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17 January 2020

FAQs: Claims and how the NDIS works with providers and industry services.

Here at Leap in! HQ, we get asked a wide range of questions about the NDIS, including how the scheme works with other government and industry programs and funding.

Below are some of the questions we get asked regularly (and also some that are a little more unusual)…

Can I use my NDIS funds to pay the gap for Medicare or private health services?

You cannot use your NDIS funds to pay the gap for Medicare services provided by the health system or for private health care costs including any fee gaps.

Your NDIS Plan should cover the full costs of any ‘reasonable and necessary’ supports, so there should be no additional costs or gaps.

When making a claim for a support, you should use either a health fund (private or Medicare) or your NDIS Plan.

If my GP has created a mental health care plan, do I have to use the 10 free Medicare psychologist sessions before I can access my NDIS-funded supports to see a psychologist?

No. If your NDIS Plan includes supports such as a psychology services, the cost of these are covered.

Can I get NDIS funding if I have a Transport Accident Commission (TAC) or Motor Accidents Compensation (MAC) payout?

Payouts you receive from TAC or MAC may affect the amount of NDIS funding you are entitled to. The NDIA may calculate a Compensation Reduction Amount, which could affect your NDIS entitlement. For more information, refer to the National Disability Insurance Scheme (Supports for Participants—Accounting for Compensation) Rules 2013.

How can I find out the hourly cap on service fees by providers? What are the maximum prices providers can charge?

You can find out all of the details regarding the latest provider pricing and support catalogues, by visiting our recent article, New NDIS Price Guide and Support Catalogue changes just released, which details some of the recent updates and provides a link to the Price Guide and Support Catalogue.

Within this Price Guide are the maximum prices can be charged by providers for specific supports. However, you and your provider are free to negotiate lower prices than those listed in the Price Guide.

Will I lose my Disability Support Pension if I apply for the NDIS?

No. If you are claiming the Disability Support Pension you can still apply for the NDIS – they are entirely separate.

Will the NDIS cancel out my Carer’s Payment and Pension?

No. Income supports such as Carer’s Payment and the Pension are entirely separate to the NDIS and will not affect your NDIS eligibility.

When I transition to the NDIS, will I lose my Centrelink Mobility Allowance?

The Mobility Allowance (MOB) payment is being transitioned to the NDIS. People who receive MOB will need to determine their NDIS eligibility to continue receiving the allowance.

How you elect to have your transport supports managed will determine if you continue to receive a fortnightly allowance or flexibly include transport in your Core budgets.

If you are an existing MOB recipient but you are ineligible for the NDIS, the Australian Government will provide support through a Continuity of Support (CoS) arrangement.

Can I claim reimbursement from the NDIS if I have vehicle modifications? Am I restricted to the prices set by the NDIS?

The short answer is yes… but like all funding and NDIS supports, you must meet a number of requirements and the NDIA must deem the support reasonable and necessary.

If you have a vehicle that has already been modified, the NDIS may reimburse you, minus the depreciated value of the modifications. You must supply the original dated invoice with price of modifications included and evidence of roadworthiness with a mechanic’s report detailing the expected lifespan.

We recommend you have vehicle modifications approved in your plan before purchasing them, as reimbursement is not guaranteed.

For more information take a look at our previous article on Vehicle modifications.

We are here to help.

Here at Leap in! we help people with NDIS-related questions every day.
Call us on 1300 05 78 78, email or sign up to Leap in! plan management today.