Takeaways

• When a child turns 18, parents no longer have automatic access to the child's medical records or financial accounts.
• Powers of attorney and HIPAA authorization forms can help parents assist in an emergency.
• These documents should be completed before the student leaves for college, with state-specific requirements in mind.

When your child turns 18, something changes that most families don't anticipate: you lose automatic access to the child's medical records and the ability to make financial or medical decisions on the child's behalf. No matter how much college tuition you're paying or how closely you manage your child's day-to-day life, your child is now a legal adult, and federal law treats him or her as one.

For families with college-bound students, this shift can have real consequences. If your 18-year-old is hospitalized far from home and can't speak for himself or herself, your child's doctor cannot legally discuss his or her condition with you without prior authorization. If a financial emergency arises and your child is incapacitated, you may not be able to act on his or her accounts.

Before your new adult child heads to off to college, have him or her sign three documents:

• a financial power of attorney,
• a medical power of attorney, and
• a HIPAA authorization form.

Together, these cover the legal bases most families don't think about until they need them.

What Is a Financial Power of Attorney?

A financial power of attorney (POA) is a legal document (not a person!) in which one person, the “principal,” gives another person, the “agent” or “attorney-in-fact,” the authority to handle financial matters on the principal's behalf. For a college student, this typically means authorizing a parent (or other trusted family member) to manage bank accounts, pay bills, handle tax matters, deal with landlords or financial aid offices, or take other financial actions if the student is unable to.

A durable financial POA remains in effect even if the principal becomes incapacitated, which is the scenario most families want to prepare for. Without one, parents have no legal authority to act on a child's financial accounts, even in an emergency.

Situations Where This Can Matter

• Your student is in an accident and hospitalized for weeks. Bills, rent, and financial aid paperwork still need to be managed.
• A banking error freezes your child's account while he or she is abroad on a study trip. You need to resolve it without your child being present.
• Your child needs someone to file tax returns or sign documents during a medical or mental health crisis.

A well-drafted financial POA can be broad or narrow in scope. Some families prefer to authorize only specific actions, while others give more general authority. An estate planning attorney can help tailor the document to the family's needs and comfort level.

What Is a Medical Power of Attorney?

A medical power of attorney, also called a health care proxy or health care power of attorney, allows an individual (the "principal") to designate someone ("health care agent" or "health care proxy") to make medical decisions for the principal if the principal becomes unable to do so. (This is different from a living will, which states specific end-of-life wishes.) A medical POA can be used to appoint a trusted person to make judgment calls across a range of medical situations.

For a college student who might be living hours from home, this document can be critical. If the child is seriously injured, unconscious, or otherwise unable to communicate his or her wishes, a medical POA ensures that a parent or other trusted adult can speak with doctors, consent to treatment, and make decisions in real time.

Without a Medical POA

• Doctors cannot legally consult with you about treatment decisions.
• Hospital staff may not be able to share information about your child's condition or prognosis.
• Decisions about surgery, medication, or other care may be delayed while legal authority is sorted out.

Most states have specific (optional) forms for health care proxies or medical POAs. Some states combine medical and financial powers of attorney into a single document. Requirements for signing and witnessing these documents vary by state, so it's worth using a state-specific form or consulting a local attorney.

What Is a HIPAA Authorization Form?

The Health Insurance Portability and Accountability Act, or HIPAA, sets strict rules about who can access a patient's medical information. Once a person turns 18, his or her medical records become private; even the individual's parents cannot access them. A HIPAA authorization form is a signed document that allows a health care provider to share medical information with specified individuals.

Unlike a medical POA, a HIPAA authorization doesn't grant the ability to make decisions; it simply opens the door to communication. But that communication can be crucial. Parents who receive a call that their college student has been taken to the emergency room often find themselves in the dark as to what is happening.

A HIPAA form can be as general or as specific as the student wishes. It might authorize a parent to receive any and all health information, or it might be limited to emergencies. Students should discuss their preferences openly with their families.

Important Distinctions

• A HIPAA authorization is separate from, and works alongside, a medical POA.
• Even if a parent holds a medical POA, providers may still require a separate HIPAA authorization before sharing certain information.
• Many hospitals and doctor's offices have their own HIPAA release forms; your student may want to complete one for their campus health center as well.

When Should These Documents Be Signed?

Ideally, a student should sign these documents before leaving for college. A quiet weekend at home, before the chaos of move-in day, is a natural time to review these documents as a family. Some families address this the summer after a student turns 18 or before the first semester of college begins.

For students who are already away at school, it's not too late. These documents can be signed at any time the student has legal capacity to do so.

Students who want to study abroad should consider completing these documents before departure. Legal situations in foreign countries may be more complicated, and having existing authorizations in place can simplify matters.

A Note on State Laws and Legal Advice

Since powers of attorney are governed by state law, requirements vary. A document valid in one state might not be recognized in another, though many states have provisions for recognizing out-of-state documents.

HIPAA is federal law, so a HIPAA form signed in one state should be recognized in all other states. However, some states have stricter privacy laws, so your student may need to sign an additional HIPAA form for the state where they will be attending college.

Some estate planning attorneys prepare these documents as part of a basic “young adult” package. Some legal aid organizations offer low-cost or free services for this purpose. Banks, hospitals, and campus legal services offices may be able to provide guidance or referrals.

The Bottom Line

Turning 18 is a milestone worth celebrating, but it comes with legal boundaries that most families don't anticipate until they run into them. A financial power of attorney, a medical power of attorney, and a HIPAA authorization form are not grim or overly cautious documents. They are straightforward tools that ensure a parent can step in and help when their adult child needs it most.

Setting aside time to get these documents in place when a child turns 18 is one of the most practical things a family can do.