A plain-language guide to Australia's National Disability Insurance Scheme, who is eligible, how NDIS plans work, what disability support is funded, and how to get started across Newcastle, Lake Macquarie, Maitland, and the Hunter Valley.
The National Disability Insurance Scheme (NDIS) is an Australian government program that provides funding directly to people with permanent and significant disability, so they can purchase the supports and services they need to live their life, on their terms.
Unlike older disability support models where the government decided which services someone got, the NDIS puts funding in the hands of the individual. Each participant receives a personalised plan with a budget, and they choose which providers to use, which services to prioritise, and how to achieve their goals.
The NDIS is not a charity and not means-tested welfare. It is an insurance scheme, like Medicare, based on the idea that anyone could acquire a disability at any point in their life, and that all Australians benefit when people with disability are supported to participate fully in society.
The scheme is run by the National Disability Insurance Agency (NDIA), an independent Commonwealth agency. It began rolling out nationally in 2016 and now supports over 600,000 Australians.
You must meet all of the following criteria to access the NDIS. Meeting the criteria does not guarantee a specific funding amount, that is determined through your planning meeting.
Residency: You are an Australian citizen, permanent resident, or hold a Protected Special Category Visa (SCV) and live in Australia.
Age: You are under 65 years of age when you first apply. People who acquire disability after age 65 access aged care services instead (My Aged Care).
Permanent disability: You have a disability caused by a permanent condition, one that is lifelong and unlikely to improve significantly.
Significant impact: Your disability significantly affects your ability to participate in daily activities, communication, mobility, self-care, or social and economic participation.
Early intervention (under 7): Children under 7 with developmental delay or disability may access the NDIS through an early intervention pathway, even if permanent disability is not yet confirmed.
Live in Australia: You must currently be residing in Australia (not temporarily overseas) to access NDIS supports.
Every NDIS plan is divided into three broad budget areas. Understanding these helps you know what your funding can and cannot be used for.
Funds everyday supports that help you with daily life and community participation. The largest and most flexible budget in most plans.
Funds supports that build your skills and independence over time, investing in your capability so you need less support in the future.
Funds higher-cost items that are purchased rather than ongoing services, equipment and home modifications that support long-term independence.
You can choose how your NDIS funding is administered, and different parts of your plan can be managed differently.
Getting onto the NDIS and receiving your first plan typically takes several weeks to a few months. Here is what happens at each stage.
Submit an Access Request Form to the NDIA, with supporting evidence from a GP, specialist, or allied health professional documenting your disability and its impact on daily life. The NDIA will assess whether you meet the eligibility criteria. Call 1800 800 110 or contact your Local Area Coordinator (LAC) to start.
The NDIA reviews your access request and evidence. They will write to you with a decision. If approved, you become an NDIS participant and move to the planning stage. If declined, you have the right to request a review or appeal the decision.
You meet with an NDIA planner or Local Area Coordinator to discuss your goals, daily life, support needs, and what you want to achieve. It helps to come prepared with a list of your current supports, your goals, and what you struggle with day-to-day. A family member, carer, or advocate can attend with you.
Your NDIS plan is created and approved. It shows your total funding, broken down by support category (Core, Capacity Building, Capital). You receive a copy and can access your plan through the myGov NDIS portal (myplace). Your plan typically runs for 12 months initially.
Decide how your plan will be managed, agency, plan-managed, or self-managed (or a mix). If plan-managed, engage a Plan Manager before engaging other providers. If agency-managed, your providers will claim directly through the NDIS portal.
If your plan includes Support Coordination funding, engage a Support Coordinator to help you find and set up providers, understand your plan, and navigate the system. This is especially important for first-time participants.
Contact and engage providers for each support in your plan. Sign Service Agreements with each provider. Begin your services and keep track of your budget using the NDIS portal or through your Plan Manager's statements.
Before your plan ends (usually after 12 months), you have a plan review meeting with the NDIA. This is your opportunity to request more funding, change goals, or adjust supports based on what has worked. Having evidence of how your budget was used and what your goals are for the next period helps greatly.
Understanding what is excluded helps avoid frustration and allows you to plan alternative funding for these costs.
The NDIS does not fund medical or health treatments, these are funded through Medicare and the public health system. This includes GP visits, specialist appointments, surgery, and hospital care.
Prescription medications are funded through the Pharmaceutical Benefits Scheme (PBS), not the NDIS, even if the medication is directly related to the participant's disability.
The NDIS does not pay for school fees, tutoring, or university costs. It may fund disability-specific supports within an educational setting (e.g., a support worker for a student with a disability), but not the education itself.
Rent, food, clothing, transport costs (your own transport costs, not a support worker's), utilities, and other costs that any person without disability also incurs are not funded by the NDIS.
The NDIS funds the support worker accompanying you to an activity, not the activity cost itself. Gym memberships, art class fees, pool entry, and event tickets are personal costs.
The NDIS generally will not fund supports that are already being provided informally by family members unless there is a specific reason why those informal supports cannot continue or are unreasonable to expect.
Before approving any support, the NDIA must be satisfied it meets six criteria. Understanding this test helps you advocate for appropriate funding in your plan and understand why some requests may be declined.
The support must be related to the participant's disability, not a general health or lifestyle need that anyone might have.
The support must help the participant pursue their goals and aspirations, increase their independence, or improve their social and economic participation.
The support must represent value for money, not necessarily the cheapest option, but a cost that is proportionate to the benefit provided.
The support must be likely to be effective and beneficial for the participant, based on evidence of what works for people with similar disability and goals.
The support must not be something that could reasonably be provided by an informal carer, or that should be funded by another system (health, education, housing).
The type, frequency, and cost of the support must be appropriate given the participant's age, situation, and what could reasonably be expected from informal networks.
The NDIS has its own language. Here are the most important terms explained clearly.
The government agency that runs the NDIS, approves access requests, creates and reviews plans, and sets the rules and pricing for supports.
A person who has been approved for the NDIS and has an active NDIS plan. Once approved, a person is always referred to as a "participant."
An NDIA-funded role (usually employed by a community organisation) that helps participants access the NDIS, develop their plan, and connect with local supports and services.
A provider (funded through the participant's plan) who helps implement the plan, finding, engaging, and coordinating providers. Not all plans include Support Coordination funding.
A higher-level Support Coordinator for participants with complex or high-risk situations requiring specialist knowledge to coordinate effectively.
A registered provider who handles the financial administration of a participant's plan, paying invoices, tracking budgets, and reporting. Plan management is funded separately in the plan.
A written agreement between a participant and a provider that outlines the supports to be delivered, the cost, the cancellation policy, and both parties' rights and responsibilities.
An organisation or individual that has been registered with the NDIS Quality and Safeguards Commission and can deliver NDIS-funded supports. Registration requires meeting standards and ongoing compliance checks.
The official document published by the NDIA that sets maximum hourly rates for each type of NDIS support. Providers cannot charge above these rates for agency-managed participants.
The test that all NDIS supports must pass, related to disability, beneficial, value for money, not the responsibility of another system, and appropriate given the participant's circumstances.
The independent body that regulates NDIS providers and workers, handling complaints, investigating incidents, and ensuring providers meet standards. Phone: 1800 035 544.
A type of NDIS support that funds assistance for participants to live in their own home or in shared accommodation, including overnight and 24-hour care for those who need it.
If you are in Newcastle, Lake Macquarie, Maitland, Cessnock, or the Hunter Valley, here is how to navigate the local NDIS landscape.
Call 1800 800 110 (Monday-Friday 8am-8pm) to start an access request, ask about eligibility, or get help with your plan. TTY: 1800 555 677.
LACs in the Hunter Region can help you through the access request and planning process. Contact the NDIA to be connected with the LAC partner for your area.
Safe Hands provides Support Coordination across Newcastle and the Hunter, helping participants implement their plan and connect with quality local providers.
If you disagree with an NDIA decision, you can request an internal review. If still unsatisfied, the Administrative Appeals Tribunal (AAT) provides independent review. Hunter Community Legal Centre can provide free advice.
If you have concerns about a provider or support worker, contact the NDIS Quality and Safeguards Commission on 1800 035 544. You can also contact Safe Hands directly to discuss any concerns about our services.
Hunter Advocacy Service and Disability Advocacy NSW provide free independent advocacy for NDIS participants in the Hunter Region who need help navigating the system.
If the NDIA declines your access request, you have the right to request an internal review, ask the NDIA to look at the decision again. You can provide additional evidence from doctors or specialists. If the review also declines, you can appeal to the Administrative Appeals Tribunal (AAT). It is worth seeking free help from a disability advocacy service before going through these processes alone.
You can request a plan review at any time, you do not have to wait until your plan's annual review date. To request a change, contact the NDIA and explain that your circumstances or support needs have changed. Providing evidence from providers, therapists, or doctors about why additional funding is needed greatly strengthens your case. A Support Coordinator can help you prepare for this review.
It depends on how your plan is managed. If agency-managed, you can only use NDIS-registered providers. If plan-managed, you can use registered and unregistered providers. If self-managed, you can use anyone, including informal supports like a neighbour or friend. Safe Hands works with participants under all plan management types.
A Support Coordinator helps you understand and implement your NDIS plan, finding providers, setting up Service Agreements, and coordinating supports across different areas of your life. Not everyone's plan includes Support Coordination funding. If your plan is complex (many providers, high support needs, complex disability), it is worth advocating for Support Coordination to be included at your planning meeting or next review. For simpler plans, a LAC may provide enough guidance.
The NDIA has a legislated target of 21 days to process an access request once all required evidence is received. In practice, it often takes longer, particularly if additional evidence is requested. From access request to your first plan being approved, the total process typically takes 3-6 months. Having thorough supporting documentation from doctors and specialists prepared in advance helps reduce delays.
Yes. Children under 7 can access the NDIS through an Early Childhood pathway if they have developmental delay or disability. The Early Childhood approach focuses on early intervention supports designed to reduce the impact of disability over the child's lifetime. Children aged 7 and over access the NDIS through the same process as adults. Early intervention investment through the NDIS is particularly important, the earlier children access appropriate supports, the better the long-term outcomes.
If you are already an NDIS participant when you turn 65, you can choose to remain on the NDIS or transition to aged care (My Aged Care). Most people choose to remain on the NDIS as it typically provides more funding and flexibility. If you are not yet on the NDIS when you turn 65, you cannot apply, aged care supports through My Aged Care become the relevant pathway. There are exceptions for people who had NDIS-like supports before the NDIS launched.