Oklahoma Kids

Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Benefit Plan members under age 21 can get any treatment or health service that is medically necessary to treat, prevent or improve a health problem. This special set of benefits are called Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services.

Members who need EPSDT benefits:

• Can get EPSDT services through their health plan;
• Do not have to pay any copays for EPSDT services; and
• Can get help with scheduling appointments and arranging for free transportation to and from the appointments.

Some EPSDT services may require a prior authorization (PA). To learn more about which services may need prior authorization please call Member Services at 855-223-9868 TTY: 711 8am - 5pm Central time . EPSDT includes services that can help treat, prevent or improve a member’s health issue, including, but not limited to:

• Health and immunization history;
• Physical exams;
• Various health assessments and counseling;
• Lab and screening tests;
• Necessary follow-up care; and/or
• Applied behavioral analysis (ABA) services.

If you have questions about EPSDT services, talk with your child’s primary care provider (PCP). You can also find more information on EPSDT services online by visiting our website at Humana.com/HealthyOklahoma or by visiting the SoonerCare EPSDT web page.

Child Health Visits Schedule

We recommend regular child health appointments on the following schedule:

• Infancy – Younger than 1 month, 2 Months, 4 months, 6 months, 9 months, 12 months
• Early Childhood – 15 months, 18months, 24 months, 30 months, 3 yrs, 4 yrs
• Middle Childhood – 5 yrs, 6 yrs, 7 yrs, 8 yrs, 9 yrs, 10 yrs
• Adolescence and Young Adults – 11 yrs, 12yrs, 13 yrs, 14, yrs, 15 yrs, 16 yrs, 17 yrs, 18 yrs, 19 yrs, 20 yrs, 21 yrs (through the end of the enrollee’s 21st birth month)

Children enrolled in Sooner Select are eligible to earn rewards for having well-child visits. Members can then redeem rewards for e-gift cards. To earn rewards:

• Download the Go365 for Humana Healthy Horizons^® App
• Create an account to access and engage in the program

Please note: Members under the age of 18 must have a parent or guardian register on their behalf to participate and engage with the program, and the person completing the registration process on behalf of a minor must have the minor’s Medicaid Member ID.

Go365 for Humana Healthy Horizons for different activities, including child well visits, PDF

Learn more about Go365 for Humana Healthy Horizons

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

The KidsHealth consumer video library includes personal stories to help parents, kids, and teens understand medical diagnoses. The library has information about chronic and serious health conditions, including:

• Asthma
• Diabetes
• Medications
• Pain management
• Seizures
• Weight management