For children, teens and young adults

Medicaid has special benefits for children and teens who are age 20 and under. This program is called EPSDT and it covers almost any services that children and teens need, including:

• regular checkups and other doctor visits
• Dental care
• Vision care
• Mental health services
• Developmental problems

Co-pays for children and teens

• There are no co-pays for children under 18.
• There are no co-pays for pregnant women (any age)
• There are no co-pays for young adults over 19 who are in a managed care organization
• Young adults 19 – 20 may have to pay a small co-pay for doctor, pharmacy or hospital stays

Our Outreach Coordinators can help you!

Call an EPSDT Outreach Coordinator for help

• Finding doctors or dentists who take Medicaid
• Learning out about other community services, such as food banks, housing agencies, Head Start, WIC and childcare
• Understanding how the medical system works

In Denver: 303-866-6006 or 303-866-6167.
Outside of Denver: 1-888-221-3943. The call is free.

Medicaid benefits for children and teens:

Medicaid’s EPSDT program provides all these benefits and many others:

• Regular checkups for babies, children, teenagers and young adults up to age 20, including sports physicals
• Developmental evaluations, to check on a child’s growth, and find help if the child needs it
• Behavioral evaluations, to check a child’s emotional development and health habits
• Vision testing
• Immunization (shots)
• Hearing testing
• Dental checkups
• Checkups of heart and lungs
• Lab tests, when the child needs them
• Family planning information, such as birth control and abstinence information

See a list of EPSDT services covered by Medicaid.

√  You do not need a referral to see a dentist, eye doctor, mental health or behavioral health provider, hearing doctor, or for family planning services.

√ Your EPSDT Outreach Coordinator can help you find a doctor or dentist in your county

Lead poisoning

Lead poisoning can cause very serious health problems for children, especially children ages birth to six. Most children do not have symptoms, so it’s important to get a blood test to see if the child has lead in his or her blood.

Children get lead poisoning from eating paint that has lead in it, from some imported candies and toys and some home remedies, such as Greta and Azarcon, and from some ceramic dishes.

Special health care needs

Some children have special health care needs, such as a developmental delay or a health problem that is expected to last a long time. These children may need extra services.

A child with special health care needs can get any services or support that are medically necessary.

To find out more about how to get services for special health care needs, contact your EPSDT Outreach Coordinator.

Regular checkups

Children, teens and young adults should have medical checkups regularly until age 20.
Medicaid will pay for them.

Here are the times that doctors suggest you bring a child in for a checkup:

• 1 month
• 2 months (shots also)
• 4 months (shots also)
• 6 months (shots also)
• 9 months
• 12 months (shots also)
• 15 months (shots also)
• 18 months
• Once each year until age 20

Learn more