Does the NDIS fund prosthetic limbs?

We are often asked questions about specific supports and whether they are funded through the NDIS.

One specific support that we were asked about this week is prosthetic limbs, so we thought we’d outline some of the key information and share it with everyone.

Prosthetic or artificial limbs are devices that aim to, in some capacity, replace the functions of a natural arm or leg which may have been lost due to an accident or illness or is absent at birth. For the people in this situation, a prosthetic limb can help improve their quality of life.

Are prosthetic limbs covered under the NDIS?

Prosthetic limbs are covered but as is the case with all supports, the NDIA must be satisfied that the funding for a prosthetic limb represents value for money and that the cost of the support is reasonable and necessary. Generally, funds for a prosthetic limb will be provided when:

• The prosthetic is prescribed by health professionals who are designated and accredited by the artificial limb service in the state or territory where you reside

• The prosthetic specifications meet the minimum level of components required related to:

  • Your weight

  • Your goals and aspirations

  • Your ability to use, put on and remove the prosthetic

  • Your other medical needs like the residual limb shape, skin integrity and alignment-relevant conditions where one or more conditions exist at the same time

The prosthetic should also take into consideration your needs and requirements to make sure it’s as useful as possible. This means considering what you need the limb to do and whether the prosthetic provides a good match for those needs.

So what will the NDIS fund?

Under the NDIS, prosthetic limbs will generally be funded to the following level:

• Entry level or standard grade prostheses for participants up to K2 classification (though K3 and K4 will be considered)

• Repairs, maintenance, adjustments

• Additional costs related to prosthetic limbs such as limb socks and sheaths

• Upper limb myoelectric prosthesis in specific cases

• Replacement limbs when needed (typically every 3 years for adults and as needed for children under 18 years)

In general, the NDIS won’t fund:

• A spare prosthetic limb

• Repairs needed due to use outside what was recommended

If you have more questions or would like help getting started on your NDIS journey or preparing for a NDIS Plan meeting, call us on 1300 05 78 78 to ask any questions or sign up to Leap in! plan management today.