NDIS and Eye Care,What's Covered for Participants in NSW

The National Disability Insurance Scheme (NDIS) funds supports for Australians with permanent and significant disability. Eye care intersects with the NDIS in several ways,but the coverage is not always straightforward, and many participants are not aware of what they may be eligible for. This guide explains the key principles and how Prime Optometrists Auburn can support NDIS participants.

What the NDIS May Fund for Eye Care

NDIS funding for eye care depends on whether the eye care need is related to the participant's disability and whether it meets the criteria of being "reasonable and necessary." Key areas include:

• Low vision aids and assistive technology: Magnifiers, electronic magnification devices, specialised optical aids for vision impairment. These are typically funded under the Assistive Technology support category.
• Specialist optometry assessment for low vision: Comprehensive low vision assessments are typically funded when vision impairment is part of the participant's disability.
• Specialty contact lenses: Where contact lenses (particularly scleral lenses for keratoconus or other corneal conditions) are clinically required due to a disability-related condition, NDIS funding may be available.
• Glasses: Standard glasses are generally considered a health need (covered by Medicare and health funds) rather than a disability support,but where glasses are required because of a disability condition, NDIS funding may be appropriate.

What NDIS Does NOT Fund

• Routine eye examinations (funded by Medicare)
• Standard glasses for a typical refractive error unrelated to the participant's disability
• Standard contact lenses for routine correction
• Items that are the responsibility of another government system (Medicare, Pharmaceutical Benefits Scheme)

How to Access Eye Care Through NDIS

• Review your NDIS plan to identify relevant support categories (usually Assistive Technology or Capacity Building,Health and Wellbeing)
• Obtain a referral or support from your Support Coordinator or Local Area Coordinator
• Book an appointment with Dr Tahiri,we provide clinical letters and reports to support NDIS funding applications
• For low vision assessment referrals, ask us about appropriate low vision specialist referral pathways