Can I use both NDIS and Medicare for the same service?

No. You cannot claim the same service from both NDIS and Medicare. This is known as 'double-dipping' and is not permitted. If a service is covered by Medicare, the NDIS will not fund it. If a service is funded by the NDIS, Medicare will not cover it. Source: NDIS Act 2013, ndis.gov.au.

Who funds physiotherapy — NDIS or Medicare?

It depends on the purpose. Medicare funds physiotherapy when it is part of a GP Chronic Condition Management Plan (GPCCMP, item 965) — up to 5 sessions per year for eligible patients. The NDIS funds physiotherapy when it is related to your disability and supports long-term independence goals. If your NDIS plan includes physiotherapy funding, use NDIS. If not, Medicare may cover it via a care plan.

Does NDIS cover prescription medications?

No. Prescription medications are not funded by the NDIS. They are covered by Medicare and the Pharmaceutical Benefits Scheme (PBS). The NDIS may fund related disability supports such as medication management training or assistive technology for medication administration, but not the medication itself. Source: ndis.gov.au.

Does having an NDIS plan affect my Medicare access?

No. Having an NDIS plan does not affect your Medicare entitlements. You can continue to see your GP, access specialists, and use Medicare-funded services just like anyone else. Your NDIS plan and Medicare operate independently.

NDIS & Medicare — Who Pays for What?

The two systems serve different purposes and don’t overlap. Select a service type to see who funds it and why.

📋 Sources: National Disability Insurance Scheme Act 2013 — ndis.gov.au ↗. MBS Online (GPCCMP item 965, allied health item 10997) — mbsonline.gov.au ↗. Services Australia — servicesaustralia.gov.au ↗. NDIS Pricing Arrangements and Price Limits 2025–26. Always check with your NDIS planner or the NDIS helpline for your specific plan.

🇦🇺 Australia · General information only

ℹ️ General information only — not financial or legal advice. Actual NDIS funding depends on what’s in your plan. Always check with your NDIS planner, support coordinator, or the NDIS helpline (1800 800 110) for your specific situation.

The one rule that matters

❌ No double-dipping. You cannot claim the same service from both NDIS and Medicare. If Medicare covers it, NDIS won’t. If NDIS funds it, Medicare won’t. Source: NDIS Act 2013 · ndis.gov.au

🟣 NDIS funds

Disability-related supports for daily life

Therapy to build independence and function

Personal care and support workers

Assistive technology and home modifications

Community participation

For people with permanent & significant disability, under 65

🔵 Medicare funds

GP consultations and specialist visits

Allied health via care plans (5 sessions/year)

Mental health sessions (up to 10/year)

Hospital treatment as a public patient

Diagnostic tests and pathology

For all Australian residents, any age

Select a service type

Tap a service to see who typically funds it and how.

Common questions

Does having an NDIS plan affect my Medicare?
No. Your NDIS plan does not change your Medicare entitlements. You still have full access to Medicare — GP visits, specialist referrals, pathology, hospital. The two systems run independently. Source: ndis.gov.au

What if the NDIS doesn’t fund something I need?
Medicare may cover it instead (e.g. allied health via a GPCCMP, or psychology via a Mental Health Treatment Plan). Your GP is the starting point for accessing Medicare-funded allied health services. Source: Services Australia

Can my NDIS plan fund therapy that Medicare also covers?
Not for the same appointment. If a session is funded by Medicare, it cannot also be claimed to NDIS, and vice versa. In practice, NDIS-funded therapy focuses on disability-related goals, while Medicare-funded therapy focuses on health conditions. Source: NDIS Act 2013

Does NDIS cover hospital stays?
No. Hospitalisation, surgery, and medical treatment in hospital are covered by Medicare (public patients) or private health insurance. The NDIS does not fund medical treatment or hospital care. Source: NDIS Act 2013