Early and Periodic Screening Diagnostic and Treatment (EPSDT)

EPSDT Program

EPSDT covers care for those under the age of 21 at no cost to you. EPSDT stands for:

  • Early – So problems are treated soon
  • Periodic – To set up routine visits
  • Screening – To check for a health problem
  • Diagnostic – To find a health problem
  • Treatment – To care for a problem

Your child’s PCP will work with you to make sure your child gets the care they need. EPSDT includes:

  • Well-child exams
  • Vision and hearing tests
  • Health education
  • Lab testing
  • Lead screening
  • Health assessments
  • Immunizations
  • Dental health

Your child should have an EPSDT check at:

After that, children should have at least one exam per year.

EPSDT also covers medically necessary care for issues found by an exam. This includes things like glasses and hearing aids.

Your child may also earn rewards for completing healthy activities. Visit our Rewards page to learn more.

Schedule an EPSDT Preventive Health Visit With Your Child’s PCP

Preventive health is key to overall health. Seeing a PCP on a routine basis even if you and your child are healthy helps the PCP find and treat problems early before they get worse. As a part of EPSDT, care management services are available to all members who have special health care needs.

Call your PCP to schedule an EPSDT visit. Make sure to ask for an EPSDT preventive health visit when you call. You should have your child’s first exam within 90 days of becoming a member.

Some services may require a referral from your PCP or prior authorization by HAP CareSource.

  • Prior Authorization means that HAP CareSource must approve the service before you receive it. Your provider will request the approval from HAP CareSource.
  • Referral means that your provider will recommend or request these services for you before you get them. Your provider will either call and arrange these services for you, give you a written approval to take with you, or tell you what to do.

Member Services: 1-833-230-2053 (TTY: 711), 24 hours a day, seven days a week.