Understanding the NDIS: Eligibility, funding, and how it works

Navigating the NDIS can seem complex, with a lot of information to review. However, if you're living with disability or seeking support for a loved one, you've found the right resource.

Our aim is to make it easy, with everything you need in one place. 

On this page, we’ll outline the National Disability Insurance Scheme (NDIS), who it’s for, the application process and the role of providers. 

Whether you’re looking for disability support services or more clarity, Five Good Friends is here to help.

Key takeaways:

  • The NDIS provides personalised funding for people under 65 with permanent and significant disabilities.
  • Funding is based on individual goals and needs, not income.
  • The participant chooses the provider, support coordinator and plan manager.
  • NDIS will decide how the funding is managed, though it will usually go with what the participant wants.

How does the NDIS work?

Once approved, an NDIS participant receives a personalised plan. This plan outlines:

  • Your goals
  • The supports funded to help achieve them
  • Budgets across specific funding categories
  • How your funding will be managed 

NDIS plans are now funded across set funding periods. These are usually quarterly, though in some cases they may be as short as monthly. Plans can also run for up to five years, with longer-term plans becoming more common. 

Importantly, the NDIS doesn’t deliver services itself; instead, it funds support you’ll be able to access and choose through providers. 

What’s the difference? 

NDIS vs. mainstream services 

It’s common to be confused about why certain support services are funded by the NDIS, while others are not. 

Mainstream services (like Medicare, hospitals, schools, or public housing) are responsible for general health care, and community services are widely available.

The NDIS steps in when: 

  • A support is directly related to a disability
  • It helps reduce functional impact
  • It’s not more appropriately funded elsewhere

NDIS eligibility 

What are the requirements you need to meet?

Eligibility is set out in the NDIS Act and focuses on functional impact, not diagnosis alone.

  1. Age and residency

You must:

  • Be under 65 when you first apply
  • Live in Australia
  • Be an Australian citizen, permanent resident, or hold a Protected Special Category Visa
  1. Disability requirement

You must have a disability that is:

  • Permanent (or likely to be lifelong), and
  • Significant. This means it substantially affects daily activities such as mobility, communication, learning, self-care, or self-management

You’ll be required to get evidence from a health professional to show how your condition impacts everyday living. 

  1. Early intervention 

The NDIS also supports early intervention, particularly for children or conditions where early support can:

  • Reduce future support needs
  • Improve long-term outcomes

This can apply even if a condition is still evolving, provided early support is likely to make a meaningful difference.

What happens to your eligibility when you turn 65? 

If you enter the NDIS before 65, you can continue receiving support beyond that age. However, support may be more suitable through My Aged Care at this stage. At this time, you might explore the Government’s aged care program: Support at Home. 

Eligibility is different for the Support at Home program. When the time comes, if you decide Support at Home is a better for your aged-related needs, we can guide you through the transition and make sure your day-to-day care doesn’t actually change. 

What you need to know about NDIS eligibility after age 65.

Understanding 'reasonable and necessary' supports

A support needs to meet a 'reasonable and necessary' test to be funded under the NDIS. 

Support and services could include anything from education, employment, social participation, living, and wellbeing.  

For disability support and services to be considered 'reasonable and necessary', it: 

  1. Must relate directly to your disability
  2. Must not include day-to-day living costs not related to your disability support needs, such as groceries 
  3. Should represent value for money
  4. Be effective and beneficial for the participant 
  5. Consider informal supports already available from other government services, family, carers, networks and the community 

What the NDIS will and won’t fund – rules and exclusions

The NDIS will fund supports such as:

  • Support workers to assist in your home with showering, cleaning and cooking. 
  • Allied health therapies (physio, OT, speech, psychology)
  • Assistive technology and home modifications
  • Support workers for community participation
  • Anything that helps participants to develop their capacity to actively take part in their community 

The NDIS won’t fund:

  • Rent, groceries, or everyday living costs
  • Non-disability-related medical treatment
  • Holidays or entertainment unrelated to disability support
  • Supports better provided by health, education, or housing systems

We’ve made a tool called ‘Can I buy this?’ This checklist can help you see if the NDIS might pay for it.

The three support budgets

Understanding your NDIS plan 

Every NDIS plan is built around three main funding categories: core supports, capacity building and capital supports: 

  1. Core Supports  

This is all about the day-to-day things that keep life running smoothly. This budget is often the most flexible, and in some cases, you can adjust funds between sub-categories to match your changing needs. 

Examples include:

  • Personal care and daily routines
  • Household help and domestic tasks
  • Transport to appointments or activities
  • Consumables like continence products
  • Social and community participation
  1. Capacity Building

Capacity Building relates to investment in a participant’s goals. 

These funds must be used as allocated, and are therefore purpose-led. It helps participants gain skills, do more on their own and reach their goals. 

Supports might include:   

  • Allied health therapies like physiotherapy or occupational therapy
  • Behaviour support and social skills development
  • Support coordination to help you understand your plan and connect with the right services 
  • Employment support and coaching
  • Life skills training, from budgeting to cooking to getting around safely 
  1. Capital Supports 

Capital supports cover bigger-ticket items that make a real difference to your daily life and safety. Before spending, quotes and approvals are usually required. 

Examples include:

  • Mobility equipment
  • Communication devices
  • Home modifications
  • Vehicle modifications

From access to plan review

How does the NDIS work?  

  1. The access request

It all starts with an Access Request Form. This is your chance to show what matters most to you, supported by evidence like: 

  • Medical reports
  • Functional capacity assessments
  • Statements from carers or family

It’s important to provide clear, thoughtful details to help the NDIS understand your needs and speed up the process. Every little bit brings you closer to the support that makes a real difference. 

  1. Your first planning meeting 

Planning meetings are about you or your family member. Together, you’ll discuss: 

  • What matters most to you
  • Short- and long-term goals
  • Supports needed to achieve them

The stronger and clearer the goal, the easier it is to get those specific services funded. 

  1. The role of Local Area Coordinators (LACs) and Ppartners

LACs help participants:

  • Navigate the NDIS with confidence
  • Prepare for planning meetings
  • Connect with local services and community supports

LACs help turn those goals from words into a plan that works on your terms. 

Self-Managed, Plan-Managed, or Agency-Managed?

Managing your funding 

The power really is in your hands. With an NDIS plan, you can choose how your funding is handled:

Management Type What It Is Key Benefits Things to Know
Self-Managed You control your funding, choose providers, and pay invoices directly. Maximum choice, faster claims, skill-building. Must track spending, manage providers, and keep receipts.
Plan-Managed A plan manager pays providers and tracks your budget. More flexibility around choice of providers. You rely on your plan manager for bookkeeping.
NDIA-Managed NDIS pays providers directly. Minimal admin, easy tracking via myplace portal. Only NDIS-registered providers are allowed.

The good news? Your choice isn’t locked in. You can switch at any time with a provider like Five Good Friends. 

No matter how you manage your funding, we can support you with core supports and support coordination. We’re an NDIS registered provider, ready to answer all your questions.

Latest insights on upcoming NDIS changes for 2026

From mid-2026, the NDIS will roll out a new framework for planning fairer, simpler, and more flexible plans.

  • Support needs assessments will focus on your real-life goals, strengths, and daily support needs.
  • Budgets will be more flexible, longer-term, and designed to reduce unnecessary reports. 

Five Good Friends can guide you through these changes. Our team can help you understand your plan, access the right supports, and, more importantly, make the most of your funding.

How Five Good Friends supports your NDIS journey

At Five Good Friends, we help you live life your way. Our Helpers help you stay independent, make your own choices and feel connected to the people and places you love. 

Our commitment to consistent support was recently recognised in our successful NDIS mid-term audit, reflecting the strength of our systems, our people and the way we deliver care every day. 

We support NDIS participants by:

  • Helping shape supports around your goals
  • Offering flexibility as needs change
  • Connecting you with vetted, local professionals
  • Supporting independence at every stage 

Whether you’re new to the NDIS, reviewing a plan, or simply want support that suits your needs and goals, our approach always gets you to lead the way. 

Book a consultation with our team to explore how we can help.

Frequently asked questions

1. What happens to my funding if I don't meet my goals by the end of my plan?

Any NDIS funding you don’t spend by the end of your plan period doesn’t carry over. Once the plan expires, unspent funds return to the NDIA. Your next plan starts fresh, with funding based on your current needs and goals. It does not depend on how much you used previously.

2. How do the new 3-month "funding periods" affect how I pay my providers?

If your NDIS plan was approved or reviewed after 19 May 2025, your funding is usually released in three-month blocks. Instead of accessing the full amount at once, your total budget is divided evenly across each period. This helps spread costs more evenly and makes it easier to manage payments to providers throughout the year.

3. What evidence do I need for the NDIS?

You’ll need evidence from a qualified health professional that explains how your condition affects your everyday life. This can include:

  • A completed NDIS Evidence of Psychosocial Disability form (commonly used for mental health conditions)
  • Medical reports, assessments or letters
  • Relevant sections of the NDIS Access Request Form

The focus is on showing the functional impact of your disability, not just your diagnosis.

4. Is there an income limit for the NDIS?

No, your income doesn’t determine whether you’re eligible or how much funding you receive. NDIS budgets are based on what supports are considered reasonable and necessary to help you live your life, meet your goals and manage the impacts of your disability.

Written by
Emma Nuttall, home care, disability and allied health specialist (BHSc)

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