Why Choose a Plan Manager?

A Plan Manager  functions much like a personal bookkeeper for your NDIS plan.

With plan-managed funding, participants can engage non-registered providers without taking on the administrative burden that comes with self-management. By opting for this approach, you can hire a plan manager to handle payments and maintain all records on your behalf. Essentially, it’s like having a dedicated bookkeeper for your NDIS plan. Additionally, there is specific funding allocated to cover the cost of a plan manager, ensuring that your other supports remain unaffected. However, one limitation is that the NDIS restricts payments to providers within set price limits.

One of the key benefits of being able to hire non-registered providers is the opportunity to connect more with your local community. This flexibility allows you to access services from providers who may not specialize in disability support but can still meet your needs. If you have a preferred unregistered provider, plan management or self-management gives you the freedom to hire them.

What is Self-Management?

Self-management empowers participants to hire any provider they choose, regardless of whether they are registered with the NDIS. Unlike other funding options, it also allows providers to charge above the rates listed in the NDIS price guide. Essentially, anyone with an Australian Business Number (ABN) can be engaged, even if they lack experience in disability support. However, it’s important to carefully manage spending, as the NDIS budget is calculated based on standard hourly rates. Paying higher fees can risk depleting the budget before the year ends.

Some providers have criticized NDIS price limits as being too low, making self-management an attractive option for those who want to hire providers that charge above the cap. That said, caution is advised. Certain providers may charge the highest possible rates without delivering services that justify the cost. This can lead to poor value for money, reduced hours of support, and may even prompt a review of the participant's self-management status.

Drawback of Self-management

Drawbacks of self-directed plans is the administrative responsibilities, such as maintaining records, separating funds, submitting claims, and paying service providers. The care recipient must keep detailed records of all transactions under the plan for a period of five years. If a few receipts are lost or their ink fades, significant issues could arise if the agency decides to conduct an audit. While recipients can hire assistance to manage their plans, the cost of this support will be deducted from their allocated budget. Ultimately, for individuals who are comfortable acting as their own accountant and need to pay above the set price limits, self-management can be a suitable option.

Self-management provides benefits similar to plan management, such as increased control over daily decision-making, enhanced flexibility, and a broader range of choices for utilizing the allocated funding.

The main differences between plan management and self-management are that self-management participants:

• Handle their own administrative tasks for claims and payments, taking full responsibility for claiming NDIS funding and paying invoices for services and products received under an NDIS plan.
• Have the freedom to pay service providers any amount they choose, whereas plan managers and agency-managed plans are subject to price caps.

What does Agency managed mean?

When a plan is agency-managed, the NDIS agency oversees and handles the financial aspects of the plan. This option minimizes the administrative workload for the care recipient, making it the simplest choice. 

However, it also imposes limitations on the selection of support providers. Only providers registered with the NDIS are eligible for use under an agency-managed plan. That said, if the plan involves only a few registered providers and is unlikely to require changes, agency-managed funding can be a practical and straightforward option.

The term "reasonable and necessary" is used to assess the types of funded supports a participant may require. In simple terms:

• Reasonable means something fair and appropriate.
• Necessary refers to something essential to address your disability and help you achieve your goals, or a support or service to be considered reasonable and necessary, it must:
• Relate to the participant's disability.
• Offer good value for money.
• Exclude everyday living expenses unrelated to disability support needs, such as groceries.

The NDIS cannot fund supports that are:

• The responsibility of other government systems or community services.
• Unrelated to the participant's disability.

An NDIS Planner will apply specific criteria to determine what can be included in a plan, ensuring that:

• The support is directly linked to the participant's disability.
• The support helps the participant pursue their goals, objectives, and aspirations outlined in their statement of goals.
• The support enables the participant to engage in activities that promote social and economic participation.
• The support provides value for money, balancing cost with the benefits achieved and the cost of alternatives.
• The support is effective and beneficial for the participant, aligning with current best practices.
• The funding or provision considers the reasonable contributions of families, carers, informal networks, and the community.
• The support is appropriately funded by the NDIS, rather than by another person, organization, or agency.

Participants who use their own funds for approved expenses within their NDIS Plan can request reimbursement. These approved expenses are submitted as reimbursements and are processed by the NDIS, typically paid overnight. It is the participant's responsibility to confirm with their Plan Manager that the expenses are eligible before submitting a claim.

To set up an account, participants must provide their bank details (BSB and account number) to their Plan Manager. For those without access to a computer, reimbursements can be arranged through a representative or coordinator of supports. A system will be established for submitting paper-based requests and receipts.

STA, or Short-Term Accommodation, is a type of temporary respite care funded by the NDIS. It provides participants and their carers with an opportunity to take a break away from the participant's usual home environment.

The use of STA funds must align with what is considered reasonable and necessary based on the participant's specific needs and goals, as outlined in their NDIS Plan. If these details are not clearly documented in the Plan, participants should seek written clarification from their NDIA Planner or Local Area Coordinator (LAC).

If you hire carers or support workers as independent contractors, you are not required to provide insurance for them. 

Being essentially small business operators, contractors typically have their own Australian Business Number (ABN) and are responsible for managing their own insurance coverage.

That said, it is recommended that participants with carers visiting their homes to confirm that their home insurance includes public liability coverage for any visitors. 

This is considered a personal expense and is not claimable under the NDIS, as it falls under the usual responsibilities of a homeowner.