Young Adults and the Healthcare System

Not long ago, I was chatting with a special teenager in my life. As we talked, he asked, “What do you do for work?” I knew he had medical issues that required some specialist care, and so I said that I help people to talk with their doctor.

I was shocked when he recounted how much he liked his new doctor, “because she really listened.” (Unlike a previous specialist he had been seeing for the same condition.) He also said that the doctor asked a lot of questions and gave him some homework, including keeping a simple journal to track his symptoms for future discussion.

Overall, he said she had helped him understand what was going on with his body and that when he left the office, he felt like they had a plan to tackle some of what he was experiencing. This was music to my ears! After all, isn’t that what we all want when we visit our physicians?

But it made me wonder how many parents actually teach their children how to create productive, two-way relationships with their physicians. Most of the parents I know have told me about reaching a stage in life when their children go in to see the pediatrician alone — to afford some privacy. But I never hear any of them talk about preparing their kids for what to say when they get in there!

Here is what I recommend. Tell your young adult kids that…

… a relationship with a physician is a two-way street

… their job is to think beforehand about what they want to discuss, and to describe what is going on with their body, since they know it best

… the physician’s job is to listen to what they have to say; if the physician is not listening, it’s okay to ask that they do

… the end of a visit is a time to create an action plan together, and to decide when the next visit will be

(And yes, in case you’re wondering, these same guidelines apply to older adults and their physicians as well!)

Planning for College

In one my many previous professional lives, I was the Director of Managed Care for an insurance company that provided health insurance to college students. In that role, I worked closely with student health centers to offer insurance products that wrapped around the primary care offered through the center.

Our student members had to access health center services first, and then use their insurance if an emergency happened or a referral was needed to a specialist outside of the center. Students that did not have our insurance would use their parents’ plans, a situation that often became complicated if there were regional, in-network restrictions.

One topic that frequently came as a surprise to both students and parents was that if the student was over age 18, and became ill or sought care, the student had to grant permission before information could be shared with their parents. As you can imagine, this could create problems in an emergency situation in which the student was unable to communicate.

With all this in mind, here are some things young adults need to think about and understand in the context of college and healthcare:

• What services are available at the student health center and what do you need to do to access that care?
• Does the health insurance offered by the college or university require you to first see a provider at the student health center, or are you on your parents’ plan? If it’s the latter, does their coverage extend to your new location?
• Is there a Patient Portal associated with the student health center? If so, go ahead and enroll in it so that health information is more readily accessible, and communication can be streamlined.
• If you need specialist care, what are the requirements? For example, do you need a referral and/or do you need to stay within a defined network of providers to have any coverage?
• Have you signed a HIPAA Release Form? Parents should keep copies of these for emailing/faxing, in order to stay informed as necessary.

Insurance After Age 26

As you may know, once a young adult turns 26, they can no longer stay on their parents’ health insurance plan— they need to get one of their own. This is an opportunity for the young adult to become directly engaged in how our complex healthcare / health insurance systems work, and to pay attention to something they may have previously taken for granted.

But when I insist that the young adult participate in our work together, I often hear things like:

I’m healthy, I don’t need insurance!

Do I really need to spend money on this when I have other things I need?

I’ll just go to an emergency room if I need something!

As we talk further, I end up explaining the following:

The status of their health and any conditions that require management, along with preventive care required to keep them healthy, directly relates to their coverage

How insurance coverage mitigates risk against large, unanticipated healthcare-related costs that can leave them in debt

How an out-of-pocket maximum included on a healthcare insurance product can protect them and their parents

That the Affordable Care Act may help them to enroll in a plan that has adequate coverage for their individual circumstance and may not cost much at all

How health insurance may be a valuable “employee benefit” of a current or future job and how employer-sponsored coverage works

How health insurance must be considered if one plans to start a family

Summary

Whatever your age, it’s important to understand how our equally complex healthcare and health insurance systems operate together. Developing relationships with our providers and our insurers is critical to navigating these well.

The earlier in life one learns such skills, the more informed and satisfied you will be!