Reasonable and Necessary: What Does It Actually Mean in an NDIS Context?
Understanding what the National Disability Insurance Scheme (NDIS) means by “reasonable and necessary” is essential for both participants and their families. This phrase determines which supports and services can be funded through your NDIS plan — and, more importantly, which cannot.
At Connect Support Group, our role as your Support Coordination provider is to help you navigate this framework with confidence and clarity. In this article, we’ll break down what “reasonable and necessary” really means in the NDIS context, how it’s applied, and how we can support you in making the most of your funding.
What Does “Reasonable and Necessary” Mean?
NDIS funding is not unlimited — it’s designed to ensure that participants receive fair, effective, and disability-related support that aligns with their goals. That’s where the concept of reasonable and necessary comes into play.
According to the NDIS, a support or service must meet the following criteria to be considered reasonable and necessary:
- Directly related to the person’s disability
- Helps the participant pursue their goals, objectives, and aspirations
- Facilitates social and economic participation
- Is value for money
- Is likely to be effective and beneficial
- Takes into account support provided by informal networks (family, friends)
- Is most appropriately funded by the NDIS (and not another government system)
Let’s unpack each of these a little more.
Criteria Explained
- Disability-Related Support
Only supports that are clearly connected to your disability will be considered. For instance, a wheelchair for someone with mobility issues is reasonable and necessary, but a gym membership might not be unless it’s clearly linked to a therapeutic outcome.
- Helps Achieve Your Goals
Whether it’s gaining independence, securing employment, or becoming more socially engaged, every support in your plan should help you work toward your stated NDIS goals.
✅ Tip: When preparing for your planning meeting, clearly define your goals and desired outcomes. Our team at Connect Support Group can help you articulate these in ways that align with NDIS guidelines.
- Encourages Social and Economic Participation
Supports that help you integrate into your community, find work, or participate in education and training are more likely to be funded.
- Value for Money
The NDIS will evaluate whether the support is reasonably priced and delivers measurable benefits. Sometimes, a cheaper alternative that offers similar outcomes may be favoured.
- Effective and Beneficial
The support must be based on evidence, best practices, or known outcomes. For example, therapies with a proven track record are generally seen as beneficial.
- Consideration of Informal Supports
Supports provided by friends, family, or community (called informal supports) are also taken into account. NDIS won’t replace what’s reasonably expected to be provided by others.
- Funded by the Right Body
If another government department (such as health or education) should be funding the support, then the NDIS won’t cover it.
Examples of Reasonable and Necessary Supports
✅ Yes:
- Occupational therapy sessions
- Assistive technology like hearing aids or mobility aids
- Support workers for personal care
- Transport for attending therapy sessions
- Home modifications for safety and accessibility
❌ No:
- General living expenses like rent, food, or utilities
- Holidays unrelated to a disability goal
- Cosmetic procedures
- Supports not clearly linked to disability needs
How Connect Support Group Can Help
At Connect Support Group, our expert Support Coordinators help you understand how the reasonable and necessary framework applies to your plan. We can assist you to:
- Prepare for your planning and review meetings
- Document and justify the supports you need
- Ensure that supports align with your NDIS goals
- Liaise with providers and submit reports that demonstrate outcomes
We’re here to help you get the right mix of supports that are not only fundable but also meaningful for your daily life and future aspirations.
Learn more about how we can support you on your NDIS journey.
Navigating Challenges and Appeals
Sometimes a requested support might be denied. In such cases, you have the right to request a plan review or appeal the decision. Having the right documentation, reports, and a skilled support coordinator can make a big difference.
If you’re unsure whether a support is reasonable and necessary, contact us for guidance.
Understanding what “reasonable and necessary” means is the key to accessing meaningful supports through the NDIS. With expert guidance, careful planning, and clarity around your goals, you can ensure your NDIS plan truly reflects your needs and aspirations.
Let Connect Support Group be your partner in achieving the life you envision. Visit our website or contact us today to connect with a trusted Support Coordinator.