With a referral from a provider, the early and periodic screening, diagnosis and treatment (EPSDT) program offers well-child exams for the diagnosis and treatment of all children from ages 0-20. These services are covered, with no cost, to members under age 21. Children and their families can get transportation help to get to appointments for these services (visit our Transportation page to learn more).
EPSDT services include:
- Regular exams to check the health, growth and development of infants, children and youth. This includes:
- Physical exams
- Mental health exams
- Substance use treatment
- Nutrition checks
- Hearing and vision tests (and glasses and hearing aids, if needed)
- Vaccines, as needed, according to a child’s age.
- Lead testing for children between 1-2 years old, or 2-6 years if they haven’t had one yet. This includes follow-up services for children with high lead levels.
- Dental services when needed. See the “Dental Health Care” section of this booklet to learn more.
- Screening to find physical or mental defects in members under age 21.
- Health care and treatment to correct or improve defects.
- Services, as needed, for severe, infrequent or chronic conditions.
- An agreement showing your responsibilities and how long services will be given.
- Help with referrals for other needed services. This includes:
- Social services
- Education
- Nutrition help
Your provider can help you get EPSDT services — contact them to learn more and get a referral. If screenings show that your child needs further care, your provider can help you get more help. You can also call Customer Service with any questions at 855-722-8206. Families who have not used EPSDT services will be notified about them every year.
