What to Know Before You Go
by Susan Sugerman, MD, MPH | Contributor
Senior year—I call it “the big lie.” It’s the “top of your game,” “easy street,” a time for “no worries.” From movies to social media, that last year of high school is portrayed as a time to relax and enjoy the fruits of your labor as you joyfully look toward embarking on your next adventure—college.
BUT IT’S TERRIFYING!!! You’re leaving everyone you know, everything you know, to live with people you don’t know in a place you’ve never lived before, doing things you’ve never done before. And guess what? Now, it really counts.
What’s a parent to do? We want so badly to make this a good experience for our child, but at this point there is much they have to do for themselves. Much like the Serenity Prayer, focus on the things you can do, and let go of the things you can’t. But in at least one area where it counts—your child’s health—there are things you can do in advance that will go a long way toward keeping your child healthy when they are out of your reach.
Most colleges and universities no longer require a pre-college health exam. Many simply want verification of immunization status. That doesn’t mean your child doesn’t need a full check-up prior to launch. The pre-college physical is a chance to make sure their immunization and health history information is up to date and to rule out any significant health problems before leaving for school. It is also an opportunity for their physician to review health concerns that may affect their success as a college student, including maintaining healthy sleep and nutrition patterns, smoking, drinking, drug use, eating disorders, sexual practices, and mental health concerns. Most importantly, this is a good time for your child to establish a different kind of relationship with his or her existing primary care physician, or perhaps transition to a new provider. Make sure your child has a list of all their medications, known allergies, significant family medical history, and current/prior health problems (even if they have resolved).
Do your homework and plan in advance
Check out the student health center; most student health centers provide high-quality, low-cost, primary health care; ask questions about after-hours care and what’s included in the school fees. If your child has a chronic medical or mental health condition, make sure to establish a team of providers ahead of the first day of class (or at least within the first few weeks). Even if your child’s condition is stable or resolved, recommend your child establish a relationship with a physician and/or therapist early in their college career, just in case something flares up with the stress of adapting to college life.
Know what you can’t know
After reaching 18 years of age, students may make their own medical decisions and sign their own medical consents (for physical or mental health matters). Parents may not be entitled to information about their children’s health. While this is often difficult for parents, it is helpful to understand that confidentiality is an important part of a student’s transition to adulthood and will help him or her to talk openly with healthcare providers.
Face the elephant in the room… health insurance
Students obtain health insurance in several ways: 1) Health insurance policies offered by the university, 2) Dependent-care coverage offered through their parents through age 26, or 3) Government policies for the disabled or medically indigent.
Regardless of how they obtain their insurance, make sure you and your child understand the following:
• Network: Does the coverage include the relevant geographic area?
• Deductible: How much do I have to pay before any coverage applies?
• Copay: How much do I pay per visit?
• Lifetime Maximum: Is there a limit? Are there limits on the numbers of visits or types of visits that are covered?
• Specific Coverage: Are there some types of conditions or services that are not covered (e.g. eating disorders, counseling)? Are club sport injuries covered? What about NCAA athletic injury coverage?
• Insurance Card: Am I provided an individual card with adequate identifying information? Make sure
your student keeps this accessible at all times (recommend a photo of the front and back of the card stay on their phone at all times).
• Double Coverage: Sometimes the school-sponsored program is a better fit than the parents’ private coverage. Will it be hard to reenroll in the family policy after school is over? What happens when a student with a school policy is not near campus? Which insurance applies when both cover a problem?
• Prescription/Lab/X-ray Coverage: These are handled separately from physician care in some universities. Make sure to check how this works at your school.
Pack up a “Care Package”
Send the essentials of your home medical cabinet, such as basic cold medications, lozenges, acetaminophen, and ibuprofen; include a digital thermometer and first aid items in case of injury, such as bandages, antiseptic wash, antibiotic ointment, and a chemical cold pack.
Don’t forget the TLC
Remind your child that you were 18 once and that you understand the pressures and opportunities facing college students. If you anticipate they may be around alcohol, offer guidance about how to be social without being intoxicated. Let them know that you will be available to talk about relationships and even sexuality concerns. Suggest strategies you remember using to keep yourself safe in potentially dangerous situations. Establishing honest communication now means it will be easier for them to turn to you should a crisis occur. Remind them–again and again–that you are their strongest advocate and supporter.
Chances are your student is up to date on their primary childhood immunizations. However, most schools require boosters of some vaccines prior to enrollment.
Check to see if your child has completed the following:
Tetanus, Diphtheria, Pertussis (Tdap) Booster dose at age 11-12, then Td every 10 years ongoing
Hepatitis A Requires two doses, at least six months apart
Hepatitis B Three doses, most likely completed during infancy
Human Papilloma Virus (Gardasil) Three doses over six months (optional, strongly recommended)
Measle, Mumps, Rubella (MMR) Two doses typically required by age 5 or 6
Varicella (Chicken Pox) Two doses required, usually completed in early childhood
Bacterial Meningitis, “Quadrivalent,” Serotypes ACWY Menactra or Menveo, total of two doses required for most all college freshman (first typically at age 11 to 12, second age 16 or later)
Bacterial Meningitis, Serotype B Two doses of Bexsero or three doses of Trumenba (optional)
Tuberculosis Screening PPD skin test or Quantiferon