Becoming an adult

When teens become adults, they have new health care needs.  Finding and using adult health care will take a few steps.

Where to go for health care

• You will need to find a doctor who sees adults. Talk to your current doctor or your insurance company about doctors you can see. 
• If you are seeing any specialists they can help you find adult specialists. 
• Make sure any new doctors are in your insurance plan.  

Paying for health care 

It is important to always have health insurance to help pay for your healthcare needs. Make sure you understand your insurance.

• Healthcare insurance through your job: Your job may offer this. Ask your employer. 
• Healthcare insurance through your parents: You may be able to stay on your parents’ insurance for a time. 
  – If your parents’ insurance plan covers children, you may be able to stay on their plan until you turn 26 years old.
• Marketplace coverage (also known as Obamacare): Almost everyone can get a Marketplace plan.  Financial help is based on how much you earn. For more details call 1-800-318-2596.Medicaid (may be called BadgerCare): In Wisconsin, if your insurance is under your parents’ BadgerCare plan it will change when you turn 19 years old. You will need to apply for your own plan.  The BadgerCare plan is based on how much money you earn. To apply for Medicaid (BadgerCare) go to https://access.wisconsin.gov/ 

More resources for people with disabilities

Katie Beckett Waiver: If you have insurance through the Katie Beckett Waiver it will end when you turn 19 years old.  Apply for insurance through one of the Medicaid programs. You will get a letter about what to do next. 

Health benefits for workers with disabilities: Medical Assistance Purchase Plan (MAPP) allows people with disabilities who are working, or want to work, to get insurance through the Wisconsin Medicaid Program. You may have to pay for it.  It will depend on how much money you make.  Search ‘MAPP WI’ online for more information.  

Supplemental Security Income (SSI):  Persons with disabilities may be able to get SSI.  Apply or reapply in the month you turn 18 years old.  Do not do it any earlier or your parents’ income will be counted.  To start the process call Social Security Administration (SSA) at 1-800-772-1213.  You can also visit your local SSA office.  Ask your social worker if you need help.

Aging and Disability Resource Center (ADRC): Your local ADRC is the best place to find helpful resources.  They can help with adult services you might need like:

– Housing
– Transportation
– Medicare, Medicaid and Social Security

For information about your county’s ADRC, go to www.dhs.wisconsin.gov/adrc.  

Education, Training and Employment

If you have an Individualized Education Plan (IEP) or a 504 plan you can stay in school until you:

– earn enough credits to graduate or
– turn 21 years old.

Before you leave high school, talk to your vocation or transition coordinator at your school. They can help you make a plan for your future. Your local Department of Workforce Development (DWD) can also help. For information go to  https://dwd.wisconsin.gov/dvr/  

If you are getting Medicaid and also start to work, it is very important to find out how much you can earn and still keep your benefits. Talk with your assigned caseworker.

• Ticket to Work (Work Incentive Improvement Act) is a program for people with disabilities who work. It may let you keep your Medicaid benefits if you cannot get health insurance from your job.  You may have to pay for Medicaid.  For more information call 1-608-261-0050.

Decision-making 

Advanced Directives (Also called a living will or Power of Attorney): These are legal documents that you can use to say what should be done for your health if you are no longer able to make your own decisions. Talk to your doctor or a social worker for more information.   

Supported Decision Making: Sometimes you may need extra help to make important decisions. Family and friends can help you make decisions. For more information call the Children’s Hospital Family Resource Center at 414-266-3169.

Guardianship: For persons who are not able to make medical decisions for themselves, a parent or another adult will need to apply for guardianship. This is a legal process done in court. It is best if Guardianship is done by the age of 18 years old. It should be started at 17 years and 6 months old. To get help with this contact your local Aging and Disability Resource Center.