Child wellness visits

Keeping your kids healthy shouldn’t be hard. Yet it often is. We want to catch problems early and help kids stay healthy. Members under age 21 can get any health service that treats, prevents, or improves a health problem at no cost. This is a special set of benefits known as Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services. 

Members who get EPSDT benefits:

• Can get EPSDT services through their health plan
• Do not have to pay copays for EPSDT services
• Can get help to schedule appointments 
• Can get help arranging for free transportation to and from their appointments

Some EPSDT services may require approval. This approval is called prior authorization. To learn more about which services may need prior authorization please call Member Services 866-432-0001 (TTY:711), Monday – Friday, 8 a.m. – 8 p.m., Eastern Time. EPSDT services include: 

• Health and immunization history
• Physical exams
• Health assessments and counseling
• Lab and screening tests
• Follow-up care
• Applied behavioral analysis (ABA) services
• And more! 

If you have questions about EPSDT services, talk with your child’s primary care provider (PCP). 

Learn more about EPSDT in South Carolina

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 and adolescence – once a year for ages 5-20 
• Enrollees qualify through the end of their 21st birth month

These visits help your child’s doctor detect, diagnose, and treat health problems as early as possible. Children older than 24 months through age 20 can have an in-person or virtual care (telehealth) visit, if the doctor offers this service.

Well-being visits can include:

• Dental screenings
• Growth measurements
• Immunizations and vaccines
• Other important tests and services
• Physical exams
• Preventive and comprehensive services
• Referrals for diagnosis and treatment, if necessary
• Vision and hearing screenings

If your child has a virtual care (telehealth) visit, the doctor will set up a follow-up in-person visit for a physical exam, vaccines, and other important tests and services that cannot be done during a virtual care (telehealth) visit.

Learn more about virtual care visits

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

Our members who are 18 and younger who have a yearly well visit with a pediatrician or PCP can earn $20 in rewards through Go365 for Humana Healthy Horizons.  To earn rewards:

• Download the Go365 for Humana Healthy Horizons App for Apple iOS or Android.
• Create an account to access and engage in the program

Members under the age of 18 must have a parent or guardian register for them to participate and engage with the program, and the person completing the registration process for a minor must have the minor’s Medicaid Member ID.

Learn more about Go365 for Humana Healthy Horizons