How to Make the Transition from Pediatric to Adult Health Care

Making transitions is part of being a pediatric cancer patient.

Diagnosis to treatment. Treatment to follow-up care. Follow-up visits to long-term survivor care.

Moving from pediatric to adult health care is one of the most important transitions. It marks the time when patients take responsibility for their medical well-being.

When to make transition to adult health care

The American Academy of Pediatrics advises that parents and patients plan for this transition when the patient is between ages 14 and 18.

After therapy is over, patients who are younger than 18 will likely get regular medical care from their pediatrician in their home community.

But around the age of 18, patients should begin seeing a provider for adults, usually a family medicine or internal medicine doctor. Family medicine doctors may see patients from infants to adults. Internal medicine doctors treat adults. Many women also choose to see a gynecologist.

Childhood cancer survivors may also need to seek the care of specialists in their community such as an endocrinologist or cardiologist.

How to make the transition

Parents and the pediatric care team can help teens and young adults prepare to manage their medical care. For example, patients need to know how to:

• Make an appointment
• Get a prescription filled
• Share a copy of their survivorship care plan when they visit providers
• Ask questions during an office visit
• Be their own health care advocate

Parents, patients, and the care team can:

• Assess the patient’s skills to manage their own health care and work on areas that need improvement.
• Review the survivorship care plan and make sure patients are familiar with their medical history. Some patients may not remember being treated for cancer especially if they were very young when they were diagnosed.
• Discuss changes in privacy and consent that happen at age 18.
• Help prepare a plan that include a list of providers, types of follow-up visits needed, and how to pay for health care.
• Help patients make a plan for who will make health care decisions if they become injured or sick and are not able to make their own decisions. This is called an advance directive.

The goal is to have this transition happen sometime between age 18 and the early 20s.

How to identify and pay for care providers in the community

Patients will first need to determine how they will pay for care. That will have a large influence on the providers they select.

• Young adults whose parents have health care may be covered under their parent’s plan until they turn 26.
• Patients are encouraged to find employment with a company that provides health insurance.
• If not, they may need to consider the Medicaid program in their state. Patients who have a disability may qualify for Medicare.
• Patients are strongly encouraged to consider how they will pay for prescription medications. Medicines are often covered partially by insurance. Needymeds.org is also a good resource for information.

Patients may also want to ask their pediatric cancer care team for referrals to providers in their community.