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Early and Periodic Screening, Diagnostic and Treatment (EPSDT)

EPSDT provides a broad range of prevention, diagnostic, and treatment services for low-income infants, children and adolescents under age 21. The EPSDT benefit is more robust than the benefit for adults and is designed to assure that children receive early detection and care, so that health problems are averted or diagnosed and treated as early as possible. The goal of EPSDT is to assure that individual children get the health care they need when they need it – the right care to the right child at the right time in the right setting.

Who can get EPSDT preventive care services?

Santa Clara Family Health Plan (SCFHP) Medi-Cal Plan members who are infants, children, and youth under age 21 can get these services at no cost.

What are EPSDT preventive care services?

Services that ensure that infants, children, and youth under age 21 get the care they need at the right age. Services like:

  • Well-child visits and teen check-ups (important visits children need to check their developmental history
  • Immunizations (also called vaccinations or shots)
  • Mental health services such as trauma screening exams (specialty mental health services are covered by the county)
  • Dental services (covered by Medi-Cal Dental)
  • Hearing, and vision screenings
  • Lab tests (including blood lead testing)
  • Health and preventive education

Which preventive care services do I need?

You or your child may get screenings, developmental services, specialty care, and needed immunizations (also called vaccines or shots) to keep you healthy whenever you need. For more guidelines, see Bright Futures/American Academy of Pediatrics' recommendations for preventive care based on age. See the general guidelines for preventive care based on age below.

Infancy (0–12 months)

Well-care visits for babies (also called well-child visits) include: checking your baby’s growth, getting shots to prevent diseases, and getting screenings for vision, hearing, lead, oral health, and development.

For more information, see Bright Futures/American Academy of Pediatrics' complete list of recommendations for preventive care based on age.

Early childhood (12 months–4 years)

Well-child visits for children ages 14 include: checking your child’s growth, getting shots to prevent diseases, and getting screenings for vision, hearing, lead, anemia, tuberculosis, oral health, and development.

For more information, see Bright Futures/American Academy of Pediatrics' complete list of recommendations for preventive care based on age.

Middle childhood (5–10 years)

Well-child visits for children ages 510 include: checking your child’s growth, getting shots to prevent diseases, and getting screenings for vision, hearing, lead, anemia, tuberculosis, oral health, psychosocial/behavioral, and development.

For more information, see Bright Futures/American Academy of Pediatrics' complete list of recommendations for preventive care based on age.

Young adolescents (11–15 years)

Well-child visits for children ages 1115 include: checking your child’s growth, getting shots to prevent diseases, and getting screenings for vision, hearing, oral health, anemia, tuberculosis, substance use disorder, sexual health, depression, and development.

For more information, see Bright Futures/American Academy of Pediatrics' complete list of recommendations for preventive care based on age.

Adolescents (16–21 years)

Well-care visits for adolescents ages 16–21 include: checking your teen’s growth, getting shots to prevent diseases, and getting screenings for vision, hearing, substance use disorder, depression, sexual health, and development.

For more information, see Bright Futures/American Academy of Pediatrics' complete list of recommendations for preventive care based on age.

Medi-Cal covers medically necessary screenings (including lead blood-level assessment) any time you need them at no cost to you.

Check-ups and screenings can help doctors find health issues early. If a physical or behavioral health issue is found during a check-up or screening, Medi-Cal will cover the care needed to address it.

How do I get EPSDT preventive care services?

Call your child’s doctor to schedule check-ups, screenings, or other preventive care.

You may qualify for Wellness Rewards!

SCFHP rewards its Medi-Cal members for taking steps to a healthier life. Click here, to see a full list of Wellness Rewards we offer eligible members for completing routine health exams, screening, or education.

If you have more questions about preventive care services, please call SCFHP Customer Service at 1-800-260-2055 (TTY: 711), Monday through Friday, 8:30 a.m. to 5 p.m.

If you speak a language other than English, language assistance services, free of charge, are available to you. Call Customer Service at 1-800-260-2055 (TTY: 711), Monday through Friday, 8:30 a.m. to 5 p.m. The call is free.