It might seem like only yesterday that you stepped into the pediatrician's office
for your child's very first visit. And you might have been a little nervous as you
got to know the person who'd be caring for your little one.
But after years of interaction (complete with late-night phone calls, last-minute
appointments, and trustworthy advice), your pediatrician probably feels like part
of the family. So when the time comes for your child to transition into adult health
care, it can be hard to say goodbye.
Done abruptly, this change can be overwhelming and anxiety-inducing for you and
your child. But if you're both prepared and plan accordingly, it can be a smooth step
on the path to adulthood.
Finding a New Doctor
Once kids become legal adults at age 18, they can visit an adult primary
care physician(PCP), such as an internal medicine doctor
(internist), a general practitioner, or a family medicine doctor.
Your pediatrician, who is specifically trained to care for kids and teens, might
be able to provide care for a little longer if your child is in college (usually until
college graduation or age 21). But this varies from doctor to doctor, so be sure to
Ask your pediatrician for a referral if you don't have a family doctor that your
child wants to see or if your child has a chronic condition that will require an adult
If your child has a rare condition, disability, or pediatric-onset condition (one
that only develops in childhood), it may be challenging to find a PCP or adult specialist
who is knowledgeable and comfortable caring for these complex needs. In this case,
start searching for doctors early on, during the teen years.
Ask if your child can see a new doctor for a trial period; then, follow up with
the pediatric specialist to discuss how things went and put both doctors in touch
to plan for the transition of care. Allow plenty of time for this process —
that way, if there is an issue your child can continue seeing the pediatric specialist
until you find an adult provider who is a better fit.
Choosing Health Care Coverage
If your child is a dependent under your health care coverage, the Affordable Care
Act allows your child to be covered until age 26, regardless of whether he or she
is in college, living at home, or even married. Your child can be employed and still
on your policy, as long as he or she is not eligible for health insurance benefits
through an employer.
Coverage will expire on the day your child turns 26, so he or she should begin
looking for new coverage well before this date.
Many employers offer group health care coverage as part of their
employee benefits package, which lets employees customize a plan that may include
dental care, vision care, emergency care, and routine medical care. Long-term disability
insurance (insurance that offers medical benefits for those who are out of work for
an extended period of time) also might be offered by the employer, but at an added
If insured through an employer, your child will have to pay a monthly fee (premium),
based on the number of exemptions your child claims. He or she is also responsible
for any co-pays and out-of-pocket fees that go directly to health care providers like
doctors or pharmacists.
If no longer covered under your insurance plan and health coverage is not offered
by an employer or spouse's plan, your child might be eligible for coverage under COBRA,
the Consolidated Omnibus Budget Reconciliation Act. This U.S. mandate requires all
health insurance carriers to temporarily extend coverage in a group plan to former
dependents for up to 36 months.
Since COBRA does not kick in automatically, your child must apply for coverage
(and should do so quickly, since time of eligibility is limited). Premiums will be
higher than what your child paid as a dependent on your plan.
Your child also can opt for individual health coverage (rather
than through a company group plan), but premiums will be higher.
If your child has a pre-existing condition, insurance companies can't turn him
or her down or charge more for coverage. If your child has special health care
needs, your insurance plan may have an adult disabled child clause, which allows adult
children with disabilities to stay on a parent's plan indefinitely. Check with
your insurance company to see if this is offered.
Those who are disabled prior to turning 22 also may be eligible for Social Security
Disability Insurance (SSDI). These benefits are offered to disabled children whose
parents paid into Social Security throughout their careers. After a child has
SSDI for 24 months, he or she is also eligible for the U.S. government's Medicare
Kids whose parents are deceased, retired, or receiving disability benefits themselves
may qualify for benefits. Adult children who are disabled also may receive coverage
through the government's Medicaid program if their incomes fail to cover the cost
of medical services, or if they qualify for and/or receive Supplemental Security Income
Being a Responsible Patient
Unlike pediatric care, adult health care is based on patient responsibility —
and with that responsibility comes control. So, your child will have the authority
to make all medical decisions and also is entitled to privacy regarding all medical
conditions, unless he or she opts to share information with you.
Once responsible for their own health care, it's important for young adults to
relay medical information — such as previous illnesses, operations, medications,
and immunizations — to all health care providers. Be sure your child mentions
allergic reactions to medications (like penicillin), and whether or not there's a
family history of disease, like cancer or heart disease. This information should be
shared with all doctors, especially those working together to treat an illness or
Encourage your son or daughter to keep copies of all medical records and an up-to-date
list of medicines and dosages.
And while it's important to see a doctor with a health concern, it's also important
to visit regularly for checkups and screenings. Health care providers will make recommendations
about when to undergo screenings based on your child's personal and family medical
Before Your Child Reaches Adulthood
Since kids will be responsible for managing their own health care as adults, it
makes sense for them to start "co-managing" their health care during the teen years.
So, little by little, encourage your teen to take an active role — scheduling
appointments and refilling prescriptions are good places to start. This builds self-confidence
and also gives parents a sense of relief knowing that their kids can take care of
The transition into adult health care won't happen overnight. But by planning in
advance and talking about what to expect, you'll help your child successfully manage
his or her own health care when the time comes.