Maryland Healthcare Transition for Young Adults with Disabilities

The Transition Nobody Plans For

Families spend months coordinating DDA applications, DORS referrals, and SSI paperwork — and then discover, the week after school ends, that the student's pediatrician won't see patients over 21. Or that the psychiatrist who's managed their child's medication for eight years doesn't take adult Medicaid. Or that the specialist they've traveled to since kindergarten doesn't have a single adult counterpart in the same health system.

Healthcare transition gets overlooked because it doesn't have a single agency managing it. There's no CCS for healthcare, no waiver application with a deadline. It's on the family to find adult providers, transfer records, and ensure continuity of care — and if they wait until exit year, the options narrow fast.

When to Start

Begin identifying adult healthcare providers when the student is 17 or 18. This gives enough time to:

• Find providers who accept the student's insurance (Medicaid, private, or both)
• Schedule introductory appointments while the pediatric providers are still active
• Transfer medical records, including medication histories and specialist reports
• Train the student to communicate with new providers if they're able to self-advocate

Some pediatric practices will continue seeing patients until age 21, others cut off at 18. Ask each provider directly — don't assume the pediatric relationship continues through the school years.

The Medicaid Continuity Question

For students who qualify for SSI at age 18, families should also check Maryland Medicaid (Medical Assistance) eligibility. SSI and Medicaid are separate administrative tracks, and the route to coverage depends on the student's circumstances; confirm whether a separate Medicaid application is required.

The coverage is adult Medicaid, which has a different provider network than the children's program. Providers who accepted Maryland Medicaid for pediatric patients may not participate in the adult Medicaid panel. Verify coverage before the first appointment.

For students who earn above SSI limits but still need Medicaid for DDA waiver services, the Employed Individuals with Disabilities (EID) program may provide a pathway. Check current Maryland eligibility and premium rules before relying on it.

What to Transfer

Compile a comprehensive healthcare file before the transition:

• Medication list with dosages, prescribing provider, pharmacy, and medication history
• Specialist records — neurologist, psychiatrist, orthopedist, cardiologist, or whoever manages condition-specific care
• Immunization records (adult providers and employers may require them)
• Dental records — finding adult dentists who accept Medicaid and have experience with patients with disabilities is often the hardest placement
• Behavioral health records — therapy notes, behavioral assessments, crisis plans
• Signed release forms authorizing record transfers between pediatric and adult providers

If the student has a supported decision-making agreement or a healthcare power of attorney, bring copies to every new provider appointment. Adult providers won't discuss care with parents unless they have documented authority.

Finding Adult Providers

Maryland's disability service network can help identify providers:

The DDA Coordinator of Community Services may have referral lists for healthcare providers experienced with adults who have developmental disabilities. This is particularly useful for finding primary care physicians who understand the intersection of disability, medication management, and behavioral health.

DORS vocational rehabilitation counselors can help with employment planning and workplace supports.

The Maryland Department of Health maintains provider directories for Medicaid participants, searchable by specialty and location.

For dental care, the Maryland Dental Action Coalition and community health centers (FQHCs) are often the most accessible options for adults with disabilities on Medicaid.

Building the Student's Health Self-Advocacy

For students who can participate in their own healthcare decisions, the transition years are the time to build self-management skills:

• Understanding their medications — what each one does, what happens if they miss a dose, and when to call the doctor
• Recognizing and communicating symptoms
• Managing appointments — scheduling, transportation, and remembering to go
• Understanding their insurance card — what it covers, who to call, and how to refill prescriptions

These skills belong in the IEP transition plan under independent living goals. If the IEP team hasn't addressed healthcare self-management, request that it be added.

The Maryland IEP Transition to Adulthood Guide includes a healthcare transition checklist that tracks provider identification, record transfers, and Medicaid continuity alongside the DDA and DORS timelines — so the healthcare transition doesn't fall through the cracks while the family manages everything else.

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