What does reasonable and necessary mean?

What does reasonable and necessary mean?

If you’re an NDIS participant or have looked into the NDIS in any detail, you’ve probably come across the term ‘reasonable and necessary’. The NDIS will strictly only fund support and services that it considers reasonable and necessary to the participants’ disability. So, what does that actually mean?

This quick guide breaks down the criteria used by the NDIS to assess whether a support is reasonable and necessary.

  1. Is it directly related to your disability?

To be considered reasonable and necessary, your supports should be directly related to your disability. This means, the reason you need the product or services is because of your disability.

  1. Is it a day-to-day living expense?

The NDIS will not fund day-to-day living expenses, because paying for these is part of everyone’s daily life regardless of disability. Daily living expenses include things such as groceries, public transport tickets, utility bills and phone bills.

  1. Is it reasonably priced or value for money?

Products and Services funded by the NDIS must be reasonably priced or represent value for money. This means that if there is a cheaper option that serves the same purpose as a more expensive version, the NDIS expects you to choose the more affordable option.

  1. Does it help you achieve your NDIS goals?

In order to be considered reasonable and necessary, your support needs to be linked to the goals outlined in your plan, help you build independence, and/or participate more actively in the community. It is recommended that you have broad goals in your plan to widen your options for support.

  1. Can it be provided by your informal support network?

There is an expectation for people in your life such as family, friends, partners and carers to play a role in your support. If these informal support networks can realistically deliver your support, the NDIS may not consider it reasonable to fund.

  1. Can it be funded by another Government program?

If your support can be provided by another Government program, such as Medicare, the Department of Transport and the Department of Housing, the NDIS is unlikely to consider it necessary to fund.

Because most of this information is dependent on individual circumstances, there’s usually not a clear yes or no when it comes to whether the NDIS will consider something reasonable and necessary. If you’re unsure, speaking to the experts at Bila Support Services can help you determine what support you can access using your plan. Contact us with any questions, we’re here to help.

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We acknowledge Aboriginal and/or Torres Strait Islander peoples and communities as the Traditional Custodians of the land we work on and pay our respects to Elders past, present and emerging. We recognise that their sovereignty was never ceded.

We are committed to cultivating inclusive environments for staff, consumers, and carers. We celebrate, value, and include people of all backgrounds, genders, sexualities, cultures, bodies, and abilities.

We acknowledge Aboriginal and/or Torres Strait Islander peoples and communities as the Traditional Custodians of the land we work on and pay our respects to Elders past, present and emerging. We recognise that their sovereignty was never ceded.

We are committed to cultivating inclusive environments for staff, consumers, and carers. We celebrate, value, and include people of all backgrounds, genders, sexualities, cultures, bodies, and abilities.