Explaining NDIS Funding: Does the NDIS Cover Medication?

While the NDIS funds various therapeutic supports for the participants, does the NDIS cover medication? Read on to learn more about NDIS funding coverage.

Updated on Mar 25, 2024
5 min read


The NDIS was designed to fund many support services to Australians with disabilities. These services include help with personal care, everyday living, transportation, and therapeutic services. 

But does the NDIS cover medication? 

Medication falls into the grey area because it can be considered a necessary and reasonable expense. But even though an NDIS participant might need to take their medication every day, it will not be covered by NDIS funding. 

If you want to know more about NDIS funding and medication, this article will give you all the information you need. 

Can the NDIS Pay for Medication?

The NDIS funds anything deemed reasonable and necessary. The funding must somehow aid the NDIS participant in completing everyday tasks and living as independently as possible.

In other words, NDIS funding must help the participant live with their disability. 

Many NDIS participants may be confused about what is and isn't included in NDIS funding. That's because the NDIS decides what is reasonable and necessary. This gets particularly confusing in the area of healthcare. 

General medical services, treatment, and medication are not covered. Any type of support that might be more appropriately funded or provided by the health system falls out of the scope of NDIS funding. 

So, the NDIS does not pay for medication. This also includes prescription medication. 

The rule is that the NDIS does not cover general medical care. This is routine medical care provided by general practitioners, specialists, hospitals, or other healthcare professionals. This includes services such as:

  • Consultations
  • Check-ups
  • Diagnostic tests
  • Medical treatments
  • Prescription medications
  • Hospital care

The NDIS primarily focuses on funding supports and services that directly relate to a participant's disability. This scheme aims to improve their independence, social participation, and well-being. 

Why Doesn't the NDIS Cover Medication?

The NDIS focuses on funding support for those with disabilities. These services must directly relate to a participant's disability. 

Medication isn't covered by the NDIS because of the following reasons:

  1. It's the responsibility of the Australian healthcare system.
  2. It would reduce the available resources for other services that are more necessary.
  3. Funding for medication can be achieved through other systems.
  4. The NDIS funds support that address the specific needs and goals of those with disabilities. 
  5. The NDIS operates within a framework of fairness and equity. 

The NDIS operates within a specific framework. This framework distinguishes between disability-related supports and general healthcare services.

The NDIS has finite resources. They are allocated to support disability-related needs. Medications come at a high cost. Covering those costs would significantly strain the scheme's budget. It may compromise its ability to provide essential disability support.

NDIS support services address the specific needs and goals of people with disabilities. Medication may be necessary to manage certain health conditions associated with disability. But, it is generally considered a healthcare expense. 

The NDIS aims to provide support based on individual needs. Medication costs can be significant for some. But, they are treated similarly to other healthcare expenses not directly funded by the NDIS.

How Can NDIS Participants Get Funding for Medication?

Medication is considered a healthcare expense. That is why it falls outside the scope of NDIS funding.

But NDIS participants may have other options for financial aid for medications. These include:

  1. Pharmaceutical Benefits Scheme (PBS)
  2. Concessional pricing
  3. Private health insurance
  4. State and territory programs
  5. Other support services

The first option is the Pharmaceutical Benefits Scheme (PBS). Many prescription medications are subsidised under the PBS. This program reduces the cost of medications. PBS subsidies are available to all Australian residents. This includes NDIS participants. 

Some individuals may be eligible for concessional pricing on medications through the PBS. This option provides further discounts for pensioners, healthcare card holders, and other groups.

Private health insurance policies may provide coverage for prescription medications. Participants with private health insurance should check their policy. This will help them determine what medication benefits are included.

Some states and territories in Australia offer programs to help with the cost of medications. Eligibility criteria and available support vary depending on the jurisdiction.

Certain charitable organisations and community groups may provide aid with medication costs. Participants can ask about available support services in their local area.

What Does the NDIS Cover?

While the NDIS does not cover medication, there are many other expenses that the NDIS will pay for. These include:

  • Assistive technology
  • Therapeutic support
  • Personal care
  • Home modifications
  • Early interventions
  • Help with transportation
  • Social and recreational activities
  • Specialist Disability Accommodation (SDA)
  • Supported employment

As you can see, the NDIS helps individuals in different aspects of their lives. With the help of the NDIS, participants can complete everyday tasks through disability support. 

The NDIS doesn't only focus on the participant's health. This scheme is meant to help them in social, professional, and academic aspects as well. 

To apply for the NDIS, you must be eligible. The NDIS sets forth certain eligibility criteria you must meet to apply. But anyone with a significant and permanent disability may be eligible. 

You can use NDIS services to make your life easier. You will be able to create an NDIS plan with your support coordinator. You can tailor your plan to your unique needs and preferences. 

The NDIS and Medication: Is It Covered by NDIS Funding?

Medication is not covered by the NDIS because it's considered a healthcare expense. 

The NDIS is pretty clear about what the funding covers. But rules about what is not covered by the NDIS are a little bit more vague. That's why we're here. 

Inclusive Home Care is here to help you navigate the NDIS system. We are an approved NDIS provider offering support to Australians with disabilities. 

If you want to know more about our services, feel free to reach out to us. You can also request a callback, and we will get back to you as soon as we can.

Schedule a free personalised consultation now.

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