Parenting Grown Children: What Dr. Spock Forgot to Tell Us

Health Coverage for Grown Kids: The limits on what you can know about their health issues

(Photo credit: Wikipedia)

       

            One of the breakthroughs of Obamacare is our ability to put our college- and post-college-age kids on our health insurance. No more hunting down an affordable individual policy for them that will see them through a medical emergency. Once you've got them covered under your coverage, they can stay insured until they're 26--even if they get married

 

So far, so good. But a friend pointed out a little flaw in that coverage. You may get the paperwork and a bill for a visit your 20-year-old paid to a doctor but you may have no idea what health issue your son or daughter was addressing. Your grown child may have been to see an orthopedist, family doctor, Ob/GYN or psychiatrist. You may be worried about what the visit was all about, but short of directly asking your progeny 'wassup?', you can't find out.

 

Under the health privacy rules of HIPAA, you would need their signed authorization for the doctor to hand over any information.

 

Maybe that's as it should be. But there's a crucial reason to have that authorization in hand. If your son or daughter has a medical emergency that lands them in an emergency room, you can't get information from the nurses or doctors on the case.They are not permitted to disclose details to parents about the medical condition of a child who's older than 18. Or as one attorney put it, “Once a child turns 18, the child is legally a stranger to you.” That is, you have no more right to that information than you would to details about the treatment or condition of a stranger--even though you're paying the tab.

The way around the issue is to have grown children sign a HIPAA authorization form. It allows health care providers to disclose a person's health information to anyone specified in the form. Your child can also stipulate that certain information is out of bounds. So they can still keep you from learning about medical issues that touch on sex, drugs and other personal stuff. But you'll be in a position to be there for them in a real emergency.

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Emerging Adults: Navigating the financial minefield of earning a paycheck

They're launched. They've finished college and are ready to set out into the world. We've brought them up to be independent, thoughtful individuals, of course. But they still may be babes in the woods when it comes to making the day-today financial decisions they face in their first few post-college years. Sometimes it helps to have words of advice come from a third party--as opposed to the doting parents themselves.

There's a book out there that covers some of the issues: Generation Earn: The Young Professional's Guide to Spending, Investing, and Giving Back by Kimberly Palmer. Here are five paraphrased tips on what young adults should do as their paychecks start flowing in:

1. Build your credit history slowly and steadily by opening up accounts in your own name and paying them off on time.

2. Instead of using the first paycheck to make upgrade the lifestyle--new 60-inch TV, new sofa--spread out purchases over time and start with necessities, like a bed.

3. Start saving at least one-quarterof income for future goals, including retirement. The first priority is to establish an emergency savings accoung with at least three months' worth of expenses . If the employer offers any type of 401k matching program, take advantage of it—passing it up is like saying no to a pay increase. Then open an after-tax savings account for other goals, from traveling to homeownership.

4. Even in this economy, employers expect some haggling over salary and benefits. A simple request after expressing enthusiasm and appreciation for the job offer can lead to hundreds of thousands of dollars more in lifetime earnings or better benefits.

5. There's no avoiding the fact that being an adult comes with some secretarial duties. Suddenly, there are pay stubs, health insurance forms, tax documents, and credit card statements to keep organized. Take advantage of modern technology by going paperless whenever possible. Online accounts are easier to manage; websites such as shoeboxed.com keep receipts organized online, which is especially helpful at tax time. Mint.com makes it easy to track spending and establish a budget.

Setting a Deadline: When grown children move back home, how long should they stay?

When her son's business crashed, Sheri invited him and his family--wife, two toddler-aged children--to put it all behind them . She encouraged them to move across the country and into her house until they got back on their feet. Two and a half years ago, they accepted the invitation. They're still living with Sheri.

"Friends asked me if I put a deadline on it," Sheri says. "Did I tell them they had a few months or a year or something like that?"

She did not. "If it had been just my son or just my son and daughter-in-law, I might have put a time limit on it. But when there are two children, it's different." Besides, it is not as though they wanted to prolong the stay. As Sheri puts it, "I have sympathy for my daughter-in-law.  Who at 33 wants to come live with your mother-in-law? I have been cognizant of that."

And then there was Sheri's past history: "My first husband passed away when I was 35 and I had three  children. My parents and my sister were there for me. My mother never said, "We can’t always help you." So there's a unique bond because of what happened. I'm giving  back to my son the way my mother gave to me."

Even if there were no emotional reasons, hard economic times make it trickier to set a deadline. And certainly, Sheri's son and daughter-in-law faced harsh times, moving as they did from the fire of Florida into the frying pan of California--two states that have suffered inordinately from the economic downturn. Besides, Sheri wanted her son to not just get a job but a career-line job. "I told him to take time to get his feet on the ground," she says. "You can't put a time limit on that."

In a few months, the family of four will be moving to a rented house an hour's drive from Sheri's. Both adults now have good jobs. Although there were difficult times and Sheri is looking forward to having her house, her husband and her life to herself again, she is not sorry she did it. Friends badgered her about not setting a time limit, but she doesn't see why she should have. Yes, it was hard. Yes, it was uncomfortable. But she had a goal in mind--not just employment but good employment--for her son and her daughter-in-law. And she was fortunate enough to have the means to afford the luxury of time it took for her son to get back on his feet. She can count the 2 1/2 years but she has never toted up the cost of the gift in terms of money. Do her other children? That's another issue.

Money Matters: Who pays for what when the kids move back home

When Shari's son, daughter-in-law and two children moved into her house, they had, financially speaking, nothing. The cookie business they started together had failed--despite infusions of money from the family. So when Shari and her husband Hal opened their home as a refuge--"a lifeline" she calls it--money was an issue. "We could have subsidized their rent," Shari says of the decision to have the family move in with her, "but their needs were so far above and beyond that. They needed food, medical insurance, car insurance, clothes--the works." Shari and Hal were fortunate to have the wherewithal to pick up the tab for the big things, but what to do about "walking around money" while the son and daughter-in-law were job hunting?

At first, the four adults held Sunday night meetings: to go over any unmet needs or frustrations; to keep Shari and Hal up to date on job interviews and other employment prospects. Once it became clear what some of the day-to-day cash needs were, Hal came up with a plan. Every Monday morning they would leave Shari's son a check that was big enough to cover lunches, car fare, outings with the kids, other incidentals for both the son and his wife. That way, the younger couple wouldn't have to ask every time they needed something. This was important to Shari: "Money can be very divisive," she says. "It can be a wedge." She didn't want her son to feel demeaned by his circumstances, that he had to ask his Mommy for money to meet a friend for lunch or take his kids to the movies. And there was this: she didn't want either her son or daughter-in-law to rush into a job that wasn't on a career path.

It helps when you can afford to be as generous as Shari and Hal were. But the important point, to me, was not so much how much they could give and how many bills they could cover, but the open way they communicated. Talking things out--being up front about even the most personal money issues--can ease a tricky financial situation. And for Shari, setting a clear goal--jobs for her children that were on a career path--helped her formulate a plan she could live with and not resent.

Health Coverage: Even if they're married, you can help.

Maybe it's because it was such a sore point for paterfamilias and me: When our children graduated from college and set forth to various parts of the country to figure out what to do with their lives, neither of them figured they needed health insurance. Never thought about it. We, of course, did, and we had to scour plans in the states where they had wandered to find catastrophic coverage for them--to make sure that if something terrible happened, a doctor and hospital wherever they were would take them in and that we wouldn't be stripped of our assets when the bills came due.

I blogged about this a while ago. The big news then was that a few states were allowing parents to keep their grown kids on their health insurance policies until those kids were 25 or 26 years old. Now, it's easier. The health reform law that finally inched and sighed and crept through Congress and onto President Obama's desk this year has important provisions for parents of young adult children. Not only can we keep our adult children on our health insurance plan until those children are 26, we can keep them there even if the kids get married. However, if your child's employer decides to offer coverage, all bets are off--your child can no longer stay on your policy.

The other news? Some states are expanding that age-of-coverage to 30. Given the current employment picture--hard to find a job; growing trend toward contract work, which doesn't offer health coverage--that could be invaluable.

Money Matters: An Aussie take on what we can afford to give our adult kids

The economic retrenchment is, as we know, global. We aren't the only families having to pull back financially, and that includes support for our grown children--be it paying off a college debt or helping with the down payment on a house. A report out of Australia mirrors what many here are experiencing.
Evidently, the hard times down under are silencing the peal of wedding bells. Here are some highlights from a report by the St George Bank:

Generation Y expects parents to help pay for weddings, house deposits and education fees, but concerns over retirement and debt have taken priority for most mums and dads.

70 per cent of baby boomers believe the global financial crisis has seen their assets shrink in value, and 71 per cent are now concerned about their financial health. As a result, only 6 per cent of parents rate providing financial assistance to their adult offspring as a top priority.

Almost half of those parents with adult children said they were focused on saving, either for retirement (25 per cent) or other future expenses (24 per cent).

Another 41 per cent favored paying off debt, either their credit card (24 per cent) or mortgage (17 per cent), the survey showed.

Bottom line: “Circumstances have changed for many and it’s understandable that parents are now having to focus on their own needs and financial health,"a general manager of the bank said. “As a result, when it comes to paying for things like weddings, first home deposits, overseas travel and childcare, many Gen Ys must now stand on their own two feet.”

Money Matters: Health insurance for your grown kids is not an indulgence

Paterfamilias and I had dinner with friends the other night--friends whose oldest child is about to graduate from college. They are recovering from the $50,000 a year it's been costing them and looking forward to his independence, particularly his financial independence. He doesn't, of course, know exactly what he wants to do. He's hoping to take a year or two to figure it out.

That brought back a lot of memories for me and the pater. When our kids graduated from college--lickety-split, within one year of each other (talk about recovering from tuition stress)--our daughter headed out to the West Coast : She loved painting and wanted to be an artist. Our son went to New England: He wanted to see if he could make it as a writer. Both of them took part time jobs to support themselves--to pay their share of a shared room in a group house and their share of the spaghetti that they lived on. So they were independent--except that they did not put aside any of their earnings from part-time work for health insurance. Naturally not. What 22-year-old who has had nothing more than some sports-related injuries to deal with, thinks about health care coverage.

But we did. There they were, far from home and on their own. But what if something terrible happened to them--an illness that put them in the hospital or required high-priced specialist care. Naturally, we'd want to make sure they were in the best hospital for their problem and hire the best physicians we could find. There is nothing in life that we love or treasure more than our children. So we took out so-called catastrophic health insurance policies for them. I say for them--it was not something they were going to do. And we didn't see it as an indulgence. We weren't insuring them so much as our assets. A 10-day stay in a hospital and a few visits to a specialist could wipe out our savings.

Our friends at dinner hadn't had the chance to think this little "dependence" issue through yet. One thing that has changed in the past year or two is that several states have passed laws allowing parents to cover their adult children--most set limits at 26 years of ag but in Florida, it's 30.

Insurance for those young adults is something worth planning for. We'll all need our assets for the little luxuries of life for our children's children--when they finally arrive.