PBS and NDIS

What is the PBS

An Australian government program that aims to provide essential medicines to people who need them regardless of their ability to pay.

-As of Jan 1, 2024, patient co payments for most PBS subsidised medication was $31.60, or $7.70 for most concession card holders— the government pays the remaining cost

What is the PBS Safety Net?

Protects individuals and families from large overall expenses from PBS- listed medicines

-Once you pay more than $1647.90 on PBS-listed medication in a calendar year, your patient co-payment becomes $7.70 (concession rate).

What is covdered by the PBS?

-More than 5000 brands of prescription medicine

-Meds part of PBS reviewed three times a year by the Pharmaceutical Benefits Advisory Committee (PBAC), an independent committee made up of health professionals who review and consider new medication

-PBAC reviews medication around its clinical effectiveness, safety and cost-effectiveness compared with other treatments.

What does the NDIS do?

Provides services and support for people with permanent, signifcant disabilities, and their families and carers.

-Funded by federal and state/territory governments

-Works to assist individuals to live an ordinary life

How does one become eligible for NDIS?

-Must be under 65 when applying

-Must live in Australia and be an Australian citizen or hold a permanent visa or Protected Special Category visa.

Four Disability requirements:

- you have an impairment or condition that is likely to be permanent

-You are likely to require support under the NDIS for your lifetime

-Your impairment affects your capacity for social and economic participation.

- your impairment substantially reduces your ability to participate effectively in activities, or perform tasks or actions unless you have:

• assistance from other people, or

• you have assistive technology or equipment (other than common items such as glasses), or

• you can’t participate effectively even with assistance or aides and equipment

What is the first step once you are eligible for NDIS?

-Creating an individualised plan based on the goals and aspirations of the individual

-Identifying functional support needed for daily living and participation, the support needed to pursue goals, and how the indvidiual wants to manage their plan over time.

What does the NDIS assist participants to do?

-Access mainstream services

-Access community services (sport clubs, communitty groups, libraries or charities)

-Maintain informal support arrangements

-Receive reasonable and necessary funded support

NDIS x Maintaining informal support arrangements

-The help people get from their family and friends- support people don’t pay for and, generally part of most people’s lives.

NDIS x Provide reasonable and necessary funded supports

The NDIS can pay for supports that are reasonable and necessary- meaning supports related to a person’s disability and are required for them to live an ordinary life and achieve their goals

-Funding is provided for assistive tech such as a mobility cane, nonslip bathmat, and wheelchairs

-Funding also provided to pay for carers if the individual required assistance with daily tasks.