does insurance cover well child visits

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Preventive care benefits for children

Coverage for children’s preventive health services.

A fixed amount ($20, for example) you pay for a covered health care service after you've paid your deductible.

Refer to glossary for more details.

The percentage of costs of a covered health care service you pay (20%, for example) after you've paid your deductible.

The amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself.

• Alcohol, tobacco, and drug use assessments  for adolescents
• Autism screening  for children at 18 and 24 months
• Behavioral assessments for children: Age  0 to 11 months ,  1 to 4 years ,  5 to 10 years ,  11 to 14 years ,  15 to 17 years

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• Blood pressure screening for children: Age  0 to 11 months ,  1 to 4 years  ,  5 to 10 years ,  11 to 14 years ,  15 to 17 years
• Blood screening  for newborns
• Depression screening  for adolescents beginning routinely at age 12
• Developmental screening  for children under age 3
• Fluoride supplements  for children without fluoride in their water source
• Fluoride varnish  for all infants and children as soon as teeth are present
• Gonorrhea preventive medication  for the eyes of all newborns
• Hematocrit or hemoglobin screening  for all children
• Hemoglobinopathies or sickle cell screening  for newborns
• Hepatitis B screening  for adolescents at higher risk
• HIV screening  for adolescents at higher risk
• Hypothyroidism screening  for newborns
• PrEP (pre-exposure prophylaxis) HIV prevention medication  for HIV-negative adolescents at high risk for getting HIV through sex or injection drug use
• Chickenpox (Varicella)
• Diphtheria, tetanus, and pertussis (DTaP)
• Haemophilus influenza type b
• Hepatitis A
• Hepatitis B
• Human Papillomavirus (HPV)
• Inactivated Poliovirus
• Influenza (flu shot)
• Meningococcal
• Pneumococcal
• Obesity screening and counseling
• Phenylketonuria (PKU) screening  for newborns
• Sexually transmitted infection (STI) prevention counseling and screening  for adolescents at higher risk
• Tuberculin testing for children at higher risk of tuberculosis: Age  0 to 11 months ,  1 to 4 years ,  5 to 10 years ,  11 to 14 years ,  15 to 17 years
• Vision screening  for all children
• Well-baby and well-child visits

More information about preventive services for children

• Preventive services for children age 0 to 11 months
• Preventive services for children age 1 to 4 years
• Preventive services for children age 5 to 10 years
• Preventive services for children age 11 to 14 years
• Preventive services for children age 15 to 17 years

More on prevention

• Learn more about preventive care from the CDC .
• See preventive services covered for  adults  and  women .
• Learn more about what else Marketplace health insurance plans cover.

Preventive Care 

Annual physical exams and other preventive services are free when you use a Preferred provider.

Preventive Care

Watch this video to take a closer look at your preventive care benefits and see how they can help you stay on top of your health.

As a Service Benefit Plan member, everyone on your plan can access a wide range of preventive care services—at no cost—when seeing a Preferred provider. Speak to your primary care doctor about which preventive care services are recommended for you.

General Health Screenings

These can help you and your doctor identify lifestyle changes you can make to avoid certain health conditions.

• Annual Physical
• Blood Pressure
• Cholesterol
• Hepatitis C
• Tobacco Use
• Well-child Visits 

Immunizations and Vaccines

It's recommended that everyone receive routine vaccinations depending on age and medical history. This includes

• Influenza (Flu Shot)
• Measles, Mumps, Rubella (MMR)
• Tetanus, Diphtheria, Pertussis (Tdap)

Cancer Screenings

Early cancer detection helps prevent the need for extensive treatment.

• Breast Cancer/Mammograms 
• Cervical Cancer
• Colon Cancer 

Family Planning

We cover a range of voluntary family planning services at no cost, limited to these services.

Contraceptive counseling, diaphragms and contraceptive rings, injectable contraceptives, oral and transdermal contraceptives, intrauterine devices (IUDs), implantable contraceptives, tubal ligation or tubal and occlusion/tubal blocking procedures only

HRSA-supported Guidelines

View a list of HRSA-supported Women’s Preventive Services Guidelines.

Contraception Coverage

View what contraception coverage is included under FEHB. If you have difficulty accessing contraceptive coverage or other reproductive healthcare, you can email [email protected]. 

Contraceptive Exception Form

View the necessary form for the contraception exception process.

Service not listed?

If your doctor recommends a surgical contraceptive service not listed above, please contact the customer service number on the back of your member ID card. They will ask that your provider send them information as to why one of the services above cannot be rendered. They will then make a coverage determination within 24 hours of receipt of sufficient medical records.

Ensure your child is healthy at every age

During their early years, children experience a lot of important development for their health. Through age 18, children should regularly see the doctor to make sure they’re growing up healthy and on track—even if they’re feeling well. These are called ‘well-child visits.’ These visits allow your child’s doctor to keep an eye out for key developmental milestones and get important routine vaccines.

Well-child visits are essential during the first 30 months of life

15 months old.

Babies need extra attention early in life. Newborns should have at least six well-child visits with their doctor during their first 15 months.

30 months old

Your baby should then have at least two more well-child visits with their doctor before they turn 30 months old.

Download our Well-Child Guide

Good health begins at an early age. This guide gives you a schedule of well-child visits recommended by the American Academy of Pediatrics plus a recommended vaccine schedule from birth through age 18.

Routine Annual Physical Incentive Program

FEP Blue Focus ®  members can get rewarded for having their annual checkup. Earn rewards like a personalized nutrition plan, a free health club membership or other incentives.

Find a Doctor

Browse our online directory of Preferred providers, urgent care centers, pharmacies and other facilities.

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Preventive Care

Most plans must over a set of preventive services – like shots and screenings – at no cost to you.

For example, depending on your age, you may have access to no-cost preventive services such as:

• Blood pressure ,  diabetes , and  cholesterol tests
• Many cancer screenings, including  mammograms  and  colonoscopies
• Counseling on such topics as  quitting smoking ,  losing weight ,  eating healthfully ,  treating depression , and  reducing alcohol use
• Regular  well-baby and well-child visits
• Routine  vaccinations against diseases  such as measles, polio, or meningitis
• Counseling, screening, and vaccines  to ensure healthy pregnancies
• Flu shots  and other vaccines

Why am I being charged a fee for preventive care?

Your health plan may charge a fee if:

• Out-of-network providers: These services are free only when delivered by a doctor or other provider in your plan’s network. Your health plan may allow you to receive these services from an out-of-network provider but may charge you a fee.
• Office visit fees:  Be aware that your plan can require you to pay some costs of the office visit if the preventive service is not the primary purpose of the visit.
• Grandfathered plans:  If your plan is “ grandfathered ,” these benefits may not be available to you.
• Talk to a health care provider to know which covered preventive services are right for you — based on your age, gender, and health status. 
• Contact your insurance company if you have questions about your plan or fees.

Need health insurance?

Find affordable health care and compare plans at Healthcare.gov .

University of Utah Hospital

General questions.

• Billing & Insurance

You are listening to Healthy Kids Zone :

"I Thought It Was Covered?" Why You May Receive a Bill After Your Child’s Well Visit

You've taken your child to scheduled well visits, but a few weeks later, you receive a bill in the mail for their care. Aren’t well visits covered by insurance? Dr. Cindy Gellner explains what happens on the billing side of pediatrics and how you may have accidentally asked for extra services during a covered check-up.

Episode Transcript

Dr. Gellner: So you take your child in for a well visit, but then you get a bill from your pediatrician's office. Well visits are covered 100% by most insurance companies. So why are you getting a bill?

Announcer: Keep your kids healthy and happy. You are now entering "The Healthy Kids Zone" with Dr. Cindy Gellner on The Scope.

Dr. Gellner: When a parent brings their child in for a well visit, often they want their pediatrician to address other issues. We've all had it happen. I'll have parents come in for a well visit, but then they'll also want me to refill medications or discuss headaches or stomach aches that their child's been having. And sometimes they want to discuss behavior concerns, evaluate for ADHD or depression. The problem is that insurance companies have very clear guidelines about what constitutes a preventive visit, which is how a well-child visit is billed versus what is billed under "E&M coding or evaluation and management coding."

Every insurance company has their own guidelines, but there are some things that are standard across the board, and these are set based on recommendations from the American Academy of Pediatrics and the Affordable Care Act. For example, checking your child's growth, getting routine immunizations, and checking developmental milestones are standard from birth to 5 years old. Screening for autism is now part of a well-child visit at ages 18 and 24 months. Vision screenings start at three, and some blood work is covered, especially if they're screening for medical conditions.

So what is not covered at a preventive visit? That's anything that is an acute or chronic issue. If your child fell and you think they have a broken arm, not covered. If your child takes several medications for asthma and you need refills for all of them, not covered. If your child has depression or anxiety and you're wanting to discuss that and possibly have them started on medications, not covered. All these things that require your pediatrician to ask questions that are unrelated to preventative care, to evaluate those issues, and then manage them however needed, hence the evaluation and management coding I mentioned, not covered.

In those cases, your pediatrician can do one of a few things. Sometimes depending on what is being discussed and how long of an appointment is needed, we might ask you to come back and our staff will help you schedule an appointment to be seen as soon as possible. If your pediatrician has time, they may tell you that they can address these other issues, and they should tell you about how the coding will be done. There are special modifiers that we use with coding to let the insurance companies know, "Hey, we understand this isn't part of a preventive visit, but we're trying to save the family from having to come back for a second visit and get everything done today." If we don't put that modifier in, it could put us in hot water, because insurance companies don't like us to do more than what we're coding for.

Also, as pediatricians, we do a lot of education and evaluating at a well visit, which we often only have a 15-minute appointment for. So if we're spending extra time addressing extra issues, it's not only pushing into another patient's appointment, but we would like to get paid for doing the additional work. Despite how important preventative care is, especially for the youngest patients, insurance companies pay very little to the pediatricians themselves. Pretty much we all knew that going into peds, but our little patients make the job so rewarding. I know I couldn't imagine being any other type of doctor. What other type of doctor can play with babies, talk to their patients about PokÈmon or superheroes, or look for elephants in their earwax? Seriously, it's the best type of practice.

Now, we know sometimes things are unavoidable, like you have a well-child visit scheduled and your child wakes up with a fever of 102 or cold symptoms for instance. In those cases, depending on how sick your child is, we'll often address the acute issue and reschedule the well visit and also use that rescheduled well visit as a follow-up to make sure they're better. If it's just a mild virus, we just carry on as usual with a well visit, because we know kids get six to eight viruses per year, and it can be guaranteed that your child will have one at a well visit at some point. If it's something simple, I'll just document that we discussed supportive care.

Another reason for getting a bill, which is less common, is that you are getting a well visit on your child too soon. This is mainly for children over the age of 3 where insurance only covers one well visit per year. Some insurance policies consider one year from the date of the last well visit. Some consider it one per policy year. But for all insurances, they can only have one well-child visit per year if they're over 3. So if your child already had a four-year checkup, for example, they have to be five before the next one and it has to pass that one year period.

Also, when scheduling well visits, make sure enough time has passed before the next set of vaccines if they're due for vaccines. An example of this is that there has to be at least six months between the first and second hepatitis A vaccines. Your child's pediatrician should be able to tell you exactly when they would be due for the next vaccine in the series.

So if you have any questions about when your child can be seen for a well visit or what all is covered in a well visit, please either check with your insurance company or talk to your pediatrician directly. Most of us know the rules.

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Family Life

AAP Schedule of Well-Child Care Visits

Parents know who they should go to when their child is sick. But pediatrician visits are just as important for healthy children.

The Bright Futures /American Academy of Pediatrics (AAP) developed a set of comprehensive health guidelines for well-child care, known as the " periodicity schedule ." It is a schedule of screenings and assessments recommended at each well-child visit from infancy through adolescence.

Schedule of well-child visits

• The first week visit (3 to 5 days old)
• 1 month old
• 2 months old
• 4 months old
• 6 months old
• 9 months old
• 12 months old
• 15 months old
• 18 months old
• 2 years old (24 months)
• 2 ½ years old (30 months)
• 3 years old
• 4 years old
• 5 years old
• 6 years old
• 7 years old
• 8 years old
• 9 years old
• 10 years old
• 11 years old
• 12 years old
• 13 years old
• 14 years old
• 15 years old
• 16 years old
• 17 years old
• 18 years old
• 19 years old
• 20 years old
• 21 years old

The benefits of well-child visits

Prevention . Your child gets scheduled immunizations to prevent illness. You also can ask your pediatrician about nutrition and safety in the home and at school.

Tracking growth & development . See how much your child has grown in the time since your last visit, and talk with your doctor about your child's development. You can discuss your child's milestones, social behaviors and learning.

Raising any concerns . Make a list of topics you want to talk about with your child's pediatrician such as development, behavior, sleep, eating or getting along with other family members. Bring your top three to five questions or concerns with you to talk with your pediatrician at the start of the visit.

Team approach . Regular visits create strong, trustworthy relationships among pediatrician, parent and child. The AAP recommends well-child visits as a way for pediatricians and parents to serve the needs of children. This team approach helps develop optimal physical, mental and social health of a child.

More information

Back to School, Back to Doctor

Recommended Immunization Schedules

Milestones Matter: 10 to Watch for by Age 5

Your Child's Checkups

• Bright Futures/AAP Recommendations for Preventive Pediatric Health Care (periodicity schedule)

Shop for Plans

Shop for your own coverage, plans through your employer.

Learn about the medical, dental, pharmacy, behavioral, and voluntary benefits your employer may offer.

Looking for Medicare coverage?

Well-child visits.

It's important for your child to have regularly scheduled checkups, often called well-child visits, beginning shortly after birth and lasting through the teen years.

These appointments allow your doctor to keep a close eye on your child's general health and development. Finding possible problems early gives your child the best chance for proper and successful treatment. Also, any concerns you have about your child can be discussed during these visits.

During these visits, the doctor examines your child and asks you questions about your child's development and behavior. Immunizations also are either given or scheduled at this time.

Your child's doctor will recommend a schedule for well-child visits. One example is for visits at ages: footnote 1

• 3 to 5 days old.
• By 1 month.

After age 3, well-child visits are usually scheduled yearly through the teen years.

Citations Bright Futures/American Academy of Pediatrics (2020). Recommendations for preventive pediatric health care. American Academy of Pediatrics . https://downloads.aap.org/AAP/PDF/periodicity_schedule.pdf. Accessed February 27, 2020.

Current as of: October 24, 2023

Author: Healthwise Staff

Clinical Review Board All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use . Learn how we develop our content .

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Well-Child Care

Improving infant well-child visits.

High-quality well-child visits can improve children’s health, support caregivers’ behaviors to promote their children’s health, and prevent injury and harm. The American Academy of Pediatrics and Bright Futures recommend nine well-care visits by the time children turn 15 months of age. These visits should include a family-centered health history, physical examination, immunizations, vision and hearing screening, developmental and behavioral assessment, an oral health risk assessment, a social assessment, maternal depression screening, parenting education on a wide range of topics, and care coordination as needed. i  When children receive the recommended number of high-quality visits, they are more likely to be up-to-date on immunizations, have developmental concerns recognized early, and are less likely to visit the emergency department. ii , iii , iv , v , vi , vii  However, many infants do not receive the recommended number of infant well-child visits. 

The Centers for Medicare & Medicaid Services (CMS) offers quality improvement (QI) technical assistance (TA) to help states increase the attendance and quality of well-child visits for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries ages 0 to 15 months.

QI TA resources , to help state Medicaid and CHIP staff and their QI partners get started improving the use of infant well-child visits for their beneficiaries

Improving Infant Well-Child Visit learning collaborative resources , to share different approaches to improving well-child visit care and state examples

For more information on these materials and other QI TA, please email [email protected] .

QI TA Resources

These resources can help states get started in developing their own infant well-child QI projects:

Getting Started on Quality Improvement Video . This video provides an overview of how Medicaid and CHIP agencies can start a QI project to improve the use of infant well-child visits. The Model for Improvement begins with small tests of change, enabling state teams to “learn their way” toward strong programs and policies.

Driver Diagram and Change Idea Table . A driver diagram is a visual display of what “drives” or contributes to improvements in infant well-child visits. This example of a driver diagram shows the relationship between the primary drivers (the high-level elements, processes, structures, or norms in the system that must change to use and quality of infant well-child visits) and the secondary drivers (the places, steps in a process, time-bound moments, or norms in which changes are made to spur improvement). The document also includes change idea tables, which contain examples of evidence-based or evidence-informed QI interventions to improve the use of infant well-child care. The change ideas were tailored for Medicaid and CHIP.

Measurement Strategy . This document provides examples of measures that can be used to monitor infant well-child care QI projects.

Improving Infant Well-Child Visits: Learning Collaborative Resources

Beginning in 2021, CMS facilitated the two year Infant Well-Child Visit learning collaborative to support state Medicaid and CHIP agencies’ efforts to improve the use of infant well-child visits from 0-15 months of age. The learning collaborative included a webinar series and an affinity group to support state Medicaid and agencies’ quality improvement efforts. The webinars, listed and linked to below, described approaches that states can use to improve attendance and quality of infant well-child visits.

California, Missouri, North Carolina, South Carolina, Texas and Virginia participated in the action-oriented affinity group where teams designed and implemented an infant well-child quality improvement (QI) project in their state with tailored TA from CMS. Learnings from participating states can be found in the state highlights brief.

Learning Collaborative Webinar Series

State Spotlights Webinar on Improving Infant-Well Child Care ( Video ) ( Transcript ). This 2024 webinar spotlighted several state QI projects from the affinity group, highlighting their strategies, partnerships, and lessons learned.

Using Payment, Policy and Partnerships to Improve Infant Well-Child Care ( Audio )( Transcript ). This August 2021 webinar focused on Medicaid and CHIP payment incentives, managed care contracts, and other strategies that can increase the use and quality of infant well-child visits and advance equity. Speakers from the CMS and Mathematica introduced CMS’ Maternal and Infant Health Initiative and shared the importance of high-quality well-child visits and the opportunities within Medicaid and CHIP to impact infant health. Speakers from Pennsylvania and Texas’ Medicaid and CHIP agencies described their efforts to expand and incentivize participation in infant well-child visits, such as through value-based purchasing, performance improvement projects, CHIP Health Services Initiatives (HSIs), and partnerships with aligned service providers like the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). State presenters offered insights into ways to incentivize efforts to close gaps in care, engage families, and improve performance on quality measures. During the Q&A session, presenters discussed the impact of the COVID-19 pandemic on well-child care, the potential of using telehealth or hybrid visits to increase access, and incentives for managed care entities, and addressing the social determinants of health in value-based payment strategies.

  Improving Quality and Utilization of Infant Well-Child Visits ( Audio )( Transcript ). This September 2021 webinar focused on the characteristics of a high-performing system of well-child health care. CMS and Mathematica presenters shared the Maternal and Infant Health Initiative’s Theory of Change. Speakers from Washington and Arkansas Medicaid and CHIP agencies discussed how their states have achieved high rates of participation in infant well-child visits and how they use data to monitor performance and disparities and ensure access to services. Washington shared insights on leveraging collaborative performance improvement projects to identify and address barriers to care. Arkansas discussed the state’s per member per month incentives for performance and minimum performance measures for infant well-child visit rates. During the Q&A session, presenters highlighted efforts to improve health equity, engage parents and providers, and leverage performance measures and quality tools to improve attendance at infant well-child visits.

Models of Care that Drive Improvement in Infant Well-Child Visits ( Audio )( Transcript ). In this September 2021 webinar, three states—Oregon, Michigan, and North Carolina—shared approaches to designing and implementing models of care associated with improved infant well-child visit participation, including patient-centered medical homes (PCMHs) and home visiting. States offered insights on the importance of strategic alignment of policies, processes, and partnerships. Oregon discussed its home visiting program and quality incentive strategy for its coordinated care organizations. The state incentivizes progress on the HEDIS measures and other measures designed by the state’s Pediatric Improvement Partnership, including a measure of social-emotional health service capacity and access for infants and children. Michigan discussed how they requires MCOs to identify and publish disparities in well-child visit rates and how they encourage plans to reduce disparities. The state also uses an algorithm that automatically assigns members to MCOs based on MCOs’ performance and reimburses for maternal-infant health home visiting. North Carolina shared its Keeping Kids Well program, which aims to increase well-child visit and immunization rates and reduce disparities in those rates. The program offers coaches to practices to support their improvements, established an advisory board of key interested parties, and provides customized vaccination notices for practices to distribute to beneficiaries, in partnership with health systems and pharmaceutical companies. The state also used the Healthy Opportunities payment to incentivize the identification and redress of health-related social needs and provided the Health Equity Payment to providers serving areas with high poverty rates. 

i 3 Hagan, J.F., J.S. Shaw, and P.M. Duncan (eds.). Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents. 4th ed. Elk Grove Village, IL: American Academy of Pediatrics, 2017.

ii Gill, J.M., A. Saldarriaga, A.G. Mainous, and D. Unger. “Does Continuity Between Prenatal and Well-Child Care Improve Childhood Immunizations?” Family Medicine, vol. 34, no. 4, April 2002, pp. 274–280.

iii Buchholz, M., and A. Talmi. “What We Talked About at the Pediatrician’s Office: Exploring Differences Between Healthy Steps and Traditional Pediatric Primary Care Visits.” Infant Mental Health Journal, vol. 33, no. 4, 2012, pp. 430–436.

iv DeVoe, J.E., M. Hoopes, C.A. Nelson, et al. “Electronic Health Record Tools to Assist with Children’s Insurance Coverage: A Mixed Methods Study.” BMC Health Services Research, vol.18, no. 1, May 2018, p. 354–360.

v Coker, T.R., S. Chacon, M.N. Elliott, et al. “A Parent Coach Model for Well-Child Care Among Low-Income Children: A Randomized Controlled Trial.” Pediatrics, vol. 137, no. 3, March 2016, p. e20153013.

vi Flores, G., H. Lin, C. Walker, M. Lee, J. Currie, R. Allgeyer, M. Fierro, M. Henry, A. Portillo, and K. Massey. “Parent Mentoring Program Increases Coverage Rates for Uninsured Latino Children.” Health Affairs, vol. 37, no. 3, 2018, pp. 403–412.

vii Hakim, R.B., and D.S. Ronsaville. “Effect of Compliance with Health Supervision Guidelines Among US Infants on Emergency Department Visits.” Archives of Pediatrics & Adolescent Medicine, vol. 156, no. 10, October 2002, pp. 1015–1020.

Doctor Visits

Make the Most of Your Baby’s Visit to the Doctor (Ages 0 to 11 Months)

Take Action

Babies need to go to the doctor or nurse for a “well-baby visit” 6 times before their first birthday.

A well-baby visit is when you take your baby to the doctor to make sure they’re healthy and developing normally. This is different from other visits for sickness or injury.

At a well-baby visit, the doctor or nurse can help catch any problems early, when they may be easier to treat. You’ll also have a chance to ask any questions you have about caring for your baby.

Learn what to expect so you can make the most of each well-baby visit.

Well-Baby Visits

How often do i need to take my baby for well-baby visits.

Babies need to see the doctor or nurse 6 times before their first birthday. Your baby is growing and changing quickly, so regular visits are important.

The first well-baby visit is 2 to 3 days after coming home from the hospital, when the baby is about 3 to 5 days old. After that first visit, babies need to see the doctor or nurse when they’re:

• 1 month old
• 2 months old
• 4 months old
• 6 months old
• 9 months old

If you’re worried about your baby’s health, don’t wait until the next scheduled visit — call the doctor or nurse right away.

Child Development

How do i know if my baby is growing and developing on schedule.

Your baby’s doctor or nurse can help you understand how your baby is developing and learning to do new things — like smile or turn their head to hear your voice. These are sometimes called “developmental milestones.”

At each visit, the doctor or nurse will ask you how you’re doing as a parent and what new things your baby is learning to do. 

By age 2 months, most babies:

• Lift their head when lying on their stomach
• Look at your face
• Smile when you talk to them
• React to loud sounds

See a complete list of milestones for kids age 2 months .

By age 4 months, most babies:

• Bring their hands to their mouth
• Make cooing sounds
• Hold toys that you put in their hand
• Turn their head to the sound of your voice
• Make sounds when you talk to them

See a complete list of milestones for kids age 4 months .

By age 6 months, most babies:

• Lean on their hands for support when sitting
• Roll over from their stomach to their back
• Show interest in and reach for objects
• Recognize familiar people
• Like to look at themselves in a mirror

See a complete list of milestones for kids age 6 months . 

By age 9 months, most babies:

• Make different sounds like “mamamama” and “bababababa”
• Smile or laugh when you play peek-a-boo
• Look at you when you say their name
• Sit without support

See a complete list of milestones for kids age 9 months . 

What if I'm worried about my baby's development? 

Remember, every baby develops a little differently. But if you’re concerned about your child’s growth and development, talk to your baby’s doctor or nurse. 

Learn more about newborn and infant development .

Take these steps to help you and your baby get the most out of well-baby visits.

Gather important information.

Take any medical records you have to the appointment, including a record of vaccines (shots) your baby has received and results from newborn screenings . Read about newborn screenings .

Make a list of any important changes in your baby’s life since the last doctor’s visit, like:

• Falling or getting injured
• Starting daycare or getting a new caregiver

Use this tool to  keep track of your baby’s family health history .

What about cost?

Under the Affordable Care Act, insurance plans must cover well-child visits. Depending on your insurance plan, you may be able to get well-child visits at no cost to you. Check with your insurance company to find out more.

Your child may also qualify for free or low-cost health insurance through Medicaid or the Children’s Health Insurance Program (CHIP). Learn about coverage options for your family.

If you don’t have insurance, you may still be able to get free or low-cost well-child visits. Find a health center near you and ask about well-child visits.

To learn more, check out these resources:

• Free preventive care for children covered by the Affordable Care Act
• How the Affordable Care Act protects you and your family
• Understanding your health insurance and how to use it [PDF - 698 KB]

Ask Questions

Make a list of questions to ask the doctor..

Before the well-baby visit, write down 3 to 5 questions you have. Each well-baby visit is a great time to ask the doctor or nurse any questions about:

• How your baby is growing and developing
• How your baby is sleeping
• Breastfeeding your baby
• When and how to start giving your baby solid foods
• What changes and behaviors to expect in the coming months
• How to make sure your home is safe for a growing baby

Here are some questions you may want to ask:

• Is my baby up to date on vaccines?
• How can I make sure my baby is getting enough to eat?
• Is my baby at a healthy weight?
• How can I make sure my baby is sleeping safely — and getting enough sleep?
• How can I help my baby develop speech and language skills?
• Is it okay for my baby to have screen time?
• How do I clean my baby's teeth?

Take a notepad, smartphone, or tablet and write down the answers so you can remember them later.

Ask what to do if your baby gets sick.

Make sure you know how to get in touch with a doctor or nurse when the office is closed. Ask how to reach the doctor on call, or if there's a nurse information service you can call at night or on the weekend.

What to Expect

Know what to expect..

During each well-baby visit, the doctor or nurse will ask you about your baby and do a physical exam. The doctor or nurse will then update your baby’s medical history with all of this information.

The doctor or nurse will ask questions about your baby.

The doctor or nurse may ask about:

• Behavior — Does your baby copy your movements and sounds?
• Health — How many diapers does your baby wet each day? Does your baby spend time around people who are smoking or using e-cigarettes (vaping)?
• Safety — If you live in an older home, has it been inspected for lead? Do you have a safe car seat for your baby?
• Activities — Does your baby try to roll over? How often do you read to your baby?
• Eating habits — How often does your baby eat each day? How are you feeding your baby?
• Family — Do you have any worries about being a parent? Who can you count on to help you take care of your baby?

Your answers to questions like these will help the doctor or nurse make sure your baby is healthy, safe, and developing normally.

Physical Exam

The doctor or nurse will also check your baby’s body..

To check your baby’s body, the doctor or nurse will:

• Measure height, weight, and the size of your baby’s head
• Take your baby’s temperature
• Check your baby’s eyes and hearing
• Check your baby’s body parts (this is called a physical exam)
• Give your baby shots they need

Learn more about your baby’s health care:

• Read about what to expect at your baby’s first checkups
• Find out how to get your baby’s shots on schedule

Content last updated March 30, 2023

Reviewer Information

This information on well-baby visits was adapted from materials from the Centers for Disease Control and Prevention and the National Institutes of Health.

Reviewed by: Sara Kinsman, M.D., Ph.D. Director, Division of Child, Adolescent, and Family Health Maternal and Child Health Bureau Health Resources and Services Administration

Bethany Miller, M.S.W. Chief, Adolescent Health Branch Maternal and Child Health Bureau Health Resources and Services Administration

Diane Pilkey, R.N., M.P.H. Nursing Consultant, Division of Child, Adolescent, and Family Health Maternal and Child Health Bureau Health Resources and Services Administration

September 2021

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The Impact of the Pandemic on Well-Child Visits for Children Enrolled in Medicaid and CHIP

Elizabeth Williams , Alice Burns , Robin Rudowitz , and Patrick Drake Published: Mar 18, 2024

In Medicaid, states are required to cover all screening services as well as any services “necessary… to correct or ameliorate” a child’s physical or mental health condition under Medicaid’s Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit (see Box 1). Many of these screening services along with immunizations are provided at well-child visits. These visits are a key part of comprehensive preventive health services designed to keep children healthy and to identify and treat health conditions in a timely manner. Various studies have also shown that children who forego their well-child visits have an increased chance of going to the emergency room or being hospitalized. Well-child visits are recommended once a year for children ages three to 21 and multiple times a year for children under age three according to the Bright Futures/American Academy of Pediatrics (AAP) periodicity schedule .

A recent Centers for Medicare and Medicaid Services (CMS) analysis shows that half of children under age 19 received a Medicaid or CHIP funded well-child visit in 2020. The onset of the pandemic in 2020 had a substantial impact on health and health care service utilization, but research has shown that many Medicaid-covered children were not receiving recommended screenings and services even before the pandemic. This issue brief examines well-child visit rates overall and for selected characteristics before and after the pandemic began and discusses recent state and federal policy changes that could impact children’s preventive care. The analysis uses Medicaid claims data which track the services enrollees use and may differ from survey data. In future years, claims data will be used to monitor adherence to recommended screenings. Key findings include:

• More than half (54%) of children under age 21 enrolled in Medicaid or CHIP received a well-child visit in 2019, but the share fell to 48% in 2020, the start of the COVID-19 pandemic.
• Despite having the highest well-child visit rates compared to other ethnic and racial groups, Hispanic and Asian children enrolled in Medicaid or CHIP saw the largest percentage point declines in well-child visit rates from 2019 to 2020.
• Children over age three enrolled in Medicaid or CHIP have lower rates of well-child visits and experienced larger declines in well-child visits during the pandemic than children under age three.
• Well-child visit rates are lower for Medicaid/CHIP children in rural areas, but rates in urban areas declined more during the pandemic.

How did use of well-child visits change during the pandemic?

More than half (54%) of children under 21 enrolled in Medicaid or CHIP received a well-child visit in 2019, but the share fell to 48% in 2020, the first year of the COVID-19 pandemic (Figure 1). Rates examined here use Medicaid claims data which differ substantially from survey data (see Box 2). While the vast majority of children in the analysis (91% in 2019 and 88% in 2020) used a least one Medicaid service, including preventive visits, sick visits, filling prescriptions, or hospital or emergency department visits, well-child visit rates remained low and are substantially below the CMS goal of at least 80%. One recent analysis found that 4 in 10 children enrolled in Medicaid or CHIP experienced at least one challenge when accessing health care. Barriers to Medicaid/CHIP children receiving needed care can include lack of transportation, language barriers, disabilities , and parents having difficulty finding childcare or taking time off for an appointment as well as the availability of and distance to primary care providers. Some states have seen a loss in Medicaid pediatric providers, and one recent story reported that families with Medicaid in California were traveling long distances and experiencing long wait times for primary care appointments. Data have also shown slight declines in the share of kindergarten children up to date on their routine vaccinations since the COVID-19 pandemic, which may, in part, be associated with the decline in well-child visits. The national measles, mumps, and rubella (MMR) vaccination rate is below the goal of at least 95%, and some states are now seeing measle outbreaks among children.

Despite having the highest well-child visit rates compared to other ethnic and racial groups, Hispanic and Asian children enrolled in Medicaid or CHIP saw the largest percentage point declines in well-child visit rates from 2019 to 2020 (Figure 2). Prior to the pandemic in 2019, about half or more of children across most racial and ethnic groups had a well-child visit, with rates highest for Hispanic (60%) and Asian (57%) children. The rate for American Indian and Alaska Native (AIAN) children lagged behind at just over one in three (36%), although this may reflect that some services received from Indian Health Service providers not being captured in the analysis (see Methods ). Between 2019 and 2020, the well-child visit rate fell for all racial and ethnic groups. Hispanic and Asian children experienced the largest percentage point declines in well-child rates (9 percentage points for both groups), but they still had higher rates compared to other groups as of 2020. Black, Native Hawaiian, and Other Pacific Islander (NHOPI), and AIAN children also experienced larger percentage point declines in their well-child visit rates compared with White children, and AIAN children had the largest relative decline on account of their lower starting rate. As of 2020, rates remained lowest for NHOPI (42%) and AIAN children (29%). Twenty-two states, including some states that are home to larger shares of AIAN and NHOPI children, were excluded from the race/ethnicity analysis due to data quality issues (see Methods ).

Children ages three and older have lower rates of well-child visits and experienced larger declines in well-child visits during the pandemic than children under age three (Figure 2). Well-child visit rates are highest when children are young because multiple well-child visits are recommended for children under age three. Although children under three have highest rates of a single well-child visit within the year, it is unknown whether the rates of adherence to recommended well-child screenings are higher or lower than that of other groups because this analysis only accounts for one well-child visit in a year. Well-child visit rates steadily decrease as children get older with the exception of the 10-14 age group, where somewhat higher rates may reflect school vaccination requirements .

Well-child visit rates are lower in rural areas than urban ones, but urban areas had larger declines during the first year of the pandemic (Figure 2). The share of Medicaid/CHIP children living in rural areas with a well-child visit declined from 47% in 2019 to 43% in 2020 while the share for urban areas fell from 56% in 2019 to 49% in 2020, narrowing the gap between Medicaid/CHIP well-child visit rates in rural and urban areas. Note that 18% of children in the analysis lived in a rural area, and three states were excluded from the geographic area analysis due to data quality issues (see Methods ). This analysis also examined changes for children by eligibility group, managed care status, sex, and presence of a chronic condition; data are not shown but well-child visit rates for Medicaid/CHIP children declined across all groups from 2019 to 2020.

What to watch?

Well-child visit rates for Medicaid/CHIP children overall fall below the goal rate, with larger gaps for AIAN, Black and NHOPI children as well as older children and children living in rural areas, highlighting the importance of outreach and other targeted initiatives to address disparities. Addressing access barriers and developing community partnerships have been shown to increase well-child visit rates and reduce disparities. It will be important to track, as data become available, the extent to which well-child visit rates as well as vaccination rates (often administered at well-child visits) rebounded during the pandemic recovery and where gaps remain.

Recent state and federal actions could help promote access, quality and coverage for children that could increase well-child visit rates. The Bipartisan Safer Communities Act included a number of Medicaid/CHIP provisions to ensure access to comprehensive health services and strengthen state implementation of the EPSDT benefit. CMS also released an updated school-based services claiming guide , and states have taken action to expand Medicaid coverage of school-based care in recent years. In 2024, it became mandatory for states to report the Child Core Set, a set of physical and mental health quality measures, with the goal of improving health outcomes for children. In addition, as of January 2024, all states are now required to provide 12-month continuous eligibility for Medicaid and CHIP children, which could help stabilize coverage and help children remain connected to care. Three states also recently received approval to extend continuous eligibility for children in Medicaid for multiple years, which could  help  children maintain coverage beyond one year. In the recently released FY 2025 budget, the Biden Administration proposes establishing the option for states to provide continuous eligibility in Medicaid and CHIP for children from birth to age six or for 36 month periods for children under 19.

Lastly, millions of children are losing Medicaid coverage during the unwinding of the continuous enrollment provision, which could have implications for access. Data up to March 2024 show that children’s net Medicaid enrollment has declined by over 4 million. In some cases, children dropped from Medicaid may have transitioned to other coverage, but they may also become uninsured, despite in many cases remaining eligible for Medicaid or CHIP. While people of color are more likely to be covered by Medicaid , data on disenrollment patterns by race and ethnicity are limited . KFF analysis shows individuals without insurance coverage have lower access to care and are more likely to delay or forgo care due to costs. A loss of coverage or gaps in coverage can be especially problematic for young children who are recommended to receive frequent screenings and check-ups.

• Children's Health Insurance Program (CHIP)
• Access to Care

Also of Interest

• Recent Trends in Children’s Poverty and Health Insurance as Pandemic-Era Programs Expire
• More Children are Losing Medicaid Coverage as Child Poverty Grows 
• Medicaid Enrollment and Unwinding Tracker
• Headed Back To School in 2023: A Look at Children’s Routine Vaccination Trends