Young boy examines teddy bear while dad and doctor watch

Louisiana Medicaid: Child wellness visits

Children should see their doctors regularly from birth through age 20. These visits are part of Early and Periodic Screening, Diagnostic and Treatment (EPSDT) preventive screening services.

Early and Periodic Screening, Diagnostic and Treatment

Humana Healthy Horizons® in Louisiana members under age 21 can get medically necessary health services to treat, prevent, or improve a health problem, including regular preventive visits, including:

  • Prenatal exams during pregnancy
  • 12 checkups in the first 2 ½ years of life (at birth, 3 to 5 days after birth, and at 1, 2, 4, 6, 9, 12, 15, 18, 24, and 30 months of age)
  • Annual checkups for Medicaid recipients in Louisiana between the ages of 3 and 20
  • Tests for lead poisoning

These well-child checkups follow AAP/Bright Future schedule guidelines

EPSDT services include:

If a potential health problem is found, coverage is provided for:

  • Clinic visits
  • Health education
  • Inpatient or outpatient hospital care
  • Lab tests
  • Medically necessary follow-up care for physical, mental health, or other health concerns
  • Prescription drugs
  • Visits with a primary care physician, specialist, dentist, optometrist, and others to diagnose and treat problems or issues

Some services may require:

  • A referral from the child’s primary care physician
  • A provider to request prior authorization from Humana Healthy Horizons in Louisiana

EPSDT services are free for our members.

Aging out of Louisiana Medicaid

Most children in Louisiana with Medicaid will age out of childhood programs as of their 19th birthday. To keep Medicaid benefits, they must apply for adult coverage after turning 18 but before turning 19. Children currently in foster care must apply for coverage as an adult before their 21st birthday. Children formerly in foster care must apply for coverage as an adult before their 26th birthday.

Learn how to apply for adult Medicaid coverage

School-based health services (SBHS)

School-based health services are available to our members. To learn more about these services, including how to access them, call us at 1-800-448-3810 (TTY: 711), Monday – Friday, from 7 a.m. – 7 p.m.

Our automated phone system may answer your call on Saturdays, Sundays, and some public holidays. If you call when we are closed and are prompted to leave a message, please do so. We will call you back the next business day.

Child blood lead screenings

Federal regulation requires that all children receive a blood test for lead at:

  • 12 months and 24 months
  • 36 months and 72 months for children who have not had a previous blood lead screening

Ask your child’s doctor about this necessary screening.

Remember to:

  • Make and keep appointments with your child’s doctor when your child is well, not just when your child is sick
  • Talk to your child’s doctor about any concerns you have

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