EPSDT is a benefit that gives children and youth members under the age of 21 access to extra assessments and resources All children or members under 21 can get comprehensive services at no cost for medically necessary and medically appropriate diagnosis and treatment. Referrals may be required for some services
This includes:
- Screening and diagnostic services to help find any physical or mental concerns for all members 0 to age 21
- Treatment and services to correct or improve any concerns and chronic conditions that are found
Preventative health care is important. Regular checkups with your PCP can help catch any problems before they turn into health emergencies. Talk to your or your child’s PCP about any necessary screening or diagnostic services or if you have any concerns. If you or your child do not have a PCP, contact EOCCO Customer Services at 888-788-9821
EOCCO and OHP cover EPSDT screening visits at age-appropriate times. A screening exam that will include the following:
- A full health and growth history that includes physical and mental health
- Talk about nutrition and eating habits
- A full physical check-up
- A check-up on teeth and gums
- Immunizations (shots) as appropriate
- Lead testing
- Other tests as needed (such as anemia test, sickle cell test, and others) based on age and member risk
- Appropriate hearing and vision tests
- Health education
If there is a physical, mental health, substance abuse or dental condition found, your doctor may refer you or your child to another provider for more services. The provider will explain why you or your child are being referred. If any services are not covered or denied, you have the right to ask for us to review it again. To learn more about EPSDT, please see the EOCCO EPSDT policy posted to our website
All EOCCO members under the age of 21 will get a letter in the mail about these EPSDT services.
As a reminder, Non-emergent medical transportation (NEMT) is available for all EOCCO members. If you need help with rides to and from appointments, please contact NEMT services at:
- 877-875-4657 (TTY users, please call 711)
- The office is open Monday through Friday, 8 a.m. to 5 p.m. PT (9 a.m. to 6 p.m. MT)
If you have any questions about EPSDT, please call Customer Service at 888-788-9821. TTY users, please call 711. The office is open Monday through Friday, 7:30 a.m. to 5:30 p.m. PT
