Funding and Services From Age 18

When a child becomes a legal adult on the day they turn 18 years old, many of the services they receive will change, and how 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 and your child’s legal options for age 18 and beyond about their finances and health care decisions.
• Your child’s ability to get Supplemental Security Income benefits.
• Your child’s transition out of public education and career planning.

While there is a legal change at age 18, you can start early – even at birth – to plan and prepare your child for adulthood. We’ve put together a list of the changes in services to consider as your child goes through the 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 benefits give your child a monthly income if they can’t work or can only earn a very low amount of money in a job. If approved, your child can begin receiving SSI at 18 years old based only on their disability and income, not your family’s income.
• Medicaid offers health insurance and some dental benefits for your child based only on their income, 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 benefits for at least 24 months.

Waivers are other services 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, known by many parents as waiting lists. Even if you hope your child will never need those services, your child must be added to the interest list for any programs that can most 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 and the age 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) is for people ages 21 and older.

These waiver programs are for people of all ages:

• Community Living Assistance and Support Services (CLASS)
• Deaf-Blind with Multiple Disabilities (DBMD)
• Home and Community-Based Services (HCS) 
• Texas Home Living (TxHmL)

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

• Children’s Medicaid stops at age 18. If your child has STAR Kids, they can stay with that program through age 20. When they turn 21 years old, they will transition into STAR+PLUS. Contact your child’s service coordinator to help transition to Medicaid programs for adults.
• The Children’s Health Insurance Program stops at age 18.
• The Medically Dependent Children’s Program waiver stops at age 21.
• The Youth Empowerment Services waiver stops at age 19.
• The Children with Special Health Care Needs 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 may end. Your child can stay on your family plan until age 26 or much longer if they still depend on you financially and have a disability that meets the rules for getting SSI. Contact your health insurance company one year before your child turns 26 to see if the coverage can continue.
• Some pediatricians stop seeing children at age 18. Check with your pediatrician. And learn more on our page on transitioning to adult medical care for your child.

Career and School Planning

Some children who have been getting special education services can receive job training to help develop the skills they need to live independently. The school district can provide these services to your child through the end of the school year when they turn 22 years old. 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. 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, is receiving special education services and wants job training, they might also be able to get help from the Texas Workforce Commission. TWC offers job training programs and pays for some assistive technology for adults with disabilities and special health care needs. If your child says they want to work as an adult, TWC can send counselors to your child’s Admission, Review, and Dismissal meetings starting at age 14.

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 can 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 service.

There are still more 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 the day your child turns 18 years old.

You can also look into the Texas ABLE Program. It offers savings accounts for people whose disability or special health care needs began before age 26. An ABLE Account can help support your child’s independence, health and quality of life.

Adulthood and Legal Options

When your child is 17 years old or 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 plays an active role in their life choices, you are legally responsible for the final decisions.

The day your child turns 18 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. Or you have legal documents in place.

There are ways to share decision-making with your child or stay legally in charge of certain decisions for them. If you feel that your child can’t manage adult decisions on their own, there are 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 the day your child turns 18, you can begin getting ready even years earlier.