Knowledge is power: what you need to know up front to get the most out of your NDIS plan

Becoming a National Disability Insurance Scheme (NDIS) participant can be life changing. It means you’ll finally have access to funding to pay for supports to live life the way you want to.

It’ll come as no surprise then that, following acceptance into the Scheme, you may feel a flurry of relief, excitement and anticipation – at least, that’s what we hear from many of our clients!

And those positive feelings don’t need to give way to confusion or worry about what to do next, because we’ve gathered the information you need to know from the beginning of your NDIS journey, so you can get the most out of your NDIS plan.

Yes, the Scheme is complex, and yes, there’s lots to learn. But we’re here to help! Together, we can set you up for success.

Here’s what you need to know.

1. You have rights

Firstly, as an NDIS participant, you have rights – and you should know about them.

All providers and workers are bound by the NDIS Code of Conduct, and they must respect and uphold your right to safe and quality supports and services. You can access the Easy Read version of the NDIS Code of Conduct here.

As for the National Disability Insurance Agency (NDIA), it has a Participant Service Charter that explains what you can expect from it. For example, it includes a Participant Service Guarantee, which sets out the timeframes the Agency must adhere to when making decisions about things like Scheme access, plan reassessments, reviews, and nominee changes. We’ve written more about that here.

2. An NDIS plan manager (like us!) can support you to understand your NDIS funding...

You’ve got your plan, and you’ve got your funding… but how exactly do you spend it? The answer to that will be as unique as you are, and a plan manager (like My Plan Manager) can help.

Together – through a budget conversation – we can look at the length of your plan, the categories and budgets included in it, the funding you’ve got, the supports you need, and how often you want to access them. From there, we can set money aside to cover your costs, and create a visual picture of how much you can spend in different areas across the lifespan of your plan.

If you have a support coordinator, they can join the conversation too, or you might like to involve a plan nominee, family member or friend. The more people in your support network, the better!

In the meantime, here’s a quick guide to NDIS funding.

3. ...and keep track of your spending

Put away the pen and paper, and close that Excel spreadsheet, because we’ve got the tech to help you keep track of your plan spending with ease.

A digital platform that displays a clear, convenient, real-time picture of your NDIS budget and gives you more control over your plan funding and spending, our secure client portal can be accessed via your computer or on your mobile phone through an app.

It’s available to all My Plan Manager clients, and you can grant access to others (like your support coordinator and family members) if you want to.

Through the client portal (web and app) you can:

• view your NDIS budget
• submit invoices and claims for reimbursement
• receive alerts when payments are processed
• track your spending
• stay in control – receive spending limit notifications by SMS

You can also contact us directly through the mobile app by pressing ‘click to call’ or by requesting a call back.

4. Putting service agreements in place is useful for budgeting

A service agreement is an agreement between you and your provider that makes it clear what you have both agreed to. Usually, a service agreement will cover:

• the supports that will be provided (for example, occupational therapy)
• the cost of the supports
• your responsibilities
• your provider’s responsibilities
• how long the agreement goes for and how it can be changed
• a dispute resolution process

When you supply service agreements to us, we can set aside the service fees outlined in the agreement so you’ll always have enough money to cover your supports.

5. Provider rates vary across the days and times of the week

If you catch public transport, you’ll know there are ‘on-peak’ and ‘off-peak’ times that dictate the price of your fare. That’s similar to provider rates in the NDIS.

Rates can vary across weekdays, weekends and public holidays – as well as between mornings, afternoons and evenings. So, it usually costs less to access supports on a weekday morning than it does on a Saturday, Sunday or public holiday evening.

Maximum provider rates are set out in the NDIS Pricing Arrangements and Price Limits, which you can find here.

6. Unfair pricing exists

Inflated pricing in the NDIS is sometimes called ‘price differentiation’ or a ‘twin pricing regime’. It occurs when a provider charges a participant more for a product or service than they’d charge a person who’s not in the Scheme.

To make it fairer for participants, the NDIS Quality and Safeguards Commission is making providers more accountable by homing in on price differentiation and releasing a number of new pricing rules – meaning when you’re charged a higher rate because you’re a participant in the NDIS, you can contact the NDIS Quality and Safeguards Commission at pricehelp@ndiscommission.gov.au to let them know.

7. Unexpected costs exist too!

The two most common unexpected fees that catch participants out are transport costs and cancellation fees – but now you know about them, you may be able to avoid them.

Providers can charge your NDIS budget for the cost of travel when they spend time accompanying you out in the community, or when they travel to you or incur expenses, such as parking fees and tolls. You can reduce travel costs by accessing local providers, and by arranging less frequent appoints that run longer.

Cancellation fees can be trickier to avoid, but here’s our ultimate guide to them. The guide includes this tip – that cancellation fees only apply if your provider can’t fill your appointment with another client or divert their staff member to another job.

8. The NDIA may request key documents from you and your providers

Unfortunately, filling out paperwork doesn’t stop with your Access Request.

There are several key documents that you or your providers may be asked to deliver at one stage or another of your NDIS journey to ensure you keep receiving the funding you need.

For example, if your support needs change, your occupational therapist may be asked to supply a functional capacity assessment, a provider report or a letter of recommendation. And you may have the opportunity to supply a lived experience statement or a carer impact statement – learn how to write those here.

9. You’ll have a plan check in

The NDIA will schedule a check in with you every year to explore how you’re going with your plan. A check in can take place face-to-face, by phone or online – and you’re welcome to include a family member, support coordinator or someone else who supports you.

During your conversation, an NDIA representative may ask you how you’re going with your goals, how you’re using funded supports in your plan, and if you have any questions.

We’re here to help

If you’d like support with understanding and managing your NDIS funding, we’re here to help. You can email us at enquiries@myplanmanager.com.au or call us on 1800 592 405 from 8am-5.30pm (SA time), Monday to Friday.