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See steps you need to take to get your child started with Healthy Blue benefits.
Benefits for Children
There are no copays for members younger than 19.
Read on for benefits information for children. For general benefits information for all members, visit the Healthy Blue Member Center.
- Medical Benefits
There are no copays for members younger than 19. Your child's benefits include:
- Primary care provider (PCP) visits.
- Immunizations and wellness visits.
- Specialist visits.
- Urgent and emergency care.
- Hospital care.
- Lab and X-ray services.
- Pregnancy services.
- Family planning.
- Chiropractic services.
- Physical and occupational therapy.
- Speech and hearing services.
- Behavioral health care (mental and substance abuse services).
- Home health care services.
- Disease management for asthma, diabetes and more
- Vaccinations
Members under 21 can also receive:
- EPSDT (early and periodic screening, diagnosis and treatment) services.
- Audiological services and hearing aids.
- Developmental evaluation services.
- Dental Care
Members younger than 21 can get:
- Diagnostic, preventive, restorative and surgical benefits.
- Routine dental care.
- Oral exams.
- Cleanings.
- X-rays.
- Fluoride treatments.
For questions about your child's dental benefits or to find a dentist, call DentaQuest at 888-307-6552. You can also visit the DentaQuest website.
DentaQuest is an independent company providing dental benefit services on behalf of BlueChoice HealthPlan.
- Vision Care
Members under 21 years of age can get these services through Vision Service Plan (VSP):
- Preventive screenings.
- Eye exam once a year.
- Glasses (frames and lenses) once a year.
There are no copays for routine vision services.
For questions about your child's vision benefits or to find an eye doctor, call VSP Member Services at 800-877-7195 (TTY 800-428-4833). You can also visit the VSP website.
VSP is an independent company that provides vision services on behalf of BlueChoice HealthPlan.
- Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Well-Child Visits and Services
The EPSDT or well-child program provides comprehensive and preventive health services to children through the month of their 21st birthdays.
Preventive health care services covered under EPSDT include:
- Health screenings.
- Comprehensive health and development history.
- Developmental assessment.
- Comprehensive unclothed physical exam.
- Appropriate shots.
- Dental assessment.
- Vision screening.
- Hearing screening.
- Anemia screening.
- Blood pressure.
- Lead toxicity screening.
- Lab tests.
- Outpatient Pediatric AIDS Clinic Services (OPAC)
OPAC gives specialty care, consulting and counseling services to HIV-infected and exposed Medicaid kids and their families. They also provide clinical and lab tests.
The program will vary for each child:
- Kids born to HIV-positive mothers, but who do not test positive, will be seen every three months in a clinic until they are 2 years old.
- Kids who test positive will be seen in a clinic twice a week for eight weeks and then once a month until they are 2 years old.
- Kids who do not improve will stay in the OPAC program.
- Healthy Rewards for Well-Child Visits
All Healthy Blue members can receive Healthy Rewards for completing wellness visits and preventive screenings.
- Free Extra Benefits for Children
Children receive all the regular Medicaid benefits and services through the State, plus extra benefits just for being Healthy Blue members.
Qualifying members can get free extras including:
- Free Girl Scouts membership plus a discount toward program materials at participating sites for girls ages 5 to 18.
- Free Scouts BSA membership plus a discount toward program materials at participating sites for members ages 7 to 18.
- Free gift card for Boys & Girls Club fees at participating clubs for members ages 6 to 18.
- Free sports physical for members ages 6 to 18.
- Free over-the-ear headset for members ages 5 to 18.
- Tutoring support gift card that can be used to purchase educational support courses from outschool.com for members ages 5 to 14.
- Free gift card for internet services for members ages 5 to 18.
Find a Provider
Search for a doctor or learn about urgent and emergency care.
Renew Your Child's Coverage
You need to renew your child’s benefits every 12 months to keep them.
