Most families spend the summer before college buying extra-long twin sheets, laundry baskets and mini fridges. The more difficult challenge? A kid who has seen the same pediatrician, therapist or psychiatrist for years is about to lose all of them at once — and nobody sends a reminder.

There is a moment, usually in October, when a parent learns how this works.

The call comes from a college town. The refill didn't go through. The pharmacy says it needs a local prescriber. The psychiatrist back home — the one who has managed this medication since middle school, who knows what was tried and what failed and what happened the semester it was tapered — cannot write it, because the patient is now living in a different state.

Nothing went wrong. No one made a mistake. The system did exactly what it was built to do.

Here is the fact that explains most of what follows: doctors and therapists are licensed state by state, and the state that governs a visit is where the patient is sitting, not where the clinician is. Some professions have established interstate agreements that allow a provider to follow a patient across state lines. Many have not. Your child's care team is licensed where you live. Your child no longer lives there.

That single sentence generates a to-do list. It is not a long list, and none of it is difficult.

Before They Leave. The Healthcare Handoff

1. Ask each provider one question.

The question is: Can you still see my child when they're in Ohio?

Don't research it. Don't try to figure out which interstate agreements cover which professions — the rules differ by license type in ways that are genuinely confusing and not your problem to solve. The provider knows the answer. Ask.

Expect different answers from different providers. A psychologist may be able to continue. A psychiatrist probably can't. A master's-level therapist — which describes most therapists in this country — usually can't. A student with three providers may find that one travels and two don't. This is normal. It is also the reason the question has to be asked separately from each one.

2. Assume the answer is no, and ask for a referral anyway.

Even a provider who can't follow your child can usually name someone in the college town, or knows how to find one. A referral from a clinician who has actually treated your kid is worth more than any insurance directory, and it comes with context.

Ask for the referral in the same conversation as the first question. You will not want to make a second call next month.

3. Handle prescriptions sooner, rather than later.

New prescriber, new state, new intake appointment. For routine medication this is an inconvenience. For ADHD medication, ongoing psychiatric medication, or anything controlled, it can mean a waitlist measured in months.

Ask the current prescriber two things: how much supply can be sent, and what the handoff should look like. Then ask how the medication will be refilled in November, and listen carefully to the answer.

One timing note worth knowing: the federal rules that currently allow some remote prescribing of controlled medications have been extended temporarily, most recently through the end of 2026, while permanent regulations are still being drafted. Arrangements built on those rules are not permanent arrangements. Build something that survives the rule change.

4. Sign the paperwork that lets you be told anything.

At 18 your child is a legal adult. If they end up in an emergency room, a parent who calls can be told nothing — not the diagnosis, not the treatment plan, not even whether their child is there. Two documents fix this: a HIPAA authorization, which lets providers share medical information with you, and a FERPA release, which covers school records including, at many institutions, health center records.

Both are short. Both are free. Neither can be signed retroactively from a waiting room.

5. Call the number on the insurance card.

Ask three specific questions. Is there in-network psychiatry near campus? Is there in-network therapy near campus? Does the student health center bill as in-network, or at all?

If the plan is an HMO or has a regional network, ask whether a guest membership or away-from-home program is available. Many carriers offer one, often at no additional cost, and almost nobody knows to ask.

6. Book the first appointment before there's a problem.

This is the highest-leverage item on the list. Establishing care while a student is well takes one appointment. Establishing care during a crisis takes weeks the student doesn't have.

September is the right month. The new provider becomes a name in the phone rather than a search to conduct on the worst day of the semester.

7. Understand what campus counseling is.

Campus counseling centers are good at what they are designed for: short-term support, crisis response, and connecting students to care. They are generally not designed to be the ongoing treatment team for a student who arrives with an established diagnosis and a medication regimen. Many operate on session limits and refer complex cases to community providers.

That is a reasonable model. It becomes a problem only when a family assumes otherwise and discovers the referral-out policy in February.

8. Put three numbers in your phone.

Campus health. The after-hours nurse line, if the school has one — many do, and they are free. The nearest urgent care that takes the insurance.

Do this on move-in weekend, while everyone is standing in the same room and the information is easy to get.

Chest pain, difficulty breathing, head injury, severe bleeding, a possible overdose or thoughts of self-harm: emergency room, now. Do not price-shop this. Federal law requires health plans to cover emergency care without prior authorization regardless of network, which makes the ER the one setting where the insurance question resolves itself.

Something that can't wait until morning but isn't the above — a bad sprain, a high fever, a cut that may need stitches: urgent care, if it's covered. Check that in September, not at 11 p.m.

Everything else: campus health, next business day.

10. Take a photo of the insurance card.

Front and back, on the phone, today. The physical card will be in a drawer, in a different building, at the wrong hour.

What To Tell Your Parents

This part is for the student. The rest of the article is talking about you.

You are allowed to have your own doctor and your own privacy. You are also allowed to have your parents help. Those are not in tension, and the paperwork that gives them access can be limited to what you want shared.

If something happens and you're not sure whether to call home, call home. The alternative — a parent finding out later, from a bill — is worse for everyone, including you.

Nothing in this list prevents an emergency. It prevents an emergency from becoming a scramble as well.