EPSDT, Children’s Medicaid
EPSDT, Children’s Medicaid, is a free outreach and case management program for those who are receiving Medicaid and are under 21 years of age. EPSDT stands for early and periodic screening, diagnosis and treatment. Your EPSDT Outreach Coordinator will help you:
- Find doctors and schedule medical appointments, if needed
- Arrange other medical services for your family, including prenatal care
- Locate a dentist and eye doctor
- Arrange for transportation to appointments where available
- Explain your Medicaid benefits
- Link you with important community services
Why are health check-ups so important?
At an EPSDT Health Check-up, your child will have a head-to-toe physical examination. A history of your child’s past sickness, eating and growth patterns will be taken. She will receive urine and blood tests (including tests for lead poisoning), baby shots, immunizations and other tests or examinations, as needed.
Regular EPSDT Health Check-ups can reveal hidden health problems so that treatment may be started right away. What’s more, some health problems can become lifetime illnesses if they are not treated early.
When should your child have health check-ups?
| Age |
Check-Ups |
| Birth to 1 year old |
6-8 check-ups per year |
| 1-2 years old |
2-3 check-ups per year |
| 3-6 years old |
1 check-up per year |
| 7-20 years old |
1 check-up every 1 to 2 years |
Do I have to pay for EPSDT services?
No! EPSDT means access to good health care, free of charge, for children who have a current Medicaid card.
What else does Medicaid include?
Medicaid also pays for dental and vision care for children and young adults under 21 years of age, including:
- Dental examinations and treatment
- Dental cleanings every six months
- Vision examinations and glasses
Can another doctor other than the one listed in the Medicaid system see me?
Your PCP (Primary Care Provider) is responsible for your medical needs. You must call your PCP before you go anywhere else for care, even the emergency room (unless it is a life threatening situation). If you do not call your PCP first, you will be responsible for any bills for the services you receive.
What’s the difference between my EPSDT Outreach Coordinator and my Social Services Case Manager?
Your EPSDT Outreach Coordinator is assigned by alphabetical order based on Head of Household’s last name. They can help keep you up-to-date with your health care needs. Your Outreach Coordinator can help you with questions about Medicaid, dental needs, vision checks and eyeglasses. They will also assist you with finding doctors who are taking new Medicaid patients.
Your Social Services Case Manager is responsible for your Medicaid application, eligibility and re-determination.
Do parents have the same benefits as children?
- Anyone 21 years of age or older, with the exception of pregnancy, will need to make a co-payment to get medical attention or prescriptions.
- Only emergency dental extractions are covered.
- Yearly vision exams are covered; however, this does not include the cost of corrective lenses.
How do I select or change my doctor?
Call Health Colorado at 1-888-367-6557.
For more information about EPSDT, Children’s Medicaid, call Kathy Chavez at 719-566-6055.
