Living with a chronic illness can affect daily routines, employment, and social participation. The National Disability Insurance Scheme (NDIS) recognises these challenges and offers specialised support to help participants manage health‑related tasks, maintain independence and improve quality of life. This guide explains what chronic disease support covers, who can access it, how funding works and the steps to start receiving help in Adelaide.
What is chronic disease support and who can benefit?
Chronic disease support is a category of funded assistance that targets the ongoing impact of long‑term health conditions such as diabetes, multiple sclerosis, chronic heart disease, chronic kidney disease and autoimmune disorders. The support is designed for NDIS participants whose disability is significantly affected by the management of their illness. It can include assistance with medication administration, monitoring health indicators, coordinating appointments, and providing education on self‑management techniques. People who experience functional limitations, fatigue, or complex care needs because of a chronic condition are the primary beneficiaries.
Eligibility and access rules
To qualify for chronic disease support, a participant must meet the standard NDIS eligibility criteria:
- Age: under 65 years at the time of application.
- Disability impact: the chronic condition must result in permanent or significant functional impairment that affects daily living, social participation or employment.
- Australian residency: the person must be an Australian citizen, permanent resident or hold a protected visa.
In addition, the participant must demonstrate that the support is “reasonable and necessary” under the NDIS Act. This is assessed during the planning process, where evidence such as medical reports, specialist letters and functional assessments are reviewed. For further information on who provides NDIS support, see Who Does NDIS Support.
What is included and what is excluded?
Included services may consist of:
- Assistance with medication reminders and administration.
- Health monitoring (e.g., blood glucose checks, blood pressure tracking).
- Coordination of medical appointments and transport arrangements.
- Education on disease self‑management and lifestyle adjustments.
- Support for daily tasks that are directly impacted by the chronic condition, such as fatigue‑related personal care.
Excluded items are those that fall outside the scope of “reasonable and necessary” support, for example:
- General health services covered by Medicare or private health insurance.
- Routine medical treatments that are not linked to the participant’s disability.
- Equipment or consumables that are not listed in the NDIS Price Guide.
- Any support that can be provided by a family member without compensation, unless the level of care required exceeds what a family member can safely deliver.
Funding and planning considerations
Funding for chronic disease support is allocated within the participant’s NDIS plan under the “Improved Health and Wellbeing” or “Daily Living” budgets, depending on the nature of the assistance. The amount is calculated based on the participant’s individual goals, the level of support required and the limits set out in the latest NDIS Pricing Arrangements and Price Limits. Providers must quote prices that align with these arrangements, and participants should review their plan to ensure the funded amount matches their needs.
When developing a plan, it is useful to discuss the role of a plan manager. A plan manager can help track spending, process invoices and ensure compliance with the pricing rules. More details on plan management can be found at NDIS Plan Management in Melbourne, which offers a clear overview of the process.
How to request or activate chronic disease support
Activating the support follows a clear sequence:
- Contact your planner or support coordinator: Discuss your chronic condition, functional impacts and the type of assistance you need.
- Gather supporting documentation: Obtain recent medical reports, specialist letters and any functional assessment results that illustrate how the disease affects daily life.
- Submit a request for plan amendment (if already approved): If chronic disease support was not included in your original plan, you can request a review or a plan amendment.
- Choose a registered provider: Select a provider who offers chronic disease support and is registered on the NDIS Provider Register.
- Sign a service agreement: The agreement outlines the services, frequency, and costs, ensuring they align with the NDIS Pricing Arrangements.
- Start receiving services: The provider will schedule visits, coordinate with your healthcare team and begin delivering support as outlined in the plan.
For a deeper understanding of how chronic illness can be managed alongside daily life, read the article Chronic Illness – The Uninvited Guest Who Never Leaves.
Local context – Adelaide and surrounding suburbs
Adelaide offers a range of health‑focused community services, specialist clinics and NDIS‑registered providers that understand the unique needs of people with chronic conditions. Residents of the city’s inner suburbs such as North Adelaide, Glenelg and Norwood benefit from easy access to hospitals like the Royal Adelaide Hospital and private allied health practices. Those living in the outer metropolitan area can also draw on support networks in nearby suburbs. For example, participants residing in Point Cook, Tarneit or Werribee often travel to Adelaide for specialist appointments, and many providers coordinate transport and telehealth services to reduce the burden of travel.
People Also Ask
What types of chronic disease support are funded by the NDIS?
The NDIS funds assistance that helps manage the functional impact of a chronic condition, such as medication reminders, health monitoring, appointment coordination and education on self‑management. Services must be reasonable and necessary and align with the latest NDIS Pricing Arrangements and Price Limits.
Can I add chronic disease support to an existing NDIS plan?
Yes. If your current plan does not include this support, you can request a plan review or amendment by providing updated medical evidence that demonstrates the need for additional assistance.
Do I need a support coordinator to access chronic disease support?
A support coordinator can help you navigate the planning process, find suitable providers and manage service agreements, but they are not mandatory. You can also work directly with your planner or a plan manager.
Are family members able to provide chronic disease support?
Family members can assist with daily tasks, but if the level of care required exceeds what they can safely provide, the NDIS may fund professional support. The decision is based on the participant’s functional needs and safety considerations.
How is the cost of chronic disease support calculated?
Costs are calculated according to the participant’s individual goals, the frequency of support required and the limits set out in the latest NDIS Pricing Arrangements and Price Limits. Providers must quote prices that fall within these limits.
This article is general information only. Check your plan and speak with your planner or support coordinator.