Medicaid’s Children’s Benefit—EPSDT—Supports the Unique Needs and Healthy Development of Children

The benefits of Medicaid coverage for children are wide-ranging, long-lasting, and extend beyond childhood. Compared to uninsured children, children covered by Medicaid have greater access to health services; have better health outcomes; do better in school; and earn more as adults.

A key reason Medicaid works so well for children is its comprehensive children’s health benefit package, the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit. All states are required to provide the EPSDT benefit for Medicaid-covered children under age 21.

The benefit is designed to identify and treat or ameliorate health conditions early, when treatment can have the greatest impact on a child’s health and development. It also ensures  comprehensive and ongoing treatment for a child’s ongoing medical needs.

This issue brief provides a comprehensive look at the EPSDT benefit, including a plan-to-plan comparison with large scale health plans in two states and the Federal Employee Health Benefit Program (FEHBP). That comparison shows that Medicaid’s EPSDT benefit consistently offers more comprehensive coverage for children and greater financial protections for families. It is the gold standard in children’s health coverage.

To learn more about Medicaid’s EPSDT benefit, how it compares with other health coverage, and the threat that Medicaid cuts would pose to children’s health coverage, read the full issue brief.