The NDIS is not responsible for providing all forms of support that a person with a disability needs.

Some forms of assistance are catered for by other governmental entities (such state health systems or currently offered public or community services).

Generally speaking, the NDIS will pay for appropriate and essential services that enable someone with a disability to lead a regular life. 

Supports better funded or offered by the health system are not intended to be covered by the NDIS.

The health system is still in charge of health condition evaluation, diagnosis, and treatment as well as medicines and hospital care.

As a general rule, the NDIS does not provide or pay the following health-related services and supports:

• neither the Medicare Gap Fees nor items and services covered by the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS).
• A doctor or other medical professional’s diagnosis and evaluation of a patient’s health status, as well as any other services or supports they provide. 

Whether an impairment resulted from an illness, injury, accident, or birth, a person may still meet the NDIS access standards. A sickness or medical condition must result in considerable disability and permanent impairment (physical, intellectual, cognitive, neurological, visual, auditory, or psychosocial) in order to qualify for NDIS funding.

For instance, a stroke that causes hemiparesis (which significantly affects mobility) or severe emphysema that results in irreparable lung damage (chronic dyspnoea substantially reduces mobility, self-care and participation in community life). 

Time-limited (non-ongoing) conditions are not covered by the NDIS in terms of financing or services.

The NDIS disability requirement, for instance, will not be met by restricted mobility brought on by an acute injury such a lower limb fracture because the condition is likely to get better.

Additionally, chronic medical illnesses that are unrelated to a person’s disability will not be covered by the NDIS in terms of financing or supports. In this sense, it’s critical to distinguish between incapacity and the treatment and management of long-term medical illnesses and their comorbidities.

For instance, the NDIS may provide funding for disability assistance for a person who had a lower limb amputated due to peripheral artery disease in the context of diabetes (physical impairment leading to disability as a result of a medical condition), if they meet certain criteria. The NDIS, however, would not pay for any medicine or medical attention needed to treat diabetes or peripheral artery disease. 

Mental health issues can lead to psychosocial impairment.

Psychosocial handicap is not a symptom of every mental health disorder, but for those who do, it can have serious consequences and put them at a social disadvantage.

Those with severe disabilities who are likely to live with them forever may be eligible for NDIS help.