Are Medicare and the NDIS Linked?
If you or someone you care about has a disability, you might be wondering how Medicare and the NDIS work together. While both help Australians access essential services, they serve different purposes and don’t overlap. Let’s break it down.
What is Medicare?
Medicare is Australia’s public healthcare system, giving everyone access to free or low-cost medical services. This includes GP visits, hospital stays, medical tests, and some prescription medicines. If you need to see a doctor or get treatment for an illness, Medicare helps cover the cost.
Learn more about Medicare, including how to enrol and what’s covered, at the Medicare website.
What is the NDIS?
The National Disability Insurance Scheme (NDIS) is a program that funds support for people with permanent and significant disabilities. Instead of covering general medical care, the NDIS helps with things like personal care, therapy, assistive technology, and home modifications—supports that help people live more independently.
Read more about the NDIS on the NDIS website.
Lifely provides a range of supports under the NDIS to help people live independently. Learn more about our services on our Services Page.
What’s the Difference Between Medicare and the NDIS?
While both Medicare and the NDIS are government-funded, they support different needs.
- Medicare covers medical care, such as doctor visits, hospital treatment, and medicines.
- The NDIS provides disability support, such as mobility aids, carers, and therapy to improve daily life.
For example, if you need to see a GP for an infection, Medicare covers it. But if you need daily help from a support worker, that’s something the NDIS may fund.
Can You Get the Same Services From Both?
No, you can’t get the same service from both Medicare and the NDIS. The two systems don’t overlap, and if something is covered under Medicare, the NDIS won’t fund it.
For example:
- Medicare pays for physiotherapy if it’s part of a medical treatment plan.
- The NDIS funds physiotherapy if it helps you manage your disability long-term.
- Medicare covers prescription medicines, but the NDIS doesn’t.
Does the NDIS Pay for Prescriptions?
No, the NDIS does not cover prescription medications. If you need medicine, you’ll still need to use Medicare and the Pharmaceutical Benefits Scheme (PBS), which helps reduce the cost of certain medications.
However, the NDIS may cover related disability supports, like:
- Training on how to take your medication if needed for independent living.
- Special equipment to help with medication management, like pill dispensers.
- Support workers to assist with taking medication if it’s part of your care plan.
But the actual cost of the medicine itself is covered by Medicare and the PBS, not the NDIS.
Find out more about the scheme on the PBS website.
Does Having an NDIS Plan Affect Medicare?
Not at all. You can still use Medicare just like anyone else. Your NDIS plan doesn’t change your access to medical care. If you need to see a doctor, go to hospital, or get medicine, Medicare still covers you.
The Bottom Line
Medicare and the NDIS are both important but separate. Medicare covers your healthcare, while the NDIS funds disability supports to help you live independently. Together, they ensure people with disabilities get the care and support they need.
