The NDIS is designed to provide support to individuals with disabilities. The scheme covers a wide range of disabilities and conditions, including intellectual disability, autism, cerebral palsy, hearing loss, vision impairment, and physical disability.
The NDIS also covers some medical conditions that are considered to be chronic or permanent or that cause or result in permanent disability. The NDIS may provide funding for a range of supports and services, including assistive technology, therapy, home modifications, and respite care.
The NDIS is governed by the National Disability Insurance Agency (NDIA). When individuals apply for the NDIS, the NDIA will assess eligibility based on their disability and its impact on their daily life. Individuals with a medical condition may be eligible for NDIS funding if the condition has a significant impact on their ability to participate in daily activities and requires ongoing support. The NDIA also considers the duration and likely permanence of the medical condition when assessing eligibility for the scheme.
It is important to note that the NDIS is not a health insurance scheme and does not cover medical treatment such as a stay in hospital. Instead, the scheme focuses on providing support and services that enable individuals with disabilities to live more independently and participate more fully in their communities.
Types of medical conditions that are not covered by the NDIS
While the NDIS covers a wide range of disabilities and medical conditions, there are certain medical conditions that are not covered under the scheme. These medical conditions are often complex and require specialised medical support. Some of the types of medical conditions that are not covered by the NDIS include:
Acute medical conditions - those that are sudden and severe, such as a heart attack, stroke, or severe infection. These conditions require immediate medical attention and are typically treated in a hospital setting. The NDIS does not cover hospitalisation or medical treatment, so individuals with acute medical conditions are not eligible for support under the scheme.
Mental health conditions - while the NDIS covers a range of mental health conditions, such as depression and anxiety, it does not cover all types of mental health conditions. The scheme does not cover conditions that are considered to be short-term, such as a single episode of depression or anxiety. The NDIA considers these conditions to be a normal part of the ups and downs of life and does not provide funding for support or services.
Cosmetic surgery - is not covered by the NDIS, as it is considered to be a personal choice rather than a medical necessity. The scheme does not provide funding for procedures such as breast augmentation, liposuction, or facelifts, even if they are recommended by a medical professional.
Substance abuse treatment - the NDIS does not provide funding for substance abuse treatment, as it is considered to be the responsibility of the individual and their family. The scheme may provide funding for support and services related to the individual's disability, but not for the treatment of substance abuse.
Examples of medical conditions that are not covered by the NDIS
To provide a better understanding of the types of medical conditions that are not covered by the NDIS, here are some examples:
What to do if your meidcal condition is not covered by the NDIS
If your medical condition is not covered by the NDIS, there are still options available to you. You may be eligible for funding or support from other sources, such as:
Medicare - provides funding for medical treatment and hospitalisation. If your medical condition requires medical treatment or hospitalisation, you may be eligible for funding through Medicare.
Private health insurance - may provide coverage for medical treatment, hospitalisation, and other health-related services that are not covered by the NDIS. If you have private health insurance, you should check your policy to see what is covered.
State and territory funding - some states and territories provide funding and support for individuals with disabilities and medical conditions. You should check with your state or territory government to see what support is available.
Non-government organisations - there are many non-government organisations (NGOs) that provide support and services for individuals with disabilities and medical conditions. These organisations may provide funding for assistive technology, therapy, or other support services.
Support for inviduals with medical conditions not covered by the NDIS
If you are struggling to access support and services for your medical condition, there are advocacy and support organisations available to help. These organisations can provide advice, information, and support to help you navigate the healthcare system and access the support you need.
Some of the organisations that provide advocacy and support for individuals with medical conditions include:
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