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Early and Periodic Screening, Diagnosis and Treatment

Special Screening & Preventive Care for Trillium Members Under Age 21

The Early and Periodic Screening, Diagnosis and Treatment (EPSDT) program provides comprehensive and preventive health care services for OHP members from birth to age 21.

This program provides you with the care you need for your health and development. These services can catch and help with concerns early, treat illness, and support children with disabilities.

You do not have to enroll separately in EPSDT; if you are under age 21 and enrolled in OHP you will receive these benefits.

Starting in 2025, young adults with special Health Care Needs (ages 19-25) also qualify for EPSDT benefits.

The EPSDT benefit covers:

  • Any services needed to find or treat illness, injury, or other changes in health.
  • “Well-child” or “adolescent well visit” medical exams, screenings, and diagnostic services to determine if there are any physical, dental, developmental, and mental health conditions for members 0 through age 20.
  • Referrals, treatment, therapy, and other measures to help with any conditions discovered.

If you or your family member needs EPSDT services, work with your primary care provider (PCP) or talk to a care coordinator by calling 1-877-600-5472 (TTY: 711). They will help you get the care you need. You can work with your primary care dentist for any dental services. All EPSDT services are free to members from birth through age 21.

Under EPSDT, Trillium will not deny a service without first looking at whether it is medically necessary and medically appropriate for you. You should always receive a written notice when something is denied, and you have the right to an appeal if you don’t agree with the decision.

You can get free rides to and from covered EPSDT provider visits. For more information, call Trillium Member Services at 1-877-600-5472 or visit www.trilliumohp.com/ride.

If you have any questions about EPSDT services, call Trillium Member Services at 1-877-600-5472 (TTY: 711). You can also find more information in the Member Handbook.