Healthcare Transition

Health care transition refers to your child's move from pediatric medical services and insurance to adult medical services and insurance. Three issues may come up during this transition:

1. Age 18 is the age of majority in Texas! This is when a person assumes the rights and privileges of adulthood. Starting at age 18, a health care professional may not share information with parents unless you make provisions to do so. Parents will still have the right to information for a youth over 18:
   • If the parent has become the child's guardian,
   • if the youth has given the parent medical power of attorney,
   • if the youth has signed a form for a specific medical provider giving the parent this right. Also in many situations the youth can invite his or her parent to participate at appointments, etc.
   Another option is to build your child's capacity to describe his or her disability, medications, and medical needs starting around age 14, so that perhaps gradually the parent is not needed when the youth or adult meets with a medical service provider.
2. Finding adult medical services to replace pediatric. Often families have a close relationship with pediatric providers and find it hard to move on; also it can be difficult to find adult providers who will take on adults with disabilities and complex issues. Suggestions to cope with this transition are:
   • ask for recommendations from current pediatric providers
   • get recommendations about adult providers from other parents and the TXP2P listservs
   • start a care notebook to record your child's pediatric history and prepare to pass on records and information to new adult providers. Click here for the TxP2P Care Notebook.
3. Families must also plan for how to pay for adult medical services. Sources of medical insurance for adults with disabilities are:
   • work-place medical insurance. Children can stay on a parent's plan through age 26; after that, a working parent can petition with their workplace Human Resources Department to keep the child on the parent's plan based on the child's disability.
   • HIPP (Health Insurance Premium Payment) might pay your private medical premium for your family if your child is on your plan and also has Medicaid. See http://www.gethipptexas.org/
   • Medicaid, see http://www.hhsc.state.tx.us and http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-State/texas.html
   • Medicaid Buy-In, see http://www.hhsc.state.tx.us/
   • Your child may also end up with Medicare 24 months after going on SSDI. Medicare has an excellent website--http://www.medicare.gov/
   • Other services are available at http://www.dads.state.tx.us/

For an article on the issue of healthcare transition, see:

• Medical Transition - Getting Your Child Ready to Move from Pediatric to Adult Medical Services

Here is a great website on all phases of healthcare transition:

• http://www.gottransition.org

There is an annual conference at the Baylor College of Medicine on medical transition, the Chronic Illness and Disability Conference: Transition from Pediatric to Adult-based Care. Please call the TXP2P office for up-to-date information on this conference, which is in Houston in early October each year.