National Disability Insurance Scheme (NDIS)

The National Disability Insurance Scheme is the most significant reform to disability services in Australian history. Before its introduction, support for Australians with disabilities was delivered through a fragmented patchwork of state and territory programmes that varied enormously in quality, scope, and availability. Many people with significant disabilities received little or no funded support, and the system was widely characterised as underfunded, inequitable, and crisis-driven. The NDIS replaced this arrangement with a single national scheme that funds individualised support packages based on each person’s assessed needs, irrespective of where they live in Australia.

Established by the National Disability Insurance Scheme Act 2013 and administered by the National Disability Insurance Agency (NDIA) — a statutory agency operating under the Australian Government’s Department of Social Services — the NDIS began trial operations at several sites across Australia in mid-2013 and completed its full national rollout by 2020. As of 2024, the scheme supports more than 660,000 participants, with annual expenditure exceeding A$35 billion. These figures make the NDIS one of the largest individual-funding disability programmes in the world, comparable in ambition and scale to few other national systems.

The NDIS is built on the principle that people with disabilities should have the same opportunities as all Australians to participate in social and economic life. Rather than providing block-funded services to disability organisations — the pre-NDIS model — the scheme allocates funding directly to individual participants, who then choose how to spend that funding on supports and services that meet their goals. This consumer-directed approach gives participants unprecedented control over the services they receive, the providers they engage, and the way their support is delivered. It represents a fundamental shift from a welfare model of disability services to an insurance-based, rights-driven model.

Quality and safety in the NDIS market are overseen by the NDIS Quality and Safeguards Commission, an independent body established in 2018 to regulate NDIS providers, investigate complaints, and enforce standards of conduct. Together, the NDIA and the Commission form the institutional backbone of a scheme that now touches the lives of millions of Australians — not only participants themselves but also their families, carers, and the workforce of disability support providers across the country.

Opportunity Snapshot

Historical Background

Disability Services Before the NDIS

Prior to the NDIS, disability services in Australia were delivered and funded primarily by individual state and territory governments, each operating under its own legislation, policies, and budgetary constraints. The Commonwealth contributed funding through the Commonwealth–State/Territory Disability Agreement (CSTDA), later the National Disability Agreement, but responsibility for service delivery rested with the states. The result was a system characterised by postcode lotteries — where a person lived often determined what support they could access — and long waiting lists. In some jurisdictions, people with severe disabilities waited years for basic supports such as personal care, therapy, or assistive technology. Families carried an enormous burden as informal carers, often with little or no respite assistance.

The Productivity Commission’s landmark 2011 report, Disability Care and Support, found that the existing system was “underfunded, unfair, fragmented, and inefficient.” It estimated that only around 15 per cent of Australians with disabilities who needed support were receiving adequate services. The Commission noted that the disability support system was the area of social policy in greatest need of reform in Australia, and recommended the establishment of a national disability insurance scheme as the most effective way to address these systemic failures.

The Advocacy Movement and “Every Australian Counts”

The campaign for a national disability scheme was driven by years of grassroots advocacy from people with disabilities, their families, and disability organisations. The “Every Australian Counts” campaign, launched in 2011 by a coalition of disability advocacy groups, became the public face of this movement. The campaign gathered hundreds of thousands of signatures, held community events across the country, and secured bipartisan political support at both the federal and state levels. It was one of the most successful social advocacy campaigns in Australian history, demonstrating the breadth of public support for fundamental reform.

The campaign’s message was straightforward: every Australian should be able to access the disability support they need, regardless of where they live, how they acquired their disability, or which state or territory they happen to reside in. This principle of universality — combined with the Productivity Commission’s economic analysis showing that a well-designed scheme could deliver better outcomes at a manageable fiscal cost — created the political conditions for legislation to be introduced.

The 2013 Legislation and Rollout

The National Disability Insurance Scheme Act 2013 was passed by the Australian Parliament with bipartisan support on 21 March 2013. The Act established the NDIA as a statutory agency responsible for administering the scheme and set out the framework for determining who is eligible, what supports can be funded, and how plans are developed and managed. To fund the scheme, the Australian Government increased the Medicare levy from 1.5 per cent to 2.0 per cent of taxable income in 2014, providing a dedicated revenue stream.

Trial sites began operating from 1 July 2013, initially in the Barwon area of Victoria, the Hunter region of New South Wales, South Australia (for children), Tasmania (for young people aged 15–24), and the Australian Capital Territory. These trials tested the operational systems, planning processes, and market capacity needed for full-scale rollout. Based on lessons from the trial phase, the scheme was progressively extended across the country between 2016 and 2020, ultimately replacing all previous state and territory disability support programmes.

Growth and Scale

The growth of the NDIS has been rapid. From fewer than 30,000 participants in the trial phase, the scheme expanded to over 400,000 participants by 2020 and more than 660,000 by 2024. Annual expenditure has grown from approximately A$4 billion in the early years to over A$35 billion in 2022–23, making the NDIS one of the largest single expenditure items in the Commonwealth budget. This growth has also driven significant expansion in the disability support workforce and the provider market, though both have at times struggled to keep pace with demand.

Eligibility Requirements

Age Requirement

To access the NDIS for the first time, you must be under 65 years of age at the time of your access request. There is no minimum age — children, including infants, can be participants if they meet the disability or early intervention requirements. Once a person has been accepted into the NDIS as a participant, they remain in the scheme even after turning 65. However, a person who has never been an NDIS participant cannot apply for access after their 65th birthday; they would instead access aged care supports through the Commonwealth aged care system.

Residency Requirement

You must be an Australian citizen, hold an Australian permanent visa, or hold a Protected Special Category Visa (generally available to certain New Zealand citizens who were residing in Australia before 26 February 2001). You must usually reside in Australia — that is, Australia must be your primary place of residence. People on temporary visas, international students, and visitors do not generally meet this requirement unless they hold a specific visa class that qualifies.

Disability Requirement

The core eligibility criterion is that you must have a permanent disability that significantly affects your ability to participate in everyday activities. Specifically, the NDIA assesses whether the disability results in substantially reduced functional capacity in one or more of the following areas:

• Communication: Difficulty understanding or being understood by others
• Social interaction: Difficulty relating to others or participating in social situations
• Learning: Difficulty acquiring or retaining new skills or knowledge
• Mobility: Difficulty moving around or using public transport independently
• Self-care: Difficulty with daily personal activities such as eating, dressing, or bathing
• Self-management: Difficulty making decisions, organising daily life, or managing finances

The disability must be permanent — meaning it is likely to be lifelong — and must not be more appropriately addressed by other service systems such as health, education, or employment services. The NDIS does not fund supports for conditions that are temporary, or for general health conditions that are treatable through the mainstream health system.

Early Intervention Pathway

Children under seven years of age with a developmental delay may be eligible under the NDIS early intervention pathway, even if a permanent disability diagnosis has not yet been confirmed. Additionally, people of any age with a newly identified disability may access the NDIS through early intervention if there is evidence that early support would significantly benefit their functional capacity and reduce their future need for disability supports. The early intervention requirements recognise that timely intervention can deliver better long-term outcomes and potentially reduce the total cost of support over a person’s lifetime.

The Access Process

To determine eligibility, you must lodge an Access Request with the NDIA. This involves completing an Access Request Form and providing supporting evidence of your disability from qualified health professionals — such as medical specialists, psychologists, occupational therapists, physiotherapists, or speech pathologists. The NDIA reviews the evidence to determine whether you meet the access criteria outlined in the legislation. If your request is approved, you become an NDIS participant and proceed to the planning stage. If your request is denied, you have the right to request an internal review and, if necessary, appeal to the Administrative Appeals Tribunal.

What the NDIS Funds

The Concept of Reasonable and Necessary Supports

The NDIS does not fund an unlimited range of services. Under the legislation, supports must be “reasonable and necessary” in relation to the participant’s disability. The NDIA applies several criteria when assessing whether a support meets this standard: it must be related to the participant’s disability; it must help the participant pursue their goals; it must represent value for money; it must be effective and beneficial; and it must not duplicate supports that should be provided by other systems (such as health or education). The reasonable and necessary test is the key gatekeeping mechanism that determines what is and is not included in a participant’s plan.

Categories of NDIS Supports

NDIS funding is organised into three broad support budgets within a participant’s plan:

1. Core Supports: Funding for everyday activities and current disability-related needs. This includes:

   • Assistance with daily living: Help with personal care tasks such as showering, dressing, meal preparation, and household tasks
   • Transport: Funding for travel to and from activities, including taxi subsidies, modified vehicle costs, or public transport training
   • Consumables: Everyday items related to disability, such as continence products or low-cost assistive technology
   • Assistance with social and community participation: Support to engage in community, social, and recreational activities

2. Capacity Building Supports: Funding for supports that help a participant build their independence and skills over time. This includes:

   • Support coordination: Help to understand and implement the NDIS plan, connect with providers, and navigate the service system
   • Improved living arrangements: Assistance to find and maintain appropriate housing
   • Increased social and community participation: Programmes and activities that build social skills and community connections
   • Finding and keeping a job: Employment support, including job coaching, workplace modifications, and school-to-work transition programmes
   • Improved health and wellbeing: Exercise physiology, personal training, and other health-related capacity building (distinct from general healthcare)
   • Improved learning: Support for educational participation beyond what is provided by the education system
   • Improved relationships: Support to develop and maintain personal relationships
   • Improved daily living: Therapeutic supports such as occupational therapy, speech therapy, physiotherapy, psychology, and behavioural support

3. Capital Supports: Funding for higher-cost items and one-off investments, including:

   • Assistive technology: Wheelchairs, prosthetics, communication devices, hearing aids (where not covered by other programmes), home automation systems, and other equipment
   • Home modifications: Ramps, bathroom modifications, ceiling hoists, widened doorways, and other structural changes to make a home accessible
   • Specialist Disability Accommodation (SDA): Funding for purpose-built or significantly modified housing for participants with the very highest support needs (a small subset of participants)
   • Vehicle modifications: Adaptations to vehicles to accommodate wheelchair access or other mobility needs

What the NDIS Does Not Fund

The NDIS is designed to complement, not replace, other service systems. It does not fund supports that are the responsibility of other government programmes, including:

• General healthcare and hospital services (funded through Medicare and the public health system)
• Education and schooling (funded through education departments)
• Income support payments (such as the Disability Support Pension, which is a separate Centrelink payment)
• Childcare (funded through the childcare subsidy system)
• Activities or items not related to the participant’s disability
• Day-to-day living costs that a person would incur regardless of their disability (rent, groceries, utilities)

It is important to note that the NDIS is independent of the Disability Support Pension (DSP). A person can receive both an NDIS funding package and the DSP simultaneously — the former funds disability supports and services, while the latter provides income support. Similarly, the NDIS is separate from Medicare — Medicare funds medical treatment and healthcare, while the NDIS funds disability-related supports that are not clinical or medical in nature.

How NDIS Plans Work

The Planning Meeting

Once you have been approved as an NDIS participant, you will attend a planning meeting with an NDIA planner or a Local Area Coordinator (LAC). The purpose of this meeting is to discuss your goals, your current circumstances, the supports you are already receiving (both formal and informal), and the additional supports you need to pursue your objectives. Goals are typically framed around areas such as independence, employment, education, social participation, health and wellbeing, and living arrangements.

The planner or LAC will use the information you provide — along with any assessments or reports from health professionals — to develop your NDIS plan, which sets out the funded supports and the budget allocated to each support category. Preparing thoroughly for this meeting is one of the most important things a participant can do. Bringing supporting evidence, a list of current and needed supports, and clearly articulated goals can significantly influence the adequacy of the plan.

Plan Duration and Budgets

NDIS plans are typically approved for a period of 12 months, although some plans may be approved for longer periods (up to 24 months) if a participant’s circumstances are stable. The plan specifies the total funding available and how it is distributed across the three support budgets: core, capacity building, and capital. Within the core support budget, participants generally have flexibility to move funds between different core support categories (for example, shifting funding from transport to daily living assistance if their needs change during the plan period). However, funds cannot be moved between the three main budget categories without a plan amendment or review.

Plan Management Options

One of the defining features of the NDIS is the choice it gives participants over how their funding is managed. There are three management options:

1. Self-managed: The participant manages their own funding, pays providers directly, claims reimbursement from the NDIA, and is responsible for keeping records and receipts. Self-management offers the greatest flexibility — participants can use both registered and unregistered providers, negotiate their own prices, and employ support workers directly. It also carries the greatest administrative responsibility.

2. Plan-managed: The participant engages a registered plan manager (a financial intermediary) to handle the administrative and payment aspects of their plan. The plan manager pays providers on the participant’s behalf, manages invoices, and provides regular financial statements. Plan management still allows the use of both registered and unregistered providers, while reducing the administrative burden on the participant. The cost of plan management is funded as a separate line item in the plan and does not reduce the participant’s support funding.

3. NDIA-managed (Agency-managed): The NDIA manages the participant’s funding directly. Providers submit claims through the NDIA’s payment portal, and payments are processed centrally. Under this option, participants can only use NDIS-registered providers, which limits choice but provides the simplest administrative experience.

Many participants choose a combination of management types — for example, self-managing their core supports while having a plan manager handle capacity building or capital items. The flexibility to mix management types within a single plan is one of the strengths of the system.

Applying for the NDIS

Step-by-Step Access Request Process

1. Contact the NDIA: Call the NDIS on 1800 800 110 or visit ndis.gov.au to request an Access Request Form. You can also visit a Local Area Coordinator (LAC) office or NDIA office in person.

2. Complete the Access Request Form: Provide your personal details, residency information, and a description of your disability and how it affects your daily life. The form asks about your functional capacity in the six key areas (communication, social interaction, learning, mobility, self-care, self-management).

3. Gather supporting evidence: Obtain reports, assessments, and letters from your treating health professionals that document your diagnosis, the permanence of your condition, and its impact on your functional capacity. The stronger and more detailed your evidence, the smoother the access process will be. Evidence may include reports from medical specialists, psychologists, occupational therapists, physiotherapists, speech pathologists, or social workers.

4. Submit your application: Send the completed form and evidence to the NDIA. You can submit by email, post, or in person.

5. Wait for a decision: The NDIA aims to make access decisions within 21 days of receiving a complete application. If additional evidence is needed, the timeframe may be extended. You will be notified of the outcome in writing.

6. If approved, proceed to planning: You will be contacted to arrange a planning meeting with an NDIA planner or LAC. At this meeting, your goals, needs, and supports will be discussed, and your first NDIS plan will be developed.

7. If not approved, request a review: If your access request is denied, you can request an internal review by the NDIA within a specified timeframe. If the internal review upholds the decision, you can appeal to the Administrative Appeals Tribunal (AAT).

Tips for a Strong Access Request

• Obtain comprehensive assessments: Reports should clearly state your diagnosis, confirm that the condition is permanent, and describe in detail how it affects each area of functional capacity.
• Use functional language: The NDIA is primarily interested in how your disability affects what you can do, not just the medical diagnosis itself. Evidence should describe the practical impact on daily living.
• Include assessments from multiple professionals: Where relevant, include reports from different disciplines (e.g. a psychologist and an occupational therapist) to give a complete picture.
• Seek assistance from a disability advocacy organisation: Free advocacy services are available in every state and territory to help people navigate the NDIS access process.

Plan Reviews and Changes

Scheduled Plan Reviews

NDIS plans are typically reviewed at or near the end of the plan period — usually every 12 months. At the scheduled review, the participant meets with a planner or LAC to discuss whether the current plan is meeting their needs, whether their goals have been achieved or need to be updated, and whether the level of funding should be adjusted. The review process is similar to the initial planning meeting: participants are encouraged to bring updated evidence, reports from providers on progress, and clear articulation of their goals for the next plan period.

Participant-Requested Reviews

Participants have the right to request a plan review at any time if their circumstances change significantly. This may include a change in the nature or severity of the disability, a change in living arrangements, the loss of informal supports (such as a family carer becoming unable to provide care), or a new goal that requires different supports. The NDIA assesses each review request on its merits and may approve a plan variation or a full plan reassessment.

Section 100 Plan Reassessments

Under Section 100 of the NDIS Act, the NDIA can also initiate a plan reassessment if it receives new information that suggests the participant’s plan is no longer appropriate. This can result in an increase or decrease in funding, depending on the participant’s current needs.

Reviewing a Decision

If a participant disagrees with a decision made by the NDIA — whether about access, the content of a plan, or the outcome of a plan review — they can request an internal review within three months. An internal reviewer (a different NDIA delegate from the original decision-maker) will reconsider the decision. If the internal review does not resolve the issue, the participant can appeal to the Administrative Appeals Tribunal, which provides an independent and legally binding determination. Free legal assistance for NDIS appeals is available through disability advocacy legal centres in each state and territory.

Tips for Participants

Before Your Planning Meeting

• Write down your goals: Think about what you want to achieve in the next 12 months and beyond. Goals might relate to living independently, getting a job, improving your health, participating in community activities, or maintaining relationships.
• Document your current supports: List all the supports you currently receive — including informal support from family and friends — and identify gaps where additional funded support would make a difference.
• Gather evidence: Bring recent reports and assessments from your health professionals, therapists, and support workers. Updated evidence is particularly important if your needs have changed since your last plan.
• Know your budget categories: Understanding the difference between core, capacity building, and capital budgets helps you articulate what you need in terms the planner can use to build your plan.

During Your Plan

• Track your spending: Keep records of how your funding is being used, regardless of your management type. This helps you identify whether your funding is on track and provides evidence for your next plan review.
• Use your supports: Underutilisation of funding can lead to reduced budgets at the next plan review, as the NDIA may interpret unused funding as an indication that the support is not needed. If you are having difficulty finding providers or using your funding, contact your support coordinator, plan manager, or LAC for assistance.
• Report changes: If your circumstances change significantly — for example, if you move house, your disability changes, or you lose a carer — contact the NDIA to discuss whether a plan review is needed.
• Know your rights: You have the right to choose your providers, change providers, request a plan review, and appeal decisions. The NDIS Code of Conduct protects you from abuse, neglect, and exploitation by providers.

Choosing Providers

• Check registration status: If your plan is NDIA-managed, you must use registered providers. If your plan is self-managed or plan-managed, you can use either registered or unregistered providers.
• Ask for recommendations: Other participants, disability organisations, and LACs can often recommend providers in your area.
• Use the NDIS Provider Finder: The NDIA’s online tool at ndis.gov.au allows you to search for registered providers by location and support type.
• Negotiate service agreements: Before engaging a provider, establish a clear service agreement that sets out the supports to be provided, the cost, the schedule, and the cancellation policy.

Challenges and 2024 Reforms

Sustainability and Cost Growth

The most significant challenge facing the NDIS has been the pace of cost growth. When the Productivity Commission recommended the scheme in 2011, it estimated the mature cost at approximately A$13.6 billion per year. By 2022–23, annual expenditure had reached A$35.8 billion — well above initial projections — and was forecast to continue growing. Several factors have contributed to this trajectory: higher-than-expected participant numbers, increasing average plan costs, and the expansion of supports funded under the reasonable and necessary test. The Australian Government and the NDIA have acknowledged that the scheme’s financial trajectory needs to be addressed to ensure its long-term sustainability.

Provider Quality and Workforce

The rapid growth of the NDIS market has created significant workforce challenges. The disability support sector has needed to recruit and train hundreds of thousands of additional workers, and workforce shortages remain a persistent issue — particularly in regional and remote areas. Quality concerns have also arisen, with reports of fraud, poor-quality services, and inadequate oversight of some providers. The NDIS Quality and Safeguards Commission was established partly in response to these concerns, and it continues to strengthen its compliance and enforcement activities. The Disability Royal Commission, which reported in 2023, also highlighted systemic quality and safety issues in disability services and made recommendations for further reform.

Participant Experience

Many NDIS participants have reported positive experiences with the scheme, citing increased choice, control, and access to supports that were previously unavailable. However, the scheme has also been criticised for excessive bureaucracy, inconsistent decision-making, long wait times for plan reviews, and a planning process that can feel adversarial rather than collaborative. People with psychosocial disabilities, intellectual disabilities, and complex needs have sometimes found the access and planning processes particularly difficult to navigate. Aboriginal and Torres Strait Islander participants and people from culturally and linguistically diverse backgrounds have also experienced barriers to access and culturally appropriate service delivery.

The 2024 Legislative Reforms

In response to these challenges, the Australian Government introduced significant legislative reforms in 2024, building on the recommendations of the independent NDIS Review conducted by Professor Bruce Bonyhady AM and Ms Lisa Paul AO. Key elements of the 2024 reforms include:

• Needs-based assessments: The introduction of more consistent, evidence-based assessment processes for determining support needs, aimed at reducing variability in plan funding decisions across different planners and regions.
• New framework for NDIS supports: Clearer definitions of what constitutes an NDIS support, including the development of a legislated NDIS support list that specifies the categories of supports the scheme will and will not fund. This is intended to provide greater certainty for participants and reduce disputes about whether specific supports are reasonable and necessary.
• Pricing and payment reforms: Measures to improve pricing transparency, including independent pricing reviews and reforms to the NDIS Pricing Arrangements and Price Limits that govern how much providers can charge. The reforms also target fraud and overcharging by strengthening audit and compliance mechanisms.
• Early intervention and foundational supports: A greater emphasis on early intervention for children and the establishment of “foundational supports” — a new category of community-level supports available to people with disabilities who are not NDIS participants. These supports, to be jointly funded by the Commonwealth and state and territory governments, are designed to provide a basic level of assistance to the broader disability community without requiring NDIS participation.
• Improved participant experience: Commitments to simplify the planning process, reduce bureaucracy, and give participants greater clarity about their budgets and how decisions are made.

These reforms represent a significant evolution of the NDIS and reflect the ongoing process of refining a scheme of unprecedented scale and ambition. The goal is to maintain the scheme’s core principles — choice, control, and individualised funding — while ensuring that it remains fiscally sustainable and delivers consistently high-quality outcomes for all participants.

Next Steps

If you believe you or someone you support may be eligible for the NDIS, take the following actions:

1. Visit the NDIS website at ndis.gov.au to check eligibility criteria and access detailed information about the scheme.
2. Call the NDIS on 1800 800 110 to speak with a representative, request an Access Request Form, or find your nearest Local Area Coordinator.
3. Gather supporting evidence from your treating health professionals — medical reports, specialist assessments, allied health evaluations — that document your diagnosis, its permanence, and its functional impact.
4. Contact a disability advocacy organisation in your state or territory for free, independent assistance with the access request and planning process.
5. Complete and submit your Access Request Form with all supporting evidence to the NDIA.
6. Prepare for your planning meeting by identifying your goals, documenting your current supports and unmet needs, and bringing all relevant evidence.

The National Disability Insurance Scheme represents a transformative commitment by the Australian Government and the Australian people to ensuring that every person with a significant and permanent disability has access to the supports they need to live an ordinary life. Whether you are applying for the first time, preparing for a plan review, or exploring what supports are available, understanding the scheme’s structure, rules, and processes is the first step toward making the most of what the NDIS offers.