Transferring Health Care Responsibility to Young Adults

Six items to keep in mind as you hand physical health over to your teen, and as your role changes from advocate to sounding board.

Doctor and patient

If you’ve been scheduling your child’s annual check-ups or calling the doctor when they’re sick, you’re not alone. As your young adult prepares to leave the house this is one aspect of post-high school life many families overlook, but with a little planning ahead, you can make the transition go more smoothly. Dr. Bobbi Wegner, a clinical psychologist, says she sees parents who are surprised to notice anxiety as their child takes over their own healthcare. While it can mark a point of separation that can be difficult for some parents, it is an important psychological step in independence and self-care. Here are six items to keep in mind as you hand the reins of physical health over to your teen, and as your role changes from advocate to sounding board.

Know the Basics

Dr. Burgert says all teens preparing to take over their own medical care should know the “basics” of their health.

They should have a copy of their vaccines, know over-the-counter medications and their uses, know any prescription medications they are on, their past medical history – including any surgeries they may have had. Before they take over their own care, Dr. Burgert also recommends having a conversation about family history. Some conditions can be hereditary or genetic, meaning if someone in the family has a condition it is more likely for other family members to have the same condition. Your teen should also know if they are allergic to any medications. Dr. Burgert recommends having a conversation covering all of these topics that leads to a note or memo your teen can keep in a phone or wallet for reference in the future. Also add to that memo insurance coverage and emergency contact information. 

Where to Access Care

This may seem like a basic suggestion, but many young adults haven’t had to access healthcare on their own while living at home.

Even if they have, it’s likely they’ve been seeing a pediatrician – a doctor who specializes in care of children. Pediatricians usually end patient care after the age of 18. Missouri-based pediatrician Dr. Natasha Burgert says she’s no longer surprised when a 20-something calls her office asking where they should go to handle a sore throat. Her experience echoes what researchers found in 2015 that “many young adults face serious challenges in accessing and navigating the healthcare system, with potentially serious repercussions.”  While young adults are generally considered a healthy group, there may be emergencies, or non-emergencies, that require medical attention.

If your teen is heading off to a four-year university, many campuses have student health centers. Some of these centers even offer low or no-cost care for enrolled students. Before you leave them on campus, you may want to make sure they know where the health center is, and ensure the phone number is programmed in a phone or otherwise accessible place.

If your teen is attending a community college or other training program, either you or your teen may want to check with the institution directly. Depending on the college or program they may offer student health centers similar to those found at four-year universities.

If your teen doesn’t have a student health center, or if they are staying at home, taking a gap year, or heading into the workforce, you may still want to raise a few questions. Is there a general practitioner that the adults in your family regularly see? That can be one option for your teen if they’re staying nearby. If they’re not staying, is there a friend or family member who could recommend a clinic or doctor in the area your teen is headed?  

Your teen should also know where the closest emergency room and urgent care centers are. Emergency rooms are usually open all the time, and are only for emergencies, like a car accident or a serious head injury. Urgent care centers are a great option for seeing a doctor in off-hours or when a primary care physician isn’t available. Examples of what constitutes an ER visit versus urgent care visit can be found on New York’s Mount Sinai website here

Regardless of where they’re going, if your teen knows where to find care on their own, it can help ease the stress of trying to track down that information when they are in need of medical attention. 

Insurance

In addition to issues in transitioning from pediatricians, young adults’ biggest barriers to receiving medical care are changes in insurance coverage and cost.

This means that if you haven’t talked with your teen about insurance, you may want to do so soon. It may also require a bit of research on your end if you are looking to keep your teen on your insurance plan, or if you would be looking for a new plan for them. As of this writing, the Affordable Care Act is still in effect. The law allows children to stay on their parents’ insurance plans until age 26.

If your teen won’t be staying on your insurance plan or if you don’t have insurance coverage, there are other options available. For college-bound students, some universities and community colleges offer student health plans directly through the school. Depending on whether your state offers coverage, you can purchase insurance on an exchange, or marketplace, run by your state or plans run by the federal government. For a full list of state marketplaces, use this link. There are also plans available directly from a variety of insurance companies.

While it may seem daunting, finding the right option that works for your family could help you save costs, time, and most importantly – stress – in the future.  

Privacy

One large change in your teen’s healthcare after high school is your ability to access their records and information.

Because an 18-year-old is legally an adult, the Health Insurance Portability and Accountability Act of 1996 – also known as HIPAA – applies to them. HIPAA aims to protect the personal medical information of patients. What that means for you is that you no longer have access to their medical information. Before your teen moves out, you may want to discuss whether or not they would like to sign a HIPAA waiver and keep it on file at their school health center or with their new primary care physician. The waiver will allow medical professionals to disclose information regarding your teen’s health to you. This can be particularly helpful in emergency situations.

Another option would be to have your teen sign a health care power of attorney, also called a healthcare proxy. This allows the person authorized on the document to make medical decisions on your teen’s behalf. While some states have laws that give family members the ability to make decisions for others, you may want to consider this form as well so your family is covered regardless of where your teen resides. This can be especially helpful in emergency situations. You can find free downloadable forms like this one from New York State by searching the internet with “free healthcare proxy form” and your state.

If your young adult is still on your insurance plan, it may be important to point out to them that the charges of medical services can show up on the insurance account. So even if they do not choose to share their medical records, the billing process may give you access to sensitive information, such as if they are seeing a therapist or accessing birth control. Dr. Wegner recommends you make sure your teen is aware of this fact.  

Immunizations and Medications

For many families, handling immunizations and medications can often fall to the parents or caregivers.

But just like knowing where to go or who to call if they get sick, your teen should also be able to take over their own medical regiment. These two items can be easily overlooked in the transition out of the house, but are still important.

Before your teen leaves their pediatrician, discuss immunizations they may still need. The pediatrician should be able to give you insights into what shots your teen has already had, and what will be coming up. The MenACWY vaccine can help prevent bacterial meningitis, which your college-bound student may consider getting. Additionally, many college campus housing rules require students to have certain vaccines before moving in. Your teen should check the rules of their housing and make sure they have all the required vaccines. The HPV and seasonal flu vaccine are also shots your teen may want to discuss with their doctor. 

If your teen is on any over-the-counter or prescription medications, make sure they know the doses and frequency they should take the medication. Some teens may forget to take medications once you’re no longer there to remind them. Depending on the medication, this can have adverse reactions. Having a conversation or reminder email about the doses and medications can serve as a gentle reminder to your teen that their health is in their hands now. 

Sexual Health

As the parent, it can be difficult to tackle this subject, but if you haven’t talked with your teen about this before, it doesn’t have to be as awkward as you might think.

Having a sexual partner is likely for many young adults.  From a straight physical health perspective, there are certain considerations to make. Will they need birth control? Do they know to use protection? Do they know to get annual STD screenings? If you’re uncomfortable having those discussions, or your family believes in practicing abstinence, simply ensuring your teen knows where to access healthcare can point them in the right direction. Many student health centers have sexual health clinics and many large communities have free or low-cost screening centers. Both of those options can offer inexpensive or even free contraception.

Then there are similarly important conversations to have around consent. While this may be a discussion you’ve had previously with your teen, it is worth bringing up again as they leave the house. Keep in mind that talking about consent is not just a conversation for males or females.  Does your teen know how to ask for, and give, consent? Do they know to confirm consent verbally? Do they know how to speak up if they feel uncomfortable at any point in the encounter? There are a lot of factors to consider, and though it may be difficult to talk about, your guidance is extremely valuable. For more information on consent, read How to Talk to Young Adults about Consent.