Transitioning to Adult Care | For Patients

When you turn 18, you become a legal adult. Legally, this means that you are in charge of making all of the decisions in your life. Before you turn 18, it is your parent or guardian’s job to give permission for your treatment and to communicate with the care team. On your 18th birthday, this becomes your job.

As a legal adult, you will decide who will know about your medical situation. You can choose whether or not you would like to sign a release to continue to involve your parents.

What happens when I turn 18?

What Happens When I Turn 18? gives young adults information that they need about their responsibilities as legal adults. Learn about consenting, privacy/sharing information, assigning a health care proxy and more.

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Everyone, including adults, needs support during stressful times, particularly when it comes to medical care. Boston Children’s Hospital provides family-centered care, which means we do not want to exclude the important members of your care team, including your parents or caregivers.

If you wish to share medical information with someone, you can sign a release of information that describes what you want and do not want to share, and with whom you want to share it.

Another part of becoming a legal adult means choosing a person to be your health care proxy. A health care proxy is someone who makes medical decisions for you in the short term when you are unable to do so yourself.

Pediatric vs. adult care

Transfer of Care guide for Young Adults

Transfer of Care to Adult Providers

A guide for young adults

Transfer of Care to Adult Providers: A Guide for Young Adults provides guidance to patients as they navigate the transfer from pediatric to adult care providers.

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There are several differences between pediatric care and adult care:

Pediatric care

  • Pediatric hospitals often have many multi-disciplinary clinics. A single appointment might include visits by many specialists.
  • Pediatric specialists may provide care coordination without needing to involve the pediatrician.
  • Pediatric care follows a family-centric model.
  • Typical appointment lengths with your pediatrician are 30-45 minutes and typical appointment lengths with specialists are 45-60 minutes.

Adult care

  • In adult hospitals, it is more common to work with specialists individually.
  • Adult specialists typically make recommendations, but much of the coordination is done by the primary care physician.
  • Adult-care follows a problem-focused model.
  • Typical appointment lengths with your primary care physician are 15-20 minutes, and typical appointment lengths with your adult specialists are 30-45 minutes.
When transferring to adult care, you may see fewer specialty physicians, because your primary care physician can manage many chronic health conditions. This also means your primary care physician’s role is more important. As you partner with your primary care physician, you can speak up and advocate for yourself to coordinate your care needs.

Managing your own care

Begin by asking your pediatrician for recommendations for adult primary care physicians. You may also want to ask your insurance company for recommendations. If there is a national organization for your medical condition (e.g. Spina Bifida association, United Cerebral Palsy), contact them for recommendations.

For individuals with rarer medical conditions, it can be challenging to find adult specialists. It’s important to communicate with your pediatric specialists during the process and to start the process early. There may be a period of time where you see specialists in both pediatric and adult settings as part of a gradual transfer process.

There are several different types of primary care physicians:

  • Internists: doctors trained to take care of adults ages 18 and older
  • Family Medicine Physicians: doctors trained to take care of children and adults in which the practice is built around the family unit, instead of a specific population (children) or organ system (cardiology)
  • Med-Peds physicians: doctors trained to take care of both children and adults

Here are a few milestones to keep in mind:

  • 14 years old: Be present during your medical appointments. Start to learn about YOU!
  • 16 years old: Take your medication yourself (with supervision). Start bringing questions to your appointments.
  • 18 years old: You are a legal adult.
  • 26 years old: You will be kicked off your parent’s health insurance. Time to get your own!

A Young Adult's Guide to Health Insurance

Health Coverage and You: A Young Adult’s Guide to Health Insurance has information about things to consider related to starting out as an adult and navigating the insurance maze. It includes a helpful worksheet to help consider personal factors which might impact the choices.

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Your first appointment

Here are some questions to consider asking your new provider before you attend your first appointment:

  • How long are initial appointments? Follow up appointments?
  • Is the practice affiliated with any hospitals? Where does the physician have admitting privileges?
  • How does the provider communicate with other providers, such as electronic medical records, physician portal?
  • Does the practice have an online portal for communication and scheduling?
  • Are there evening, weekend, or same day urgent appointments available?
  • When the provider is unavailable, what are the backup coverage options?
  • Can the practice accommodate special needs, such as adjustable exam table, handicapped accessible bathroom?

What should you know about your first appointment?

  • Arrive at least 15 minutes early for your first appointment. You will have to fill out paperwork.
  • Bring your insurance card.
  • Bring your pharmacy card and a list or photos all of your prescription bottle labels.
  • Bring your phone or a calendar to schedule follow-up appointments.
  • Bring a portable medical summary.