Your Child Turns 18, and You Legally Lose Authority

In less than a week, we loaded up and moved our daughter to college. Ninety miles away. Not far, really.

The drive was the easy part.

The bigger move had already happened a few weeks earlier, on her birthday. She turned eighteen. And with that, the law stopped seeing my wife and me as the people in charge of her medical decisions. Not partially. Not gradually. All at once.

I am an attorney. I have this conversation with clients all the time. I still got caught.

Here is what most parents do not know until it matters. Right up until the day your child turns eighteen, you can talk to a doctor about their treatments, conditions, and medications. The moment that eighteenth birthday happens, you are legally no longer the decision-maker. That is the default. Not a judgment of your parenting. Just how the law works.

I saw it happen inside my own house. During the first part of the year, my wife or I had to sign off on procedures and travel vaccines for our daughter. Immediately after her birthday, legally, we’re not part of the conversation without her permission. Even when I was being asked to cover costs for medical expenses.

Most of the time, that is fine. Healthy adults handle their own appointments. They sign their own forms.

The problem is the day that is not fine. The emergency. The accident. The call from a school three states away.

Here is what most parents do not know until it matters: medical decisions when your child turns 18 are no longer yours to make.

Three walls go up the day they turn 18

When it comes to medical decisions, turning 18 means three walls go up at once: information, decision-making, and authority to act.

The first wall is information.

The second is decision-making.

The third is authority to act.

HIPAA: No Access to Medical Information

If you have done something with a doctor, urgent care, or hospital since the early 2000s, you have dealt with HIPAA. It is one of the forms you complete during check-in/admission. HIPAA is the Federal law that requires a medical provider to disclose how they will hold and share your medical information with other parties, like labs, clinics, or your insurance company. When you child is a minor, you had a “waiver” as a parent.

After eighteen, that waiver expires.

I have talked to many parents who received a request to pay a medical bill for their child who is away at college. When they called the provider to clarify what the bill was for, the provider said that they could not discuss that information without prior authorization. The provider has no problem billing the parent or taking their credit card number to pay, even though the provider wouldn’t explain what they were paying for.

Even if you child is not away at college, it is helpful for parents to have their child provide a HIPAA waiver. Many children remain on their parent’s insurance coverage well beyond the age of 18. Again, the providers have no issue billing you, even if they won’t explain the charges.

The fix it pretty simple. However, it requires a proactive execution of a document by your child.

Healthcare Decisions: you cannot make a decision

HIPAA is about information. The Appointment of a Healthcare Representative is about decisions.

In Indiana, a person has exclusive for authority for their own healthcare decisions as long as the person has the capacity to speak for his/herself. That is the law. The Appointed Healthcare Representative is turned to only when the person cannot speack for themself. That maybe if the person is unconscious or incoherent.

Without a document that clearly appoints a Healthcare Representative, Indiana’s default plan is not ideal. Indiana statute names a group of relatives – parents, grandparents, adult children, and siblings – and gives them an equal vote. A democratic process for an emergency medical decision is not an effective answer. Many physicians will not go with the “majority” of the group.

If the group cannot agree, the family may have to pursue a guardianship appointment via a court. That takes time. It costs money. It does not get to the solution quickly.

A Healthcare Representative Appointment simplifies the process in the event of an emergency situation. It directs the hospital exactly who to turn to.

One note that surprises people: the Healthcare Representative Appointment is a decision document, not an information document. It does not automatically release HIPAA on its own. A properly drafted document allows both: HIPAA lets you ask. The Healthcare Representative Appointment lets you answer.

FERPA – The HIPAA for Education Information

It is possible that your child could leave school, not tell you, and you have no right receive information from the school. Is your child taking one class? Did he transfer to major in underwater basket-weaving without telling you, but you are still paying the bill? FERPA (The Family Educational Rights and Privacy Act) transfers all rights to such knowledge to your child when he turns 18. A FERPA waiver gives parents certain rights with respect to their children’s education records. These rights transfer to the student when he or she reaches the age of 18 or attends a school beyon d the high school level. Students to whom the rights have transferred are “eligible students.” (U.S. Department of Education Website). This would be especially important if you are still “signing checks” for school. It might be a little less necessary if your child is paying her own way.

Also, legally, it would be the only way for you as the parent to complete the FAFSA form. The form is structured for your child to complete it. However, most of know there’s only one way that is completed – by us.

Financial Information – “But My Name is On Her Account”

Another surprise for me was at our bank. As my daughter and I met with a branch manager as she prepared to go on an overseas trip. In the middle of the conversation, the manager raised her hand to cut me off and say, “How old is your daughter?”

Me: “18..”

Manager: “Your daughter needs to answer these questions as she is the owner on the account.”

My short-lived protest: “My name’s on the account too.”

The manager pointed out that when she turned 18, that “custodial account” became my daughter’s account, alone, and therefore the information about the account and access to that account was exclusively hers.

The mistakes I see parents make

The first mistake is finding a form online and hoping it works. The forms matter, but they have to match Indiana law, and they have to be executed correctly. I have seen families show up at a hospital with a form the admission staff had seen before. That is not the moment to learn the form did not hold.

The second mistake is assuming the Healthcare Appointment covers information. It does not. You need the HIPAA authorization alongside it, or the phone call still ends at “I am sorry, we cannot discuss that.”

The third mistake is waiting for the right time. The right time is now, while nothing is happening. These documents are insurance. They sit in a drawer. They only get pulled out on a bad day. The goal is to never need them.

What to do next

Sit down with your adult child, ideally before they leave for school or move for work. Have the conversation about who they want speaking for them and knowing about their care.

This is not about control. It is about backup. Your eighteen-year-old is not signing away independence. They are picking the person they want in their corner if they ever cannot speak for themselves.

At CCSK Law, we’ve simplified the process for parents and children. We have created one document to address all of these needs. The process can be completed in a phone call. We explain the document, discuss who the back-up decision-maker(s) will be, and prep the document for execution.

The now young adult signs the document before a notary public. That can be done in person or “virtually,” using a remote notary service.

Eighteen is a big number. The law is going to treat it like an adult, whether you are ready or not. A few hours of paperwork before the move is what turns that number from a worry into a box that is already checked.