If you've been approved for NDIS funding, you may be struggling with the intricacies of NDIS coverage.
The NDIS provides funding for a range of health services for people with disabilities. This includes therapy services like occupational therapy, speech therapy, and physiotherapy.
But does the NDIS cover dental services?
The NDIS does not cover general medical services and treatment. This includes dental services.
In this article, we will explore NDIS funding coverage. We will also talk about dental coverage in more detail. Keep reading for more valuable information about the NDIS.
Does the NDIS Cover Dental Treatments?
The NDIS does not cover dental services. This includes dental examinations, treatments, and prescriptions.
The NDIS is designed to help Australians with disabilities. The funding covers a wide range of support services. These services are supposed to help NDIS participants handle day-to-day tasks.
Aside from help with personal care and household chores, the NDIS funds health services. This refers to therapeutic supports, such as:
- Physiotherapy
- Occupational therapy
- Speech therapy
- Psychology services
- Behaviour support
The NDIS can provide a valuable source of support for people with disabilities. But, it's not intended to replace health or other public services.
The services must be related to your disability. In other words, they must somehow help you do everyday tasks.
The NDIS is primarily focused on providing funding for support and services that help participants with the following three areas:
- Functional abilities
- Social participation
- Independence
Dental services do not fall into any of these categories.
This includes routine dental services. For instance, check-ups, cleanings, fillings, and tooth extractions.
NDIS Coverage Exceptions
Even though the NDIS doesn't cover dental services, exceptions may apply in certain cases. This may refer to:
- Children. Children who are participants of the NDIS program may be eligible for some dental services if they meet certain criteria. This is the case if the dental conditions are directly related to their disability and impact their ability to function.
- Specific cases. In some cases, people with disabilities may receive funding for dental services. It has to be deemed necessary to address their functional impairments or health needs. This usually requires evidence and support from healthcare professionals.
- Transition arrangements. Some individuals might have been receiving dental services under state-based programs before transitioning to the NDIS. Then they may continue to receive support for dental services. But, this depends on the specific arrangements made during the transition.
Whether or not you can receive funding for dental services depends on your situation. It's best to contact the NDIS to make sure.
What Services Aren't Funded by the NDIS?
You should know what services and support aren't covered by the NDIS before applying.
NDIS funding does not cover the following:
- Medication
- General medical services and treatment
- Specialist services
- Dental services and treatment
- Hospital care
- Emergency services
- Palliative care
- Surgery and rehabilitation
- Diagnosis and assessment of health conditions
- Clinical care for mental health conditions
These services and supports are the responsibility of state and territory governments. The health system is responsible for medical, rehabilitation, and clinical treatment.
The NDIS generally does not cover services provided by general practitioners (GPs) or medical specialists. Other primary healthcare providers for routine healthcare needs also aren't covered. This includes general check-ups, prescriptions, and vaccinations.
Costs associated with hospital admissions, emergency room visits, surgeries, and medical procedures are not covered by the NDIS.
It's important for participants and their families to understand the scope of services covered by the NDIS. This helps them figure out which alternative funding sources to seek.
What Services Are Funded by the NDIS?
Services covered by the NDIS include:
- Assistive technology
- Therapeutic supports
- Personal care
- Community participation
- Early intervention
- Help with transportation
- Home modifications
- Specialist Disability Accommodation (SDA)
Assistive technology includes aids and equipment. This technology should help participants with daily activities, mobility, communication, and independence.
For example, wheelchairs, communication devices, and hearing aids.
Even though the NDIS does not fund general healthcare services, therapeutic supports are funded. These supports improve or maintain one's functional abilities, health, and well-being.
The NDIS provides funding for personal care services. This includes help with grooming, hygiene, and mobility. It also supports community access activities. This is done to help participants engage in social, recreational, and educational opportunities.
The NDIS funds early intervention services aimed at supporting children with developmental delays or disabilities. These services may include speech pathology, occupational therapy, and behaviour support.
The NDIS may cover transportation costs. This helps participants access medical appointments, therapy sessions, and community activities. This only applies if it's deemed necessary due to their disability.
Home modifications are also included. It improves accessibility, safety, and independence of the participant.
Finally, the NDIS aids with Specialist Disability Accommodation (SDA). This is for participants with significant functional impairment or high support needs. The NDIS may fund specialist housing that is designed to meet their specific disability-related requirements.
Dental Services and the NDIS
The NDIS provides funding for a range of support services to assist people with disabilities. That being said, dental services are generally not covered by the NDIS. But exceptions may apply in certain cases.
It's important for participants to understand the scope of services covered by the NDIS. If you have any questions about the NDIS, we are here to help.
Inclusive Home Care is an approved NDIS provider offering high-quality support services to those who need it. Contact us for more information, and we will get back to you as soon as we can.
