Two Systems, One Person — Navigating Disability and Ageing in Australia
Australia has two parallel support systems for people with disability: the NDIS (for disability acquired before age 65) and the aged care system (for everyone over 65 who needs support). The problem is that disability does not care about birthdays — and the gap between these two systems leaves thousands of Australians without adequate support.
The NDIS has over 646,000 participants but has a strict age cut-off. My Aged Care serves 1.4 million+ people but was designed for age-related decline, not lifelong disability. If your parent has a disability — whether acquired at 20 or at 70 — understanding which system applies, what each covers, and how to navigate the gap is essential. This guide compares both systems, explains who falls through the cracks, covers the transition at 65, and provides clear guidance on accessing the right support.
The Funding Landscape
NDIS participants nationally
people accessing aged care services
age cut-off for new NDIS access
people aged 65+ have significant disability
NDIS vs Aged Care — Side-by-Side Comparison
| Feature | NDIS | Aged Care (My Aged Care) |
|---|---|---|
| Eligibility | Permanent and significant disability acquired BEFORE age 65. Must be an Australian resident. Must meet disability requirements. | Anyone aged 65+ (50+ for Aboriginal/Torres Strait Islander) who needs support with daily activities due to age-related decline or disability. |
| Age Cut-Off | Cannot apply if over 65 (existing participants can stay on after 65) | No upper age limit. Available from 65+. |
| Funding Model | Individual funding package tailored to needs and goals. Choice and control over how funds are spent. Can self-manage or use plan manager. | Tiered system: CHSP (entry-level), Home Care Packages (4 levels: $10K-$60K/year), Residential Care. Less individual choice. |
| Wait Times | 3-6 months for access decision. Plan typically active within 3 months of approval. | CHSP: weeks. HCP Level 1-2: 1-3 months. HCP Level 3-4: 3-12+ months. Residential: variable. |
| What It Covers | Daily personal care, therapy (physio, OT, speech, psychology), assistive technology, home modifications, transport, support workers, community access, supported employment, SDA housing. | Personal care, nursing, allied health, domestic help, meals, transport, social support, home modifications (limited), respite care, residential aged care. |
| Plan Management | Self-managed, plan-managed, or NDIA-managed. Full control over providers and how funds are used. | Provider-managed or consumer-directed care (CDC). Less flexibility than NDIS in provider choice. |
| Reviews | Plan reviews every 12-24 months. Can request unscheduled review if circumstances change. | Reassessment available if needs change. HCP reassessment through ACAT. |
| Cost to Participant | No fees for NDIS-funded supports. | Income-tested fees apply for HCP and residential care. CHSP: small co-contribution. |
| Complaints | NDIS Quality and Safeguards Commission: 1800 035 544 | Aged Care Quality and Safety Commission: 1800 951 822 |
Who Falls Through the Gap?
People Who Develop Disability After 65
A stroke at 68. A spinal injury from a fall at 72. Parkinson's disease diagnosed at 70. These people develop significant disability that would qualify for NDIS funding if they were younger — but because they were over 65 when the disability occurred, they can only access the aged care system. The aged care system provides lower levels of individual support, less assistive technology funding, and less emphasis on independence and community participation.
People Who Were Never Diagnosed Before 65
Some disabilities — intellectual disability, autism, acquired brain injury — go undiagnosed for decades. A person may have managed with informal family support their whole life, never entering the disability system. When family support falls away (a spouse dies, children move away), they need formal support for the first time at age 70. They had the disability before 65, but without documentation, proving eligibility for NDIS is extremely difficult.
Aboriginal and Torres Strait Islander People
The NDIS cut-off for Indigenous Australians is 50 (not 65), reflecting lower life expectancy. However, many Indigenous communities have limited access to NDIS planning and providers, particularly in remote areas. The intersection of disability, ageing, and remoteness creates compounding barriers.
People with Dementia
Dementia is classified as an age-related condition, not a disability, for NDIS purposes — even though it causes profound functional impairment. People with younger-onset dementia (before 65) can access NDIS, but the vast majority of dementia occurs after 65 and is managed through the aged care system, which has significantly less individualised support funding.
If Disability Developed Before 65 — NDIS Continues
If your parent was an NDIS participant before turning 65, they can remain on the NDIS. This is called "continuity of supports." The rules are:
What Stays the Same
- NDIS plan continues with regular reviews
- Existing supports are maintained
- Can request plan increases if needs change
- Choice and control over providers remains
- Assistive technology funding continues
- SDA (Specialist Disability Accommodation) remains
What to Watch For
- Plan reviews may try to reduce supports — advocate strongly with evidence
- Age-related needs (e.g., mobility decline from ageing, not disability) may be directed to aged care
- If entering residential aged care, NDIS supplements (does not replace) aged care funding
- New needs clearly related to ageing (not disability) are funded through aged care
- Dual system navigation can be confusing — use a support coordinator or advocate
Dual Supports — Using Both Systems
An NDIS participant over 65 can access BOTH NDIS and aged care services simultaneously. The NDIS funds disability-specific supports (specialist therapy, assistive technology, support workers for disability-related tasks), while aged care funds age-related needs (meals on wheels, domestic help, aged care nursing). This dual access ensures the person's full range of needs is met — but it requires careful coordination between both systems. A support coordinator experienced with older NDIS participants is invaluable.
If Disability Developed After 65 — The Aged Care Pathway
If your parent developed their disability after turning 65, the aged care system is their primary pathway. While it provides less individualised funding than the NDIS, there are still substantial supports available.
| Program | Annual Funding | What It Covers | Wait Time |
|---|---|---|---|
| CHSP (Entry Level) | Varies by service | Domestic help, meals, transport, social support, allied health, nursing. Individual services, not a package. | Weeks to 1-2 months |
| HCP Level 1 | ~$10,000/year | Basic care needs. 2-3 hours per week of personal care, domestic, or social support. | 1-3 months |
| HCP Level 2 | ~$18,000/year | Low-level care needs. Personal care, nursing, allied health, transport, domestic help. | 1-3 months |
| HCP Level 3 | ~$40,000/year | Intermediate care needs. Daily personal care, nursing, allied health, home modifications, assistive technology (limited). | 3-9 months |
| HCP Level 4 | ~$60,000/year | High-level care needs. Comprehensive daily support — personal care, nursing, clinical care, therapies, assistive equipment. | 6-12+ months |
| Support at Home (replacing HCP from July 2025) | Needs-based (no cap announced) | New system combining CHSP and HCP. Individualised funding based on assessed needs. Greater flexibility. | To be determined |
Assistive Technology Funding
Assistive technology (AT) — wheelchairs, shower chairs, communication devices, home modifications — is one of the biggest differences between NDIS and aged care funding. NDIS provides significantly more AT support.
| AT Category | NDIS Funding | Aged Care Funding | Other Options |
|---|---|---|---|
| Powered Wheelchair | Up to $15,000-$40,000+ (plan-funded) | Limited through HCP (typically $5,000 max) | State disability equipment programs (SWEP VIC, EnableNSW, MASS QLD) |
| Home Modifications | Major mods funded (ramps, bathrooms, widened doors) — up to $20,000+ | Minor mods through HCP ($5,000-$10,000). Major mods require separate application. | My Aged Care home modification program. DVA home modifications for veterans. |
| Communication Devices | AAC devices fully funded ($5,000-$15,000+) | Not typically funded through aged care | State equipment programs. Charity funding (e.g., NDFP, Independent Living Centres) |
| Hearing Aids | Funded if hearing loss is disability-related | Australian Government Hearing Services Program (free for pensioners) | Office of Hearing Services: 1800 500 726 |
| Personal Alarms | Can be included in NDIS plan | Subsidised through CHSP or HCP | State government subsidies available in some states |
| Vehicle Modifications | Funded for disability-related modifications | Not covered | State vehicle modification schemes. NDIS participants over 65 retain this funding. |
Advocacy and Appeals
Both systems have formal complaints and appeals processes. If you believe your parent is not receiving adequate support, you have the right to advocate and appeal.
NDIS Appeals
- Internal review: Request within 3 months of a decision. NDIA reviews the decision with a different delegate.
- Administrative Appeals Tribunal (AAT): If internal review is unsatisfactory. Free to apply. Can be done by phone. Legal aid provides free representation.
- NDIS Quality & Safeguards Commission: For complaints about NDIS providers (safety, quality, behaviour). Phone: 1800 035 544.
- Disability Advocacy: Free advocacy services in every state to help with NDIS appeals and plan reviews.
Aged Care Appeals
- Aged Care Quality & Safety Commission: Complaints about aged care providers (home care or residential). Phone: 1800 951 822.
- ACAT reassessment: If you disagree with the assessed level of need, request reassessment through My Aged Care.
- Older Persons Advocacy Network (OPAN): Free advocacy in all states for people receiving aged care services. Phone: 1800 700 600.
- Aged Care Royal Commission: Recommendations are still being implemented — ongoing reforms may improve access.
How KindlyCall Daily Calls Support People with Disability
Whether your parent accesses the NDIS, aged care, or falls in the gap between both, a daily wellness call provides monitoring that neither system funds consistently.
Routine and Structure
People with disability — particularly intellectual disability, acquired brain injury, and mental health conditions — rely on routine for stability. A daily call at the same time provides a predictable anchor point in each day. It confirms the day, date, and schedule. For people who live alone without support workers every day, this structure prevents disorientation and anxiety.
Medication and Health Monitoring
Many people with disability take complex medication regimens. A daily prompt — "Have you taken your morning tablets?" — provides a simple but effective compliance check. The system tracks whether medications are consistently taken and alerts family or support coordinators when patterns change, enabling early intervention before a health crisis develops.
Emergency Detection
People with certain disabilities (epilepsy, cardiac conditions, mobility impairments) are at higher risk of medical emergencies when alone. A daily call that goes unanswered triggers an immediate alert to nominated contacts. If the person answers but reports distress ("I've fallen," "I can't breathe"), the system escalates to emergency services. This is monitoring that fills the gaps between formal support visits.
State and Territory Equipment Programs
If your parent is not on the NDIS and aged care AT funding is insufficient, state-run equipment programs can fill the gap.
| State | Program | Contact |
|---|---|---|
| Victoria | SWEP (State Wide Equipment Program) — wheelchairs, walkers, shower chairs, communication aids | Via occupational therapist or physiotherapist referral |
| NSW | EnableNSW — equipment, vehicle mods, home mods for people with disability | enablensw.com.au or icare: 1800 068 802 |
| Queensland | MASS (Medical Aids Subsidy Scheme) — assistive technology for eligible Queenslanders | mass.qld.gov.au or 1300 443 570 |
| South Australia | Domiciliary Equipment Service — aids and equipment for home independence | sa.gov.au/topics/care-and-support |
| Western Australia | WA NDIS My Way — equipment and home modifications through WA system | disability.wa.gov.au |
| Tasmania | Community Equipment Scheme — equipment loans and subsidies | communities.tas.gov.au |
| ACT | ACT Equipment Scheme — assistive technology for ACT residents with disability | communityservices.act.gov.au |
| NT | NT Equipment Scheme — equipment subsidy through Territory Families | territoryfamilies.nt.gov.au |
Key Contacts
NDIS (National Disability Insurance Agency)
1800 800 110
NDIS access, plans, and enquiries
My Aged Care
1800 200 422
Aged care assessment, home care packages, and services
NDIS Quality & Safeguards Commission
1800 035 544
Complaints about NDIS providers
Aged Care Quality & Safety Commission
1800 951 822
Complaints about aged care providers
Disability Advocacy Finder
1800 880 052
Find free disability advocacy services in your state
Older Persons Advocacy Network (OPAN)
1800 700 600
Free advocacy for older Australians in aged care
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