplace portal to make claims or manage reimbursements.
As part of this process, your plan manager reviews invoices before submitting them for payment. If anything is missing or incorrect, the invoice may need to be updated before it can be processed. If any further approvals are required, your plan manager should be in touch with you to discuss this further.
The NDIA requires invoices to include:
The correct support item numbers
Dates of service
Rates that align with the NDIS Pricing Arrangements and Price Guide.
Different payment timeframes.
With self management, you pay the provider first and then claim the money back. With plan management, once the support or service has been provided, your plan manager submits the claim to the NDIA and, once approved, pays the provider or reimburses you.
Because there is an extra step in the process, payments can take a little longer:
- Leap in! processes invoices or receipts within one to three business days, if no follow-up is needed
- The NDIA can take up to 10 business days to assess and release the funding, although the timeframe is usually shorter
- Once payment is made, the recipient’s bank may take up to one business day to show the funds.
The NDIA expects a plan manager to validate an invoice and submit a payment request to the NDIA within five business days of receipt. Upon receiving payment from the NDIS, the NDIA expects payment or reimbursement to occur within two business days. Some plan managers like Leap in! claim and pay much faster than this.
Capped hourly rates.
The NDIS Pricing Arrangements and Price Guide sets maximum hourly rates for many supports. These are known as ‘capped rates’. When you’re plan managed:
- Providers can’t claim more than the maximum rate set by the NDIS for a support item
- If an invoice is above the capped rate, the NDIS will only pay up to the allowed maximum
- Any amount above the cap cannot be claimed from your plan and you will need to pay the difference.
The NDIA requires all invoices use the correct support item number. If an invoice does not match the correct line item, or the support is not funded in your plan, it may be returned or declined.
Using registered and unregistered providers.
If you are plan managed, you can still use both registered and unregistered providers, as long as the supports are NDIS compliant and align with your NDIS Plan.
However, there are tighter rules compared to self management. Providers must have an active ABN so invoices can be processed. Payments to someone without an ABN are generally only allowed in limited circumstances, such as for an overseas product or service. Specific forms may need to be completed such as a Statement by a supplier form.
Plan management vs self management: How each option works in practice.
| Feature | Plan managed | Self-managed |
|---|---|---|
| Who pays providers | Plan manager pays on your behalf | You pay directly |
| Bank account | No separate account required | Separate account recommended |
| Invoice processing | Managed for you | You do it yourself |
| Provider choice | Any provider (registered or not) | Any provider (registered or not) |
| Budget visibility | Tools like the Leap in! app | You manage your own records |
| Admin time | Low - managed for you | High - you do admin |
| Support and guidance | Plan manager provides help and advice | You find your own information |
Purchasing supports in line with your NDIS Plan.
We have seen an influx of participants who have been moved to plan management because they have claimed supports that are no longer considered NDIS supports under the new legislation, have not been spending in line with their plan or have run out of funds.
The NDIS guidance on When can’t you self manage? has more details about the types of situations where you may not be able to manage your own NDIS funding.
On 3 October 2024, the NDIS introduced three new lists:
- What you can spend your NDIS funding on (what IS an NDIS support)
- What you are not allowed to spend your NDIS funds on (what is NOT an NDIS support)
- Replacement supports.
Participants can only use their NDIS funds for items listed as NDIS supports. In limited circumstances, you may be able to request a substitution from the replacement support list.
It’s important to ensure all purchases with NDIS funds align with the NDIS requirements. For more information, check out the following resources:
What to do now.
If you’ve recently moved to plan management:
- It’s important to find the right plan manager for you. If you’d like to find out how, check out Choosing the best plan manager
- Speak with one of our expert plan managers on 1300 05 78 78 to discuss your plan and find out about the benefits of Leap in! plan management
- Formally endorse your plan manager so they can begin managing payments on your behalf
- Let your providers know you are now plan managed
- Give them your plan manager’s invoice submission details.
Did you know more than 65% of people on the NDIS are plan managed?
If you’re struggling to manage your NDIS Plan or keep up with all the changes, you can request to be plan managed at any time.
Some people opt for a combination plan, managing different parts of their plan in different ways.
For example, you might self manage Core supports for flexibility and control over everyday purchases, while using plan management for Capacity Building supports like therapy, which often involve regular invoicing and benefit from admin support.
How Leap in! can help.
Leap in! offers free, one-on-one Understand Your NDIS Plan sessions to anyone on the NDIS. It doesn’t matter if you’re self managed, agency managed, or with another plan manager. Call 1300 05 78 78 to book your session.
And, if you have questions or want support to make the transition smoother, the Leap in! Crew is here to help. Call us on 1300 05 78 78, email us at [email protected] or chat with us online at www.leapin.com.au.
