Children’s Medicaid Programs

What is EPSDT?

The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) program is a child health initiative for Medical Assistance members. Think of it like this:

  • Early: Assessing and identifying problems early
  • Periodic: Checking children's health at periodic, age-appropriate intervals
  • Screening: Providing physical, mental, developmental, dental, hearing, vision, and other screening tests to detect potential problems
  • Diagnostic: Performing diagnostic tests to follow up when a risk is identified, and
  • Treatment: Control, correct or reduce health problems found.

Your child’s good health starts with having regular checkups with their primary care provider (PCP). Your child's PCP will complete a yearly physical exam to make sure they are growing well, as well as conduct preventive screenings based on your child’s age, sex and medical history to make sure they do not have any health problems. For more information on our program and checkups, screenings, and test schedules, download our program brochure. (PDF)

Services

Vision Services
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At a minimum, diagnosis and treatment for defects in vision, including eyeglasses. Vision services must be provided according to a distinct periodicity schedule developed by the state and at other intervals as medically necessary. For additional information visit the Vision and Hearing Screening Services for Children & Adolescents page.

Infant Lead Screening

Testing Mandate

The Delaware Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program now requires that all children with Medical Assistance receive a minimum of two (2) blood lead screenings regardless of the child’s risk factors. The tests should be conducted at the 12 month screening and again at the 24 month screening.

The good news is these screening tests will not cost our members anything! You can schedule an appointment with your child’s pediatrician to have his or her blood levels checked. If you don’t have a pediatrician, you can find one close to you through our Find a Provider tool.

Why Get Your Child Tested?

  • Lead is a naturally occurring metal that can cause serious health problems.
  • Potential lead sources include paint (especially in older homes), toys, soil, dust, and plumbing.
  • Lead is toxic to everyone; young children are at greatest risk for health problems from lead poisoning.
  • Blood lead testing can find lead exposure early and prevent long-term damage.

Lead Screening FAQs

What is lead?
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Lead is a toxic metal used in a variety of products and materials found in your home, including: Paint and/or dust in older homes, soil that contains traces of lead, water that runs through lead pipes, some toys and jewelry, some makeup products, and certain jobs and hobbies can involve working with lead-based products and may cause parents to bring lead into the home.

Who can I call with questions?

We always encourage honest conversations with your child’s doctor regarding your concerns.

If you have questions regarding coordinating your child’s care, scheduling appointments, help with transportation problems, or questions about your child’s lead test or other wellness visits, please contact the Highmark Health Options Care Coordination Team in the Special Needs Unit for assistance at 1-844-325-6251 (TTD/TTY# 711 or 1-800-232-5460 for hearing impaired).

Need help?

If you are eligible for Medical Assistance and would like help choosing a plan, contact Delaware Health Benefits Service 1-800-996-9969.