Reasonable and Necessary? Help understanding how you can spend your NDIS funding.

Today the MOIRA Financial Plan Management team share our experience and knowledge to help you understand the National Disability Insurance Scheme (NDIS) definition of ‘reasonable and necessary’ supports.

The NDIS is revolutionising the way disability services are provided and is designed to support people with a permanent and significant disability to achieve their individual goals. The phrase ‘reasonable and necessary’ is used throughout the scheme to describe the types of supports and services that can be paid for within an NDIS plan.

Reasonable = something that is fair
Necessary = something you must have to live an ordinary life.

In order to be considered ‘reasonable and necessary,’ a support or service must meet certain criteria based on section 32 of the National Disability Insurance Scheme Act 2013 (NDIS Act). A support or service requested by an NDIS participant must meet the following guidelines to be funded within an NDIS plan:

  • The request must be related to a participant’s specific disability.
  • The request must not include day-to-day living costs not related to a disability support needs, such as groceries
  • The request should represent value for money? I.e. Is there a cheaper option that would achieve the same outcome?
  • The request must be likely to be effective and meet the required needs of the participant.
  • The request should take into account support available from other government services, family, carers, networks and the community.
    Source.

No matter which option you select to manage your NDIS funding; self-managed, NDIA managed or plan managed, each of the disability supports and services you purchase must meet these specific guidelines.

Another way to help understand what can be considered reasonable and necessary supports is to ask yourself – ‘Would someone not living with disability be expected to pay for this?’ It’s important to understand the NDIS will only cover disability specific purchases. Everyday costs like food, holidays, phone bills for example will not be funded within an NDIS plan.

MOIRA have put together a handy checklist to help you follow the NDIS Act’s reasonable and necessary criteria. Whether preparing for a NDIS plan meeting or review meeting, these guidelines can help you understand the best way to request funding for the supports you need and what the NDIS can and cannot fund.

Reasonable and necessary supports must tick ALL of these boxes.
Click here to download.

MOIRA FPM - Checklist of NDIS reasonable and necessary criteria. An image of the .pdf flyer available to download.

For more on accessing the NDIS and getting started visit – https://moira.org.au/ndis-access/

MOIRA Financial Plan Management is a financial administration service available to all NDIS participants. It comes at no cost to a participant and is available to help manage NDIS invoices and payments on your behalf. For more information on how MOIRA can work together with you and your NDIS plan visit – https://moira.org.au/financial-plan-management/