Most of us may not be aware of the fact that when our child turns 18, much of his/her medical information becomes private and you as parents cannot access it without their permission. Yes, that comes as a surprise to many, certainly did to me and my wife when we had a very similar situation.
This is due to the HIPAA laws that were established back in 90s, during the Bill Clinton Presidency and of course are followed by all the medical facilities since then. So, if a day after your child’s 18th birthday you get into their Doctor’s office and suggest that you would like to discuss whatever ailment you child is suffering through, they would politely but firmly decline to discuss without the proper authority from the patient, your child. Imagine that. The anger and the irritation the parents go through when they hear this is understandable but the law is for the Doctors and other medical professionals and it is best just to know it and follow it. Ironically the parents still could have the student child on their health insurance plan but will not be privy to the healthcare information.
WHAT IS HIPAA
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that required the creation of national standards to protect sensitive patient health information from being disclosed without the patient’s consent or knowledge. There are four generally accepted different purposes of HIPAA as given below out of which we as parents of an 18-year old get affected by the first and the fourth bullets. So, the Doctors or their office are absolutely right in declining our request if our child, still a child to us, is over 18; notwithstanding the fact that it still comes as shock.
- Assure health insurance portability by eliminating job-lock due to pre-existing medical conditions.
- Reduce healthcare fraud and abuse.
- Enforce standards for health information.
- Guarantee security and privacy of health information.
Unfortunately, in our democratic world the age for different actions or activities is different. For example, if somebody wants to babysit, the minimum age for that is 12 (also depends upon the State and the maturity of the child), for learning to drive a vehicle it is 16, for being able to vote and serve in the Armed forces it is 18, for drinking alcoholic beverages it is anywhere between 18 and 21, same for getting married without parent approval is 16 or 18 depending on the State. If you wish to work it is 16 or 18. But for learning to fire a gun and carrying a gun it is different again. For HIPAA it is 18. After that age, our children are considered to be legal adults. Would you believe, at that point your responsibility as a parent ends (not sure if we should be rejoicing or repenting and be fearful). Unfortunately, it also means (and you may have surmised this by now) that at that point your legal authority as a parent ends (at age 18). This means no legal authority to conduct financial transactions on their behalf (unless given authority via a POA), no legal authority to make healthcare decisions on their behalf and no legal authority for healthcare providers to share healthcare information with you, the parents.
It is sad that, if we are not careful or that nobody has made us aware of this new situation, we run into such scenario only at the worst time when we are generally put in a sort of a panic mode. It is clear that some advance preparation is necessary. It makes it even worse if the child (adult now) is not near by and not much can be done via modern communication, short of literally going/flying there.
Just before or just after the child crosses 18, here are the three documents that need to be created by the child or for the child so that someone else also will have the authority to deal with unforeseen circumstances.
A durable Power of Attorney to legally document who is authorized to conduct legal and financial transactions on your young adult child’s behalf.
A HIPAA Authorization that tells healthcare providers with whom they may share medical information.
A Healthcare Power of Attorney to legally document who is authorized to make healthcare decisions on your young adult child’s behalf if you child is incapacitated and unable to make their own healthcare decisions.
I may add that all three documents are equally important and should be done as a package. Granted it would cost some money if you need an Attorney’s help but considering the headache, agony and physical upheaval you would go through in the absence of proper authority bestowed upon you (via this package), it is worth it. A person at 18 may have legal right given by the Law but it may be few more years yet before the proper maturity can be established and displayed during which your assistance and guidance may be needed and valuable.
Another common scene for students is starting college in an out of State institution. In that case just make sure that the package you have created, duly signed by your child, also covers the rules of that State. I have noticed that, at least in North Carolina, many Hospitals have their own HIPAA and Health POA forms and occasionally they insist on filling their own forms. If your package is handy with you, you can handover a copy of yours because by NC State’s laws, there are common forms for both that can be used across the State and your Attorney is generally cognizant of that fact.