Insurance scheme failing me: Gai

YourLifeChoices member Gai is one of 11.4 million Australians living with a chronic disease. She says her condition is a challenging one – both physically and financially – and asks why the National Disability Insurance Scheme does not cater for people like her.


Gai writes:

Like a lot of people, I was over 65 when the National Disability Insurance Scheme (NDIS) came in and was, therefore, not eligible. I have a chronic disease and, while living independently without the need for assistance, there are certain things I require, which, unfortunately, I need to pay full price for.

For instance, my condition requires me to exercise.  However, while those on the NDIS may attend a gym and be fully covered, anyone else has to pay the full cost. A one-on-one session with an exercise physiologist would cost me $180 per session and a group session would cost $50 per session. While I do attend a gym specialised for my condition, and it is subsidised to a point, it still costs me to attend.

Last year, I tripped on an uneven footpath and broke my shoulder. I have only recently been able to return to the gym, but not before I had a two-hour assessment with a physiotherapist that cost $150.  I am unable to claim this through my private health fund. Again, those on the NDIS are able to have this assessment at no cost to them.

My gripe: Why is it that the Government says it would love to see more people able to age in their own homes, yet there is this division of under/over-65s for financial assistance for chronic diseases and many over-65s live on a pension, as I do. Where does the Government expect us to find the extra money to pay for these services?

A Department of Social Services spokesperson provided the following response:

The NDIS is aimed to address the chronic and unmet needs of people with significant non-age-related disabilities. It is not intended to replace the health or aged care systems.

The NDIS design reflects the Productivity Commission’s recommendation that a person needs to have acquired their disability before the age of 65 and meet other eligibility criteria in order to be an NDIS participant. To the extent that eligibility for the NDIS is limited to people under the age of 65, those limitations are considered reasonable and necessary because they support the broader intent of an integrated system of disability and aged care supports through different phases of life.

For those 65 and over, there is a range of supports available within the aged care system that can be accessed through My Aged Care, which may be suitable for older people with disability. Examples include the Commonwealth Home Support Program and the Home Care Packages Program.

Do you think the NDIS should be extended to over-65s? Are many parts of society failing to adjust to Australians’ longevity?

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Written by Janelle Ward


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