What is the EPSDT Benefit?
EPSDT stands for Early and Periodic Screening, Diagnostic, and Treatment.
If you have Health First Colorado (Colorado’s Medicaid program), you can get special health care services with this benefit if you are 20 years old or younger. You can also get these services if you are a pregnant adult.
The EPSDT benefit covers many types of care. These are things like preventive and mental health care. It could also be dental, developmental, and specialty care. Click here and here to learn more about EPSDT in Colorado.
This coverage ends on your 21st birthday. Visit healthfirstcolorado.com to learn more about what benefits you get after you turn 21.
You can also call us at 866-833-5717 to talk to one of our care coordinators. They can tell you what other benefits you may be able to get. Call them Monday through Friday from 8:00 a.m. to 5:00 p.m.
A medically necessary service used to treat a certain health diagnosis is covered. The diagnosis must be physical, dental, or mental health.
These services are things like:
- Annual well visits
- Developmental evaluations
- Behavioral evaluations and therapies
- Lab tests, even lead poisoning tests
- Health education
- Preventive education
- Vision services
- Dental services
- Hearing services
You can get most of these services from your doctor. You might have to see a therapist for some behavioral health services. These services are things like:
- Individual therapy
- Psychiatric hospital stay
- Work or employment training
- Intensive case management
- Prevention or early intervention services
- Clubhouse or drop-in centers
- Residential treatment
- Assertive Community Treatment (also called ACT)
- Recovery services
- Respite services
Some services may be covered even if they are not a benefit through Health First Colorado. Talk to your doctor about any of these services. They may require preapproval.
Do you want to learn more about EPSDT services? Please see:
If you have questions, please call us at 720-744-5124 or 866-833-5717. These services are available at no cost to you.