When your funds are gone

Running out of funds in your plan is extremely stressful. We walk you through what happens when your funds are exhausted, and what your options are.

Have you ever worried that your funds are not going to last to the end of your plan? Or even worse, you’ve already run out of funds before your plan has finished? For one reason or another, this happens to a lot of participants. So what do you do when your funds are gone?

Plans with Funding Periods

If your plan has funding periods, you can run out of money several times during your plan. Each funding period is like a mini-plan, and once it’s gone, you can’t pay for supports. The NDIS has been quite confusing about whether they will allow you to back claim for supports or not. Back claiming means using newly released funds to pay for supports from an earlier funding period.

For the latest on funding periods, check out our Participant Guide to Funding Periods.

When it’s ALL Gone

Here’s what happens if your plan has run out of money completely in any budget category.

We can make partial payments up to the amount left in your budget category.
Once your money is gone, we cannot pay any more invoices.
We let you and your provider know that we can’t make full payment. If you have a support coordinator, we also let them know.
If you agreed to the services, you are responsible for the payment. If you don’t have NDIS funds to pay with, your provider can ask you to pay the bill.

Important things to note

Core funds are usually flexible. For example: you run out of funds in Assistance with Daily Life, but have funds in Consumables. We can ‘move funds over’ from Consumables to cover your invoice. If you’re not sure, ask us.
If you still have funds in another budget category, we can pay those invoices. For example, if you run out of funds in your therapy budget, we can’t pay any more therapy invoices. We can still pay your support worker invoices, if you have funds left in Core. Please note: Even if you have Core funds, we can’t use those to pay for your therapy supports.

What are my Options?

If you get a plan extension, we can use the newly added funds to pay for outstanding invoices. If you’ve paid them yourself, we can also reimburse you – just send us your receipt. Remember though that this means you will have less funding for the rest of your plan.

Once you get a new plan, you will have more funding. But we can’t use the new funds to pay for services you got during your old plan. This means you will still have a debt. We can ask the NDIS if they’ll pay the outstanding invoices, once your old plan is finished. They generally won’t do this though, unless one of these criteria has been met:

s45(5) (a) Participant has experienced fraud or financial exploitation.
s45(5) (b) Participant faces an imminent threat to their life, health or safety and the payment is necessary to prevent or lessen it.
s45(5) (c) Participant was unable to request a change to their plan.
s45(5) (d) Participant has requested a variation for crisis or emergency funding due to significant change in their support needs, but the Agency has not yet made a decision.

Asking the NDIS for a ‘manual payment request’

Tell us that you want us to lodge a claim.
Your provider’s invoice must meet more criteria than usual. They can read about that on our provider’s blog post on manual payment requests. We will let your provider know if there’s anything they need to change on their invoice.
You will need to send us extra information that we can send to the NDIS. This has to show which of the above criteria applied to you in this case. You might like to get someone to help you with this – like your support coordinator or your provider.

Important things to note about manual payment requests

We can’t lodge these until you have a new plan. If you don’t get a new plan for a while, your providers will have to wait for payment.
The enquiry usually takes at least 8 weeks – often more. During that time, we cannot pay your providers.
There is no guarantee that the NDIS will make payment. Most of the time they will say no, especially if you have not experienced one of the circumstances above.

Who Pays the Bill?

As an NDIS participant, you are the one receiving services. You enter into a contract with a provider, who provides supports as you request them. If you’ve signed a service agreement, that will usually set out what happens if you cannot pay your bills.

As your plan manager, we can claim invoices for your NDIS supports from the NDIA. Once the NDIA has paid them, we then pay them on your behalf to your provider. We do not enter into an agreement with your provider.

If you do not have any NDIS funds left, or choose not to use them, you become liable for paying the bill. Your provider will then talk with you about how you can pay your debts. They may have debt recovery procedures, like sending your debt to a debt collector.

Before You Run Out of Funding

Talk to your provider. Most providers will work out a quote or estimate of how much funding they could need. Check that this is within your plan funding.
Get a written service agreement that shows how much funding the provider can access, and when. The provider should not go over this amount without your permission. If they go over, they risk not being paid.
If you have more than one provider from the same budget, make sure there’s enough funding for all of them. For example, all your therapists come from the same category of funding. Check that all those amounts don’t add up to more funding than you have remaining.
Check your funding regularly. We send out statements by email on the first day of every month. We have an app and a web portal you can use to see your plan managed funds. You can also use the MyNDIS portal to see all your funding.
Ask for help if you need it. This could be from your Support Coordinator or Psychosocial Recovery Coach if you have them. You can also ask your Local Area Coordinator or Early Childhood Partner. If you’re not sure who your contact is, you can ask the NDIS.
The NDIS has some budgeting tools on their website. You can use your current balances to work out how much funding you have left for each support.
Don’t ignore it and hope it will go away. You could end up with a lot of stress and a debt!