Transitioning from Pediatric to Adult Health Care: A Guide for Parents

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Doctor visiting her male patient and taking notes at office.It can be difficult to know what the right age is for your son to transition from pediatric to adult care. If he learns how to manage his own health care, both you and he will feel more confident that he will be able to keep himself healthy and access care when he needs it. This guide will give you some tips about what he needs to know as he approaches adulthood.

At what age should my son start transitioning to adult care?

Transitioning to adult care will be most effective if your son learns skills in the course of his teen years. He should start spending some time alone with his health care provider between the ages of 12-14. Here are guidelines that will help make this a well-prepared and stress free process.

Note: If your son is currently seeing a family medicine practitioner, he doesn’t need to transition, as his current provider will be able to continue caring for him as an adult. However, it’s still important that he learns the skills to manage his own health care.

By age 16, he should:

  • Learn about any medical conditions he has and/or special health care needs
  • Keep a current list of medications and dosages
  • Know how to fill or refill a prescription
  • Be aware of his personal and familial medical history
  • Make (and keep track of) his own medical appointments
  • Have contact information for his current primary care provider (and any specialists he sees)
  • Write down questions to bring to appointments with his medical provider
  • Spend time alone with his medical provider

By age 18, he should:

  • Know how to obtain copies of his medical records
  • Learn about his health insurance coverage and options
  • Know how to obtain a referral to a specialist (if necessary)

How can my son find a new health care provider?

Sometime between the ages of 18-24 is an appropriate time to start seeing an adult care provider such as an internist. The exact timing will depend on what your son is doing during those years (living at home or away in another city), the standards of the practice where he has been seen, and his own readiness. Work with your son and his current health care provider to obtain names of providers who see young adults, and decide on the right time for him to start seeing an adult care provider.

How should my son decide on new health care provider?

To help your son make a decision regarding his adult care provider, he might want to have the following questions answered by the providers he’s considering.

  • Which hospitals does the new primary care provider work in?
  • What are the office hours (when is the provider available, and when can he speak to office staff)?
  • Does the provider or someone else in the office speak the language that he’s most comfortable speaking?
  • Are there other providers that can see him when his primary care provider is not there? Who are they?
  • How long does it usually take to get an appointment?
  • What are the provider’s fees? Does he need to pay at the office or will he be sent a bill? Will the insurance cover the visit?
  • Does the provider or nurse give advice over the phone for common medical problems?
  • Can he contact the provider by e-mail?

Having answers to these questions will help your son make an informed decision on which provider is best for him.

What do my son and I need to know about health insurance?

If you have health insurance, you son may be eligible for coverage under your plan if you claim him as a dependent. The passing of the Affordable Care Act in 2010 has made it possible for dependents to be covered under their parents insurance until the age of 26.

Additional information regarding health insurance:

  • If you don’t have health insurance and your son is attending college or university, he should check out any health insurance options that he is eligible for through school. Suggest that he contact the student health center for information.
  • If your son is not attending college or university, has graduated and is no longer eligible for coverage under your insurance plan, or doesn’t have a health insurance policy through his employer, he may be eligible for coverage under COBRA. COBRA is a Federal law that may allow a person to temporarily keep health coverage.
  • If your son is eligible to be covered through his employer, he should investigate his options and pick a plan that is right for him.
  • If your son isn’t eligible for coverage through an employer, he can apply for individual health insurance through new state and federal websites, but it will be more expensive and the deductibles and co-pays higher than being covered through a group plan.

Making sure your son is knowledgeable about his health and health care during his teen years will help him successfully manage his own care later on. By providing support and guidance, you can help him take gradual steps towards the transition to adult health care, and help him become an educated, responsible adult.