Children and Youth with Special Health Care Needs Transitions to Adult Coverage

Chapter 5 contains recommendations to ease the transition to adult Medicaid coverage for children and youth with special health care needs (CYSHCN). Medicaid-covered CYSHCN often navigate multiple, sometimes overlapping, transitions as they reach adulthood. In addition to transitioning from child to adult Medicaid eligibility, they may simultaneously undergo the Supplemental Security Income (SSI) age-18 redetermination and transition from child-only to adult 1915(c) home- and community-based waivers. Key challenges with the transition to adult Medicaid coverage include insufficient time to prepare and respond to Medicaid redetermination notices, lack of clarity about changes to SSI and how it affects Medicaid eligibility, and inconsistent support with the Medicaid redetermination and other simultaneous transitions.