What Happens to My NDIS Plan After Turning 65?

As individuals with disabilities approach their 65th birthday, a key question arises: What happens to my NDIS (National Disability Insurance Scheme) plan after I turn 65? The NDIS has been a groundbreaking program for Australians with disabilities, providing essential supports to help them live independent and fulfilling lives. However, at the age of 65, the rules surrounding eligibility and support can change, which can be both confusing and worrying for those approaching this milestone. If you’re an NDIS participant nearing 65 or you care for someone who is, it’s important to understand the available options, the transition process, and what the future holds for your care. This comprehensive guide will break down everything you need to know about what happens to your NDIS plan after you turn 65.

What is the NDIS?

The National Disability Insurance Scheme (NDIS) was introduced in Australia to support people with permanent and significant disabilities. It provides funding for a range of NDIS services and supports, including:

• Personal care and support
• Therapies (e.g., physiotherapy, speech therapy, occupational therapy)
• Assistive technology (e.g., wheelchairs, hearing aids)
• Home modifications
• Community participation and social activities

The NDIS is designed to give participants more choice and control over the services they receive, based on their individual needs. It is open to Australians under the age of 65 who meet the NDIS eligibility criteria, which includes having a permanent disability that significantly impacts daily life.

What Happens to the NDIS When You Turn 65?

Turning 65 is a significant milestone when it comes to accessing disability support services in Australia. While the NDIS has been designed to support people under the age of 65, there are provisions in place that allow those who are already participating in the NDIS to continue receiving support past this age. However, there are certain changes that occur at the age of 65, and knowing what these are can help prepare for a smooth transition or continuation of care.

Grandfathering Clause: Continuing with the NDIS After 65

If you are already an NDIS participant before turning 65, you will generally be able to continue receiving NDIS support after your 65th birthday. This is because of a provision known as the grandfathering clause.

• What does “grandfathering” mean? The grandfathering clause ensures that if you are already enrolled in the NDIS before you turn 65, you can continue receiving your NDIS funding and supports without being forced to transition to other services like My Aged Care. The NDIS will continue to support you, and you will not automatically lose access to your plan.
• Reviewing your NDIS Plan: While your NDIS plan may remain largely unchanged, it is common to undergo a review around the time you turn 65. This review is not automatically triggered by your age but instead by your ongoing needs. If your care requirements change due to aging or other factors, your NDIS planner may adjust your plan to better meet your evolving needs.
• What happens during the review? When you approach 65, your NDIS plan may be reviewed to ensure that your needs are still being adequately met by the NDIS system. The review will assess:
  • Current supports: Whether the services you are receiving are still suitable for your needs.
  • Age-related needs: If you need different types of supports due to aging (e.g., mobility assistance, support with daily activities).
  • Eligibility: Whether continuing on the NDIS is the best option for you or if transitioning to other services might be more beneficial.

Transitioning to My Aged Care

Once you turn 65, the NDIS eligibility automatically changes. If you were not previously an NDIS participant, you would not be eligible for the scheme after your 65th birthday. However, there is a structured process for transitioning to other support systems like My Aged Care, a government-funded program designed to provide care for older Australians.

• Eligibility for My Aged Care: To transition to My Aged Care, you will need to go through an assessment process. My Aged Care provides services such as home care, personal assistance, and health support, which are more focused on the needs of elderly Australians rather than those with permanent disabilities.
• Making the transition: If you wish to move to My Aged Care, the transition process is guided by your My Aged Care assessment. During this assessment, an assessor will visit you to evaluate your care needs, which will include looking at your physical health, mobility, and personal care requirements. Based on this assessment, you will be assigned an appropriate care package that suits your needs.
• Timeline: The transition from NDIS to My Aged Care is not automatic, and it doesn’t happen overnight. There may be a period of overlap where you receive support from both the NDIS and My Aged Care as you gradually move toward the aged care system.

Dual Access to Both Systems (NDIS and My Aged Care)

In some cases, it may be possible to access both NDIS and My Aged Care services at the same time. This is particularly the case if you have complex needs that require support from both systems. For example:

• You may continue receiving disability-related supports through the NDIS (e.g., therapy, assistive technology).
• At the same time, you may start receiving aged care services like personal care or nursing assistance through My Aged Care.

This dual access can ensure that all your care needs are met effectively and that you don’t experience a gap in support when transitioning between the two systems.

Choosing Between NDIS and My Aged Care

After turning 65, you will need to choose whether to remain on the NDIS or transition to My Aged Care. Here are some important points to consider when making this decision:

• Level of disability: If you have a disability that requires ongoing, significant support (e.g., assistance with mobility, personal care, or social participation), the NDIS may still be the best option for you.
• Health needs: If your primary needs are related to aging, such as assistance with daily living or health management, My Aged Care may provide a more appropriate range of services.
• Long-term care: If you need long-term residential care, My Aged Care is the more suitable option, as it can provide access to aged care facilities and home care services.

Key Differences Between NDIS and My Aged Care

Although both the NDIS and My Aged Care offer support, there are important differences between the two systems:

NDIS:

• Focuses on people with permanent disabilities under 65 (and some individuals over 65 who meet eligibility).
• Provides a broad range of services aimed at improving independence and participation in the community.
• Services include therapies, assistive technology, personal care, and home modifications, tailored to individual goals.

My Aged Care:

• Focuses on people aged 65 and older (or 50 for Aboriginal and Torres Strait Islander people).
• Provides services primarily for older people, such as help with daily living, home care, and nursing services.
• Aims to improve the quality of life for elderly individuals and support aging in place.

Your Rights and Options After 65

If you decide to transition to My Aged Care, it’s essential to know your rights:

• Continued access to services: Even though you may no longer be eligible for NDIS once you turn 65 (unless grandfathered in), you still have the right to access a wide range of supports via My Aged Care.
• Planning and review: My Aged Care offers a person-centered approach, where you will have the opportunity to discuss your needs and goals in creating your care plan.
• Appeals: If you are dissatisfied with your assessment or care plan, both NDIS and My Aged Care provide avenues to appeal decisions.

Choosing the Right NDIS Provider

Selecting the appropriate service provider is pivotal in receiving quality care. When considering a provider, ensure they are registered with the NDIS and offer services that align with your needs. For those transitioning to My Aged Care, look for providers accredited by the Aged Care Quality and Safety Commission.

To assist in this process, here are some resources:

• How to Find the Right NDIS Provider

• Top 15 Largest NDIS Providers in Australia

• Accessing NDIS Support for Unemployed or Low-Income Individuals

Tips for New NDIS Participants

If you’re new to the NDIS or transitioning to My Aged Care, it’s beneficial to familiarize yourself with the system. Here are some helpful tips:

• Understand Your Plan: Ensure you comprehend the details of your support plan, including the services covered and any limitations.

• Keep Records: Maintain documentation of all communications and services received.

• Seek Assistance: Don’t hesitate to ask for help from support coordinators or family members.

For more guidance, refer to Tips for New NDIS Participants.

Conclusion

Turning 65 marks a significant transition in your support journey. Whether you continue with the NDIS or move to My Aged Care, it’s essential to stay informed and proactive. By understanding your options and selecting the right providers, you can ensure that your care needs are met effectively.

At Ambition Health Group, we are committed to supporting you through this transition and helping you access the services that best align with your needs. Whether you’re navigating the NDIS or exploring My Aged Care, our team is here to guide you every step of the way. Reach out to us for expert advice and personalized assistance in making the right choice for your future care.

Remember, you’re not alone in this process. Reach out to local area coordinators, aged care assessment teams, or support coordinators to assist you in navigating these changes.