state health plan covering well baby visits

History ĮPSDT was enacted in 1967 as part of Medicaid as the child health component of Medicaid, with a deliberate focus on prevention and early intervention to reduce health problems among poor children and offer them equal opportunity to succeed in life. On average, Medicaid costs per child are less than private insurance. With Medicaid and EPSDT, however, poor children's access to health care is similar to that of non-poor, privately insured children and child Medicaid beneficiaries use care in approximately the same pattern as their privately insured counterparts. Children account for approximately half of Medicaid beneficiaries but only roughly 20-25 percent of the costs of the program overall. This is true despite the breadth of coverage provided to children through EPSDT. While a small number of cases and anecdotes regarding high EPSDT costs have garnered public attention, spending per child is low compared with worker-age adults and seniors covered by Medicaid. For the 25 million children enrolled in Medicaid and entitled to EPSDT in 2012, the program is a vital source of coverage and a means to improve the health and well-being of beneficiaries.

Unlike private insurance, EPSDT is designed to address problems early, ameliorate conditions, and intervene as early as possible. Federal statutes and regulations state that children under age 21 who are enrolled in Medicaid are entitled to EPSDT benefits and that States must cover a broad array of preventive and treatment services. Early and Periodic Screening, Diagnostic and Treatment ( EPSDT) is the child health component of Medicaid.

State health plan covering well baby visits