The legal documents you may want once your child turns 18

Turning 18 is a big milestone. In most U.S. states, your child is now legally an adult. They can join the military, get married and vote. They can also make their own medical and financial decisions without needing parental approval.

This may be surprising to you. After all, you've been parenting your child for 18 years and it may feel like a big shift. To continue to be a supportive partner in their health care, consider having an honest conversation with your child during their senior year of high school. Explain why you’d like to stay involved in their medical care and what that might look like. Then, if you’re both on the same page, it can be a good idea to get some documents in order before their big birthday. 

Consider the following legal documents — and how you may be able to help talk to your child about them.

A Health Insurance Portability and Accountability Act (HIPAA) waiver

What it is

This may be a good document to have if you want to continue to stay in the loop about your child’s medical needs. Thanks to the HIPAA, most people don’t have to share their medical records or information. That includes most American children after they turn 18, even if they’re on your health plan. But if your child signs a waiver, medical providers will be allowed to give you that information.

What rights you'll have

The HIPAA waiver doesn’t give you the authority to make decisions for your child, says Elizabeth Newton, a lawyer in the trusts and estates group at Mirick O’Connell, a law firm with offices in Worcester and Boston, Massachusetts. But it does give you access to protected health information. That’s the legal term for things like medical records, including treatment and payment history, Newton explains. It also gives you the ability to talk about your child’s care with their doctor – and to call or email the provider.1

What to know

Your child will need to sign HIPAA waivers for all providers, including hospitals and clinics. But HIPAA also allows medical providers to use their best judgment when disclosing information, if they think it’s in your child’s best interest. So, for example, if your child ends up in the emergency room, the doctor can call you to let you know and give you updates, even without a waiver.2

How to talk to your child about it

Deborah M. Bain, R.N., owner and managing director of Prism Health Advocates, a health care advocacy company in Kent, Connecticut, suggests sitting down with your child before their 18th birthday. Something like the following can get the conversation going: “You’re going to be 18 soon. I want to make sure I can still provide the support, love and help you’ll need if you were to get sick or hurt. Do you feel comfortable letting me have access to your medical records and doctors? Would you like to talk with me and your doctor about this?”

You might also want to reassure your child that you won’t be stepping in or telling them what to do, adds Bain.

How to get it done

Most providers have forms in the office that can be printed and signed. If you want to have a conversation with your child and their doctor, schedule a telehealth visit or ask to speak to them during one of your child’s checkups, advises Bain. If your child is not sure, the provider can likely explain reasons why it might be a good idea for you to continue being involved in their care.

Health care proxy or medical power of attorney

What it is

These are different terms for the same legal document. A health care proxy gives you the power to make health decisions for your child. But it only comes into play if your child “either can’t make decisions for themselves or can’t communicate for themselves,” says Newton. “At that point, the doctors need to know who’s making the decisions,” she explains.

What rights you'll have

This is the type of legal power you’d want to have in a worst-case scenario. You would be the one to advocate for your child’s treatment and make any necessary decisions.3

What to know

The medical power of attorney/health care proxy is usually valid in other states, says Newton. It just has to be signed properly in your state of residence, she adds.

How to talk to your child about it

“Broach it as a very matter-of-fact housekeeping thing,” says Bain. Explain to your child: “If something happens, what are your wishes? How would you want me to best take care of you if you were unable to make decisions for yourself?” This shouldn’t be a brief 5-minute conversation, says Bain. “Make the time to have a thorough discussion. Consider including an attorney or doctor who can explain it to them.”

That’s what Newton does with her clients. After an initial conversation with the parents, Newton tells them that the child is the client. “I will want to meet with the child separately and alone. Not necessarily the entire meeting, but at least a couple of minutes to see that they’re comfortable signing these documents and that they understand what they are,” she explains.

How to get it done

You can download health care proxy documents online. But they may have to be signed in front of two witnesses and notarized. Most experts say it’s probably easiest to go to a lawyer for this.

The bottom line

Make the time for these important conversations. You’ve been caring for your child their whole life — it can be hard to imagine not being a partner in their health care. And your child, though a legal adult, may also be anxious about making medical decisions on their own. Together, you can work through this transition period and create a plan that helps make everyone feel comfortable and supported.

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