All children need regular health care. If your child has a disability, chances are that he/she is enrolled in Medicaid. All state Medicaid programs provide comprehensive and preventive health care through a program called EPSDT – Early and Periodic Screening, Diagnostic and Treatment.
What is it?
The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) program, sometimes referred to as Child Health Services, is a Medicaid health screening benefit that can help you identify possible medical, developmental, dental, visual and/or hearing problems starting at birth through age 21.
Who is eligible?
- Children under age 21 who are enrolled in Medicaid
- Even mothers and fathers who are younger than 21 are eligible
What services are available?
Services include comprehensive medical screenings for: developmental/nutritional assessments; health education; physical examinations; vision/hearing evaluations; dental assessments; lab tests; and immunizations.
Why is it important?
Early screenings are key in identifying any health or developmental problems that may keep your child from learning, growing, and doing well in school. These comprehensive screenings are repeated frequently as your child gets older. Treatment for problems identified in the screenings will be available to you as a Medicaid covered service if your child’s doctor says they are needed.
How do I get these services?
Ask your primary care doctor to determine your child’s eligibility for these screening services at every office visit. He/she must be an enrolled Arkansas Medicaid provider to provide these screenings. Your child’s school district may also provide these screenings. Ask your school’s nurse or principal. If you are currently a member of one of Arkansas’s PASSE entities (Arkansas Total Care, Empower, or Summit Community Care) your assigned Care Coordinator will be able to help you. You can also get more information from your local health unit or human service office.
Do I have to pay for it?
No, not if your child is currently eligible for Medicaid. You must provide proof of your child’s current Medicaid eligibility to your child’s doctor or school to receive these screening services.
What if I don’t have a regular doctor for my child?
Your local Department of Human Services (DHS) office or PASSE Care Coordinator can provide you a list of participating doctors when you ask for it. You can choose a doctor from that list.
What do I do if I am unable to receive or am denied access to these services?
You may appeal, in writing within 30 days, any decision or action by DHS or your PASSE, that adversely affects your ability to receive or access services provided by Medicaid.
Should you need assistance, contact us at Disability Rights Arkansas. You can call us at 800-482-1174 voice/TTY or visit us online at www.disabilityrightsar.org.
Jacqueline Gorton is an advocate at Disability Rights Arkansas. You can email her at [email protected].