Funding and Services

When a child who has a disability or special health care needs becomes a legal adult on their 18th birthday, many of the services they receive will change. And the way that they get help paying for those services will change too.

Some of those changes are with:

• Waivers and health insurance coverage and programs.
• Your child’s primary doctor and medical team for their medical transition.
• Your legal options for age 18 and beyond over your child’s finances and health care decisions.
• Your child’s ability to get Supplemental Security Income (SSI) benefits.
• Your child’s transition out of public education and career planning.

Even if there is a legal change at 18, you can start early – even at birth – to plan and prepare your child for adulthood. To help you, we’ve put together a list of the changes in services to consider as your child goes through transition.

Waivers and Health Insurance Programs

Here are some programs that your child might get as an adult if they meet all the rules and are approved:

• Supplemental Security Income (SSI) benefits give your child a monthly income if they are not able to work or can only earn a very low amount. Your child can begin receiving SSI at 18 years old based only on their (not your family’s) income and disability.
• Medicaid offers health and dental insurance for your child based only on their (not your family’s) income starting at 18 years old.
• Your child may be able to get Medicare when they are 18 years or older if they have been receiving Social Security Disability Insurance (SSDI) benefits for at least 24 months.

Waivers are another service your child might be able to get. These programs are all based on your child’s income, not the family’s income. Most of these programs have very long interest lists (many parents call them waiting lists). Even if you hope your child will never need those services, it is very important that your child be added to the interest list for any program(s) that are most able to meet their needs. You can always decline the services once your child moves to the top of the list, so sign up now. There is no minimum age for getting on an interest list.

Here is a list of waivers for adults, along with the age that your child could start using them. See our Waivers page to learn more about each program and how to sign up.

• The STAR+PLUS Home and Community-based Services (HCBS) (previously known as Community Based Alternatives or CBA) is for people age 21 and older.
• Community Living Assistance and Support Services (CLASS) is for people of all ages.
• Deaf Blind with Multiple Disabilities (DBMD) is for people of all ages.
• Home and Community Services (HCS) is for people of all ages.
• Texas Home Living (TxHmL) is for people of all ages.

Here are some programs that will end when your child becomes an adult.

• Children’s Medicaid stops at age 18.
• The Children’s Health Insurance Program (CHIP) stops at age 18.
• The Medically Dependent Children’s Program (MDCP) waiver stops at age 21.
• The Youth Empowerment Services (YES) waiver stops at age 19.
• The Children with Special Health Care Needs (CSHCN) program stops at age 21. However, if your child has cystic fibrosis, they can stay in the program until any age.
• Health insurance coverage through your employer-provided or private insurance plan. Your child can stay on your family plan until they turn 26, or much longer if they still depend on you financially and have a disability that meets the qualifications for receiving SSI.

Career and School Planning

Some children who have been receiving special education services can receive job training and help developing the skills they need to live independently from their school district through the school year when they turn 22. To get these services, your child has to have graduated without enough credits for a recommended diploma, and these training services have to be listed in their Individualized Education Program (IEP). These services are at no cost to the family. To learn more, see our Transitioning Out of Public Education page.

If your child is age 18 or older, receiving special education services, and wants job training, they might also be able to get help from the Texas Department of Assistive and Rehabilitation Services (DARS). DARS offers job training programs and pays for some assistive technology for adults with disabilities and special health care needs.

Changes in Finances

When your child turns 18 years old, most programs stop looking at your family’s income and only look at your child’s income, property, and savings to decide if your child is able to get services or benefits. Many federal and state programs set a limit of $2,000 in savings. If your child has more than that, they can’t get the services.

But, there are still ways to save for your child’s future. It is a good idea to look into creating a will and a special needs trust. These protect your child’s ability to receive and keep benefits. You can do this long before your child’s 18th birthday.

Adulthood and Legal Options

When your child is 17 years old and younger, and you take them to the doctor, bank, or school, the people there usually talk to you first about what’s happening with your child. Even when your child steps in to play an active role in their life choices, you are legally responsible for the final decisions.

Starting on your child’s 18th birthday, this changes. Your child becomes responsible for their own life choices, care, and actions. Legally, the school, bank, and doctors are all supposed to work directly with your child. They might still listen to you and consider what you have to say, but they can’t tell you anything unless your child says they can.

If you feel that your child is not able to manage these decisions on their own, you have legal tools to protect them. To find out more, see our Legal Options for Age 18 and Beyond page. Although many of these tools and protections don’t go into effect until your child’s 18th birthday, you can begin getting ready earlier, even when your child is 16 years old.