Time flies, doesn't it? You probably remember the day you took your little one to the pediatrician for the first time. But, our children don't stay little forever. The time is coming for your child to transition to adult healthcare. This transition can be a bit overwhelming for both you and your child. But don't worry, if we both prepare well, this can be a smooth transition into adulthood.
Want to help your young child find a new doctor?
When children get older, that is, when they reach a young age, they may find a doctor who treats adults. We call them a Primary Care Physician (PCP) . To be precise, there are several types of doctors:
- An internal medicine doctor or internist - These are people who have been specially trained in the treatment of diseases of adults.
- Family medicine doctor - These doctors treat the entire family, from young children to adults. So if your child can see the same doctor from an early age, that's great.
- General Practitioner (GP) - These people treat many common illnesses.
In our country, pediatricians often treat only newborns and children until the end of adolescence. However, this age limit is not the same in all pediatric practices. In some places, they do not see children after the age of 18, in other places they may wait a little longer. Therefore, it is very important to ask your pediatrician about this as soon as your child reaches adolescence.
For example, if you don't already have a family doctor who you think your child should see, or if your child has a chronic condition that requires the services of an adult specialist, ask your current pediatrician for a referral . He or she may be able to recommend a good adult specialist.
Sometimes, if your child has a rare condition , a disability, or a pediatric- onset condition (a condition that begins in childhood) , it can be a bit of a challenge to find a PCP or specialist who treats adults. This is because you need to find a doctor who is willing and experienced in treating children with these complex conditions. Therefore, it is wise to start looking for such doctors early, when your child is young.
Another thing, you can ask if you can give your child a trial period with a new specialist. Then, talk to your child's old pediatrician and discuss how the new experience is going, how things are going, etc. Give this whole process plenty of time. Then, if something goes wrong, your child can continue to see their old pediatrician until you find a good, compatible adult doctor.
Let us help you choose the right health care coverage for your child.
Now let's talk about health insurance coverage. If your child is a dependent on your health insurance coverage, according to the Affordable Care Act (ACA) , your child can be covered by your insurance until the age of 26. It doesn't matter whether the child is in higher education, living at home, working, or married. They can still be covered by your policy. In our country, these rules may vary slightly from insurance company to company, and from policy to policy. Therefore, it is best to ask your insurance company about this.
If your child is a dependent on a job-based health care plan, that coverage usually expires when the child turns 26. Therefore, you should start looking for new insurance coverage well before that date. If you have insurance through a system like the ACA Health Insurance Marketplace, like in the United States, you may be able to keep that insurance until December 31 of the year your child turns 26. The situation in our country may be different, so read the terms of your insurance policy carefully.
What are the insurance options for the child?
Many companies offer group health care coverage as part of their employee benefits package. This allows employees to customize their plan. It can include things like dental care, vision care, emergency care, and routine medical care . There may also be something called long-term disability insurance . This is medical benefits that you get if you are unable to work for a long period of time. However, this comes at an additional cost.
If you have insurance through your employer, that is, through your place of work, your child will have to pay for the following:
- Monthly premium - This is the amount you must pay each month to maintain the insurance.
- Co-pays and out-of-pocket fees are the costs you pay to healthcare providers, such as doctors and pharmacies. These are the portion of the doctor's fee or the cost of the medication that you pay out of your own pocket.
Imagine that your adult child is no longer covered by your insurance plan, nor does he or she have health coverage through his or her employer or spouse's plan. If so, they may be eligible for coverage under a program called COBRA (Consolidated Omnibus Budget Reconciliation Act) . This is a U.S. law that requires all health insurance companies to temporarily extend coverage on their group plans for up to 36 months for people who were previously dependents.
COBRA doesn't just happen. Your child has to apply for it. Also, you need to apply soon because the eligibility period is limited. But remember, it will cost you more than the monthly premium you paid as a dependent on your plan.
Although there is no specific COBRA system like this in our country, some insurance companies may offer various plans as solutions to such situations. So, check into that as well.
Another option is to choose individual health coverage through the Marketplace at HealthCare.gov in the United States. Many plans are based on your adult child's income. They are also subsidized to make them more affordable. In our country, you can also get individual insurance policies through private insurance companies. You can find out more about them from each company.
Things to consider in particular
There are some special cases, and it's good for us to be aware of those as well.
Insurance companies generally cannot deny coverage or charge more for someone with a pre-existing condition (this is a law in many countries, and it can vary depending on the terms of your insurance policy, so ask about this when you get your policy). If your child has special health care needs , your insurance plan may have a special clause for adult disabled children . This allows disabled adult children to remain on their parents' plan without any restrictions. Check to see if your insurance company offers this.
Adult children with disabilities may be covered through government programs such as Medicaid if their income is not sufficient to cover the cost of medical services, or if they qualify for/receive a benefit such as Supplemental Security Income (SSI) like in the United States. In our country, the Department of Social Services provides various benefits and assistance to people with disabilities. You can also look into that.
People who become disabled before the age of 22 may also be eligible for what is known as Social Security Disability Insurance (SSDI) in the United States. This benefit is provided to disabled children whose parents have paid into Social Security throughout their working lives. If the parents are deceased, retired, or are also receiving disability benefits, those children may also be eligible for these benefits. After 24 months of SSDI, they also become eligible for the U.S. government's Medicare insurance plan.
In Sri Lanka, there are also schemes like the Employees Provident Fund (EPF) and the Employees Trust Fund (ETF) that provide some benefits for certain medical needs. It is also important to remember that many services are available for free or at a reduced cost through the government hospital system.
How can you help your young child become a responsible patient?
Adult healthcare is based on patient responsibility . That means everything from making an appointment to listening to the doctor to taking your medication on time is your responsibility. With that responsibility comes control . So, your child is the one who makes all of their medical decisions. And they have the right to privacy about all of their medical information. Unless they choose to share it with you, you simply won't get to know that information. This may be a bit new, because when they were little, everything went through you.
Imagine that your daughter or son is going to see the doctor alone. She needs to be able to answer the doctor's questions and clearly explain her concerns. She also needs to make sure she understands and follows the doctor's instructions.
As you get older, it's important to share your medical information with every health care provider you see. This includes things like previous illnesses, surgeries, medications, and immunizations. Also, be sure to tell your doctor if you have any allergies to medications or a family history of diseases like cancer or heart disease. This information will help your doctor make an accurate diagnosis and provide the best treatment.
Tell your daughter or son to keep copies of all their medical records, as well as an up-to-date list of medicines. This can be very useful in an emergency.
Also, it is important to see a doctor when you have a medical condition, as well as to have regular checkups and screenings . The type of tests you need will depend on your child's personal and family medical history.
How can I help my children take responsibility for their own health care?
You can help your child start to co-manage their health care when they are young. Gradually, let them take an active role. For example, let them do things like schedule appointments and refill prescriptions. This builds their self-confidence and shows parents that they can take care of themselves.
Imagine, when your child is 15 or 16 years old, you say to him/her, 'Son/daughter, try to make your next doctor's appointment yourself.' At first, you may need a little help, but after a while, he/she will get used to doing it on his/her own. It is through small things like this that they learn to take on big responsibilities.
The transition to adult healthcare doesn't happen overnight. It needs to happen gradually. But planning ahead and talking about what to expect will go a long way toward helping children manage their own healthcare when the time comes.
So, let's put this together and remember what we talked about? (Take-Home Message)
While moving your child from pediatric to adult healthcare can feel like a big step, it's not a problem if it's managed properly.
- Start early: Start looking for a new doctor and looking into insurance options when your child is young.
- Talk to your child: Talk openly with him about this change and his new responsibilities. Listen to his ideas.
- Help find a good doctor: Help your child choose a doctor who is a good fit for their needs and someone they can talk to easily. This is especially important if your child has a chronic illness or special needs.
- Be careful about insurance: Research the duration of your child's insurance coverage and the options available if you need new insurance.
- Encourage responsibility: Gradually teach your child to take responsibility for their own health, medical information, and doctor's appointments. Build confidence that they can do these things on their own.
- Your help is still needed: Even though your child is older, your guidance and support are invaluable during this transitional period.
Remember, this is just one important step on your child's journey to becoming an independent adult. With your love and support, it won't be difficult for them to overcome this challenge!
` Child health, adult health care, pediatric medical care, health insurance, youth health, medical transition, parenting advice
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