The National Disability Insurance Agency (NDIA) have recently started taking a very close look at people’s supports to make sure they’re reasonable and necessary.
Why is this important?
If the NDIA decide a support you’ve been accessing isn’t reasonable and necessary, you may have to pay for it using your own money. And because the NDIA examine your history of supports, rather than assess each claim as it comes in, you may be left with significant out of pocket costs.
What you can do
To avoid getting caught out-of-pocket, we recommend a quick review of your supports to make sure they meet the criteria of reasonable and necessary. Here are some of the common reasons we’ve seen that cause the NDIA to reject a support:
It’s considered to be an everyday item
It can be funded by another support program, like Medicare
There’s a cheaper alternative that can perform the same function
If you still believe a support is beneficial for you and should be funded by the NDIS, but you’re worried the NDIA might not share your view, getting a formal letter of support from an allied health professional can help. Some supports require a bit of evidence to get them over the line. For example, if the NDIS explicitly states it doesn’t fund an item or service – white goods, for example – you will need to get an LAC or planner to approve it.
How we can help
At Plan Partners, we’re experts in both NDIS plans and funding. We work with you to explore all avenues to help you get the most out of your plan. There may be support options you haven’t considered or a more creative way to have a support funded that you don’t know about. Get in touch today to find out more about our plan management and support coordination services.
If you’re a Plan Partners customer and have concerns about whether the NDIA will consider your supports to be reasonable and necessary, our team will talk you through the reasonable and necessary checklist and look at how you can achieve your possible. Get in touch today.
Our internal review process
To avoid audits for our customers, we review all the claims for reimbursements that we receive. If we think the NDIA will have an issue with any of your supports, we flag this with you and look at alternative options that align with your plan.