Transitioning from a Pediatrician to an Adult Healthcare Provider (Teens with Special Needs)
As a teen, you are starting to be more independent. You are taking on new responsibilities. And that includes being more active in managing your own health. In a few years you will need to change from seeing a healthcare provider who treats children (a pediatrician) to one who treats adults (an adult healthcare provider). As a teen with a long-term (chronic) health condition, you may also need to find a new specialist who treats adults with your condition.
You may feel nervous about making these changes. But don’t worry. This won’t happen all at once. It will happen over time. And you will have support from your parents and your current healthcare providers too. They will help you make this transition. Read on to learn more.
When you turn 18: Legally an adult
Up until now, your parents have made all your healthcare appointments and decisions for you. But when you turn 18, you legally become an adult. You will legally be in charge of making your own healthcare decisions. Your parents will still be able to help you. But your healthcare provider will only be able to share your health information with a parent if you sign forms saying that it's OK. So the more you can do now to learn how to manage your care, the better prepared you will be later.
When do I have to stop seeing my current providers?
Ask your current healthcare providers how long you can keep seeing them. This will depend on the provider and their office. Ask if it may be possible to overlap with seeing them and an adult care provider at first. Keep in mind that:
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Some pediatrician offices may stop seeing you once you turn 18. Other offices may keep seeing you until around age 21.
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If you are seeing a family medicine provider, you may not have to change providers. Family medicine providers see people of all ages.
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If you are also seeing a pediatric specialist for your condition, ask them if you will still need to see a specialist as an adult.
Tips when looking for an adult healthcare provider
Some things to think about when finding a new provider:
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Where is the provider’s office located? How will you get there?
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Does the provider accept your insurance? Or take Medicaid, if needed?
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Does the new provider know a lot about your health condition? Do they currently see people with similar conditions?
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What hospital will you use, and is the provider on staff there?
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Will the new provider help coordinate your care with any specialists you need?
Making the transition: It happens in stages
The transition to adult care happens over time. It starts with some planning and smaller steps at first. Your early teens is a good time to start. Here’s a general guide to help you.
Your early teens: From 12 to 15
It’s important to know about your health condition. Talk with your parents and your providers about this. Ask lots of questions. You can also start working on new skills.
Things you should know:
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Your health condition and your treatments
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How your condition will affect your plans and your life after high school
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All the medicines you take, and the dosages. This includes prescription and over-the-counter medicines. It also includes vitamins, herbs, and other supplements.
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Any allergies you have
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Any surgeries you’ve had
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What immunizations you’ve had
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Any family history of disease
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How your medical benefits are paid for. Do you have health insurance? Do you have Medicaid?
Skills to work on:
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Talk directly with your provider during visits. Ask them questions. If something isn’t clear to you, ask them to explain it so you understand.
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Ask your provider for any resources they can give you about your health condition. These may be local community agencies or online groups. Or they may be support groups for families and teens.
Your middle teens: 15 to 18
You’re ready to take a more active role in your healthcare visits. Some of the skills you can work on now with your parents’ help are:
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Practice calling and scheduling your own healthcare provider visits.
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Add provider appointments to your calendar.
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Check yourself in at provider appointments.
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See the provider on your own for part of your visit, without your parent in the room. This is a time when you can feel free to ask your provider any questions you may have. These may be questions about your sexual health or other issues.
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Learn how to get your prescriptions filled and refilled.
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Store all your healthcare records and receipts in one place.
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Think more seriously about switching to an adult care provider. Talk to your parents about this. You may want to see the same provider they do. Also ask your current provider if they can recommend an adult care provider for you. This should be a provider who currently sees people with health conditions like yours. (See “Tips when looking for a new provider.”)
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If you are also seeing a specialist, ask if they can recommend an adult specialist for you.
Your late teens 18 to 21 and beyond
You are legally an adult now. It’s time for you to:
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Decide on an adult healthcare provider and specialists, if needed.
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Talk with the new provider on the phone or in person first. Ask questions and be sure you feel comfortable with them.
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Make sure the new provider accepts your health insurance or Medicaid.
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Make an appointment with the new provider.
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Ask your past provider to write a medical summary about you. They will send this to your new adult care provider. This should include your health history, current health situation and treatments or medicines, and future health goals. Be sure to get a copy of that summary too.
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In addition to the medical summary letter, have your past provider send your full medical records to your new provider. Ask for a copy for yourself too.
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Keep all of the paperwork (test results, bills, etc.) from your new provider in one place. This may be in a folder. Or you can store them electronically.
How often will I need to see an adult healthcare provider?
In general, you should schedule a well visit with your adult care provider once a year. But everyone’s personal health needs are different. Talk with the provider to discuss when and how often you should be seen.
When you're an adult: Health insurance coverage and Medicaid
As a teen, you may be on your parents’ health insurance plan. Or you may be getting health benefits through Medicaid. This is a federal and state government program. It helps people who meet certain income and disability requirements. Here’s what you should know about health coverage as an adult:
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Health insurance. Under the Affordable Care Act, you can stay on your parents’ health insurance until age 26. This is the case even if you are living on your own or married.
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Medicaid. If you’re under 18 and have health coverage through Medicaid for children or the Children’s Health Insurance Program (CHIP), you may qualify for adult Medicaid. Learn more about coverage and how to contact your state Medicaid office at www.Medicaid.gov.
To learn more
Contact the national group for your health condition or disability. They may have a local chapter in your area. Or they may have an online support group. Also try these resources: