I don't have many exacerbations, and have been able to transition out of my parents "sphere of influence" - not that this was a bad thing- their help made it possible for me to take those first steps like going to college, etc... dumping all of the insurance crap on me all at once right after high school would have been very difficult for me, and I probably would have done a bad job of it.
Looking back, I think it kind of went in steps...
While I was at college, which was 4 hours away from my parents, my parents were still very involved with my care, mostly because I was still under their health insurance. Example - my drugs were still mailed to my parents house, so they knew when to call for refills. They also fought all the insurance/preauthorization battles, etc. Ever since high school, I was responsible for doing my own treatments, with the exception of Chest PT, which my dad did with me. There was never any issue with me not doing them - I understood pretty early on that there wasn't a whole lot of choice behind doing them.
When I moved away to grad school - 9 hours from my parents, I dealt with all my drug/refill stuff, because I was so far away that they had to be delivered to me - parents still dealt with insurance crap. I shared an apartment with a friend from college who was a few years older than me... I lived on student loans, and very little else... all income from my part-time job went to tuition/expenses.
After grad school, I moved to Boston, got a job, moved into a house with 4 virtual strangers, and took over my stuff entirely... I have my own health insurance, and fight those battles now; I set up my own appointments, picked my own clinic (being in Boston I had the luxury of choices), etc. I consider myself fully independent.
When I need IV's, I do them myself, at home... I had my last one placed in outpatient, and went to work the next day - in the two week course of IV's, I missed 6 hours of work due to the weekly checkups... my home healthcare service drew all my lab work at night, and I was able to infuse in my office.
My parents did a few things while I was younger that set me up well for the future:
1) When I was 14, my mom and dad got a whole-life insurance policy in my name. Because of my age, and the policy they picked, I didn't need a medical exam. It would be virtually impossible for me to get life insurance today, especially at the price they got it. I now pay all of my premiums, etc.
2) Included me on at least some of the insurance issue stuff... by the time it came my turn to deal with it, I knew how to talk to the the companies, who to call, how to get claims resubmitted, etc.
3) Made complying with my treatments as easy for me as possible -- looking back, the fact that I didn't have to deal with refills, prior authorizations, etc., and just had to focus on doing my meds, made CF far less burdensome while I was in college, living in the dorms, and trying to be "as normal as possible."
4) My parents made me very aware of the importance of health insurance, and as a result, I chose to go directly to grad school right after undergrad - my parents' insurance covered me until age 25 as long as I was a full time student. I wanted to get my Masters while I was still covered, and was healthy enough to go to school full time and work 20 hours a week. It was demanding, but looking back, its how I got the job I have now, which has AMAZING benefits.
I hope this helps with your transitions...
Chris
25 w.CF