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Changes to Well-child Exams for Children with Medicaid

Resources for schools, providers and others

In the past, the Health Department has provided well-child health care to those children covered by Medicaid. But, a shift in reimbursement guidelines mean that children are now required to get well care at their regular doctors.

It’s estimated that 1,800 families throughout Boone, Campbell, Grant and Kenton counties will be affected by these changes.

Child being examined by a doctorChildren covered by Medicaid: will have to go to their regular doctor’s office for well-child exams, including blood lead screenings, and school physicals. Most will also do immunizations and complete immunization certificates as well. When families signed up for Medicaid, they should have been assigned to a doctor. If a family does not have one or can’t remember, contact the local Medicaid office or your Managed Care Organization (Kentucky Spirit, Coventry Cares or Well Point) for a referral.

Children without Medicaid OR private health insurance can make an appointment at the Health Department’s county health centers for well-child exams, school physicals and immunizations. Charges will be on a sliding-fee scale, based on your family size and income.

Children with private insurance can go to their regular doctor’s office for well-child exams and school physicals. Most will also do immunizations and complete immunization certificates as well. If a child don’t have a regular doctor, contact their insurance company for a list of those who take their plan.

Why is this happening? The reason for these changes is to promote a medical home for children. Children are better served by one person who can keep track of their on-going health and well-being—both when they are sick and well. The child gets to know that provider, and the provider builds a history with him/her.

If you have any questions about these changes or would like information about services provided at the Health Department, please contact your county health center.

These items are designed to help communicate these changes. If you have any questions or need another type of communication tool, contact Emily.Gresham-Wherle.

Letter to parents Word or  PDF
Sample newsletter article Word or PDF
Sample social media posts Word  or PDF
Kentucky Department of Education forms: This website has the latest required forms for school entry. Providers can download forms for dental screenings/exams, immunization certificates, medical examination of school employees, preventative health care examination form and vision exam forms.