Your health is important. When you don’t feel well, you don’t feel like going to school or making plans for the future. One of the ways that DSHS can help make sure you are healthy is by making sure you have access to health care whenever you need it. But, did you know that it is also important for you to see a doctor at least once a year to make sure you are healthy? This type of doctor’s visit is called an “Annual Physical Exam” or “EPSDT.”
EPSDT is a special Apple Health program for children and youth (ages 0 – 20). It makes sure everyone gets the right preventive, dental, behavioral health, developmental, and specialty services. An EPSDT exam is different from going to the doctor when you are sick. An annual physical/EPSDT exam looks at how you are growing and developing in comparison to other people your age.
The American Academy of Pediatrics recommends seeing the doctor for an EPSDT at least once per year between the ages of 3 and 20. Check with your doctor if you have a child under the age of 3 to determine how often they should have an EPSDT exam.
Your EPSDT benefit covers all medically necessary care, such as:
- Well-child visits and annual young adult check-ups
- Developmental evaluation
- Behavioral evaluation
- Immunizations (shots) and vaccines
- Lab tests
- Health and preventive education
- Vision services
- Dental services
- Hearing services
Extra Benefits for Apple Health Core Connections (AHCC) Members
If you are 18 – 26 years of age, you can choose to stay in AHCC (no action needed) or change your Apple Health coverage to “fee for service.” Contact the Foster Care Medical Team (FCMT) at 1-800-562-3022 ext. 15480 or FCMT@HCA.WA.GOV to help you decide what type of coverage is best for you.
Apple Health Core Connections (AHCC), has extra programs that are available to you as an adult. These extra benefits include:
- SafeLink: A free smart phone with 350 minutes per month and unlimited texting. Calling AHCC does not count against your minutes.
- CentAccount: Receive money on a pre-paid card for completing “Healthy Activities.” The card can be used to buy groceries, personal care items and more.
- Care Management: AHCC care managers can help you understand and manage your chronic health conditions like diabetes and asthma. Nurses and social workers work with you and your doctors to help you get the care you need.
- 24 hour Nurse Advice Line: Call anytime for medical + mental health support- get help deciding if you should go to an ER or urgent care.
- For more information, go to the Coordinated Care AHCC website.
Dental care is also covered at no cost through Apple Health. Covered services include fluoride treatment, dental sealants, space maintainers, oral examination, X-rays, dental fillings, crowns, oral surgery procedures, extractions, root canal treatment, gum treatment and dentures (false teeth).
When you turn 21, Apple Health Dental benefits become more limited but still include an annual teeth cleaning exam, x-rays, fillings, extractions and more.
What about braces????
Apple Health does not usually pay for orthodontia (braces). However, when orthodontia is determined to be “medically necessary,” Apple Health will cover the services if you are under 20 years of age. Contact AHCC if your dentist thinks you will qualify for orthodontia care.