You are here: Health Home > Medicaid > Benefits > Children

Medicaid Benefits for Children

• Please note:
• Medicaid covers services that are medically necessary, as determined by your Medicaid primary care physician (PCP).
• Some services need Medicaid’s approval. Your PCP will submit a Prior Authorization Request (PAR) to Medicaid to determine the amount, scope, and duration of your services.
• Please present your medical identification card (MID card) for all medical supplies, equipment, or services (e.g., wheelchair, orthopedic shoes, transportation).

 
• The following are some of the Medicaid benefits for children from birth through age 20, but this list does not include everything that EPSDT might cover if it is medically necessary.
• Assistive technology devices or services.
• Augmentative communication assessment and equipment.
• Bath equipment, such as rails or a shower chair or bench.
• Braces for the teeth or orthodontia ONLY for severe conditions, such as cleft palate.
• Care out of the state of Colorado (only if a provider is not available within the state).
• Dental care, including fillings.
• Diagnostic services, such as an EKG.
• Disposable supplies, such as diapers (after the age of 3), syringes, and catheters.
• Durable medical equipment, such as walkers, wheelchairs, and special car seats.
• Emergency room visits when prior approval is given by the PCP or covering agent.
• Extended care facilities.
• Feeding supplies, such as G-tube, J-tube, NG-tubes.
• Hearing tests and treatments, including hearing aids.
• Hospital beds, bed rails, mattresses, and pressure pads.
• Hospitalization.
• Immunizations.
• Lab tests, such as blood, skin, or urine and pap smears.
• Mental health services.
• Nurse-midwife services in pregnancy, labor, birth, and 60 days after birth.
• Orthodontics, such as braces and splints.
• Oxygen and oxygen equipment, such as nebulizers, respirators, or ventilators, and supplies.
• Physician services, including specialists.
• Prenatal care.
• Prescription drugs (usually generic), not including most over-the-counter medications.
• Prosthetics, such as glass eyes and artificial limbs.
• Radiology services, such as x-rays.
• Rehabilitation facility care.
• Skilled nursing services and therapies.
• Suctioning equipment.
• Surgeries.
• Therapies such as occupational (OT), physical (PT), and speech therapy (SP).
• Tracheotomy and laryngectomy equipment and supplies.
• Transportation to and from medical and or dental care and may require an application. You may call Logisticare of Colorado, Medicaid non-emergency transportation broker, at 1-800-390-3182 for more information.
• Vision exams and treatment, including eyeglasses.
• Well-child screening visits (EPSDT screens).
• Wheelchairs (manual, electric and specialty) accessories and repairs.