How to Make the Transition from Pediatric to Adult Health Care

What is a health care transition?

A health care transition is the process of moving from one health care provider or clinical setting to another. You may have several types of transitions during your health care journey. One of these is the transition from pediatric to adult health care.

When you were a child or adolescent, a parent or guardian likely handled your health care needs. As you transition to adulthood, you become responsible for your own health care needs.

If you have a chronic illness, the transition from pediatric to adult health care is very important. It is critical to plan so that you can be as healthy as possible throughout adulthood.

When to transition to adult health care

The American Academy of Pediatrics advises that caregivers and patients start planning for a transition to adult health care when the patient is 12–14 years old. The transition should begin between ages 14–18. The goal is to have this transition happen sometime between age 18 and the early 20s.

Around age 18, you should start seeing a health care provider for adults. This is usually a family medicine or internal medicine provider. Family medicine providers may see patients from infants to adults. Internal medicine providers treat adults. Many women also choose to see a gynecologist.

You may also need to seek the care of specialists in your community, such as an hematologist, endocrinologist, or cardiologist if you have specific health concerns.

How to prepare for the transition to adult health care

A move to adult health care requires careful preparation. If you plan ahead of time, the change will be easier to manage.

Review your medical history

• Talk with your care team to make sure that you understand your health condition, treatments, possible long-term and late effects of treatment, and health risk factors
• Get a copy of your medical records
• Keep a list of medicines you take

Practice skills to manage your health care

This includes learning how to:

• Make health care appointments
• Get a new prescription filled at a pharmacy
• Refill a prescription
• Explain your health history to new health care providers
• Share your care plan with new health care providers. If you are a cancer survivor, you should have a survivorship care plan that will help providers understand your long-term health care needs.
• Ask questions during office visits
• Speak up about your health needs and concerns

Find out how to choose health care providers and pay for care

You can ask your care team to suggest providers in your community. You will also need to know how you will pay for care. That will affect which providers you can select.

• If your parents have health insurance, you may be covered under their plan until you turn 26.
• If possible, find a job with a company that provides health insurance. If not, you may need to consider other sources of coverage, such as Medicaid.
• If you have a disability, you may qualify for Medicare.
• Consider how you will pay for prescription medications. Medicines are often covered in part by insurance.

Get help from your care team

Your pediatric care team can help as you make the transition to adult care. They can help by:

• Assessing skills and readiness to manage your own health care
• Discussing changes in privacy and consent that happen when you become a legal adult, usually at age 18
• Preparing a plan that includes a list of providers, types of follow-up visits needed, and how to pay for health care
• Helping you decide who will be allowed to have access to your medical records or who will make health care decisions if you become injured or sick and are not able to make your own decisions. This is called an advance directive.

Parents and family caregivers should reinforce these skills with their child. This helps to set them up for success.

Questions to ask your care team

• When should I start planning for the transition to adult health care?
• Do I need to see any specialists as an adult? If so, which ones?
  
• How do I explain my health history and care plan to new health care providers?
  
• How can my care team and family caregivers help me prepare for this transition?
  

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