Early Periodic Screening, Diagnosis, and Treatment (EPSDT)
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Early Periodic Screening, Diagnosis, and Treatment (EPSDT)
The Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit is a comprehensive and preventive child health program available through Medicaid in the United States. It is designed to ensure that children under the age of 21 who are enrolled in Medicaid receive necessary and appropriate healthcare services to diagnose, treat, and prevent physical, mental, and developmental conditions.
EPSDT goes beyond the regular Medicaid coverage and provides a broad range of services that are aimed at identifying and addressing health issues early on. These services include regular check-ups, screenings, immunizations, vision and hearing exams, dental care, and necessary treatments for identified health problems.
The goal of EPSDT is to promote early intervention and preventive care for children, with the understanding that early detection and treatment can improve outcomes and prevent more serious health problems in the future. By providing comprehensive healthcare services, EPSDT aims to address the specific needs of children and promote their overall well-being and healthy development.
It’s important to note that while EPSDT is a federal requirement for Medicaid programs, the specific services and coverage may vary by state. Each state has its own guidelines and requirements for implementing the EPSDT benefit within its Medicaid program, including the scope of services covered and any limitations or eligibility criteria. So, the details of the EPSDT benefit in Idaho Medicaid may differ slightly from other states.
Who can get EPSDT services?
If you are eligible for Children’s Medicaid or CHIP, you can qualify for services under EPSDT. There are not different income limits for this program. Children enrolled in Medicaid are eligible for medically necessary screenings, diagnosis, and treatment for physical conditions or mental illnesses. If Idaho Medicaid doesn’t usually cover a service under basic plans, but it is listed in the federal Medicaid law, then it is coverable under EPSDT. Companies who provide these services to children enrolled in Idaho Medicaid must use EPSDT as a guide.
Idaho Health and Welfare EPSDT Website
Optum Idaho manages the Idaho Behavioral Health Plan. EPSDT services through Optum are accessed through the following form:
EPSDT Optum (pdf)
