Health Right

Health Right - for you, your family, and your community

Medicaid Programs

Since April, 1998, Health Right, Inc. has been entrusted with the responsibility for overseeing the quality of health care services provided to an array of District residents. Eleven years later, HRI continues in its commitment to ensuring that all its members receive optimum quality health care. We offer an array of preventative health services and wellness programs that are committed to assist our members to improve their quality of life.

Prenatal Care
Health Check
Early Intervention
Immunization & Dental

Prenatal Care

Health Right provides a Prenatal Care Management Program for members that have high risk pregnancies and desire enrollment into the program. The goal of this program is to encourage pregnant members to seek timely and consistent prenatal care. The UM/CM Assistant receives the member information and contacts the member to verify pregnancy. Once screened by the UM/CM Assistant responsible for OB care, the member is referred to a nurse if medical eligibility requirements are found. Members are referred to the Healthy Start program for enrollment to receive the Healthy Start prenatal packet, assistance throughout their pregnancy, referrals to agencies, and information on Health Right benefits.

All members are provided referrals to WIC at 202-645-5663 and Healthy Start at 202-645-4174. Members or providers may access the program by calling HRI and requesting a transfer to the UM/CM Department at 202-218-0373.

Remember, if you are pregnant or think you are pregnant do not drink alcohol, use drugs or smoke.

Health Right wants to help your children grow up healthy. If your child is in the D.C. Healthy Families (Medicaid) program, your child will be in the Health Check Program, also called Early and Periodic Screening, Diagnosis and Treatment (EPSDT). This program starts right after your child is born and lasts until your child turns 21. The Health Check Program gives your child a number of important checkups.

There is a Health Check (EPSDT) information sheet in this handbook. You can also ask your doctor, call Member Services, or visit our website www.healthright-dc.com for a copy of the Health Check (EPSDT) Periodicity Schedule. The schedule tells you when your child needs to go to the doctor.

In addition to Health Check/EPSDT services, your child can also get the benefits described in the "Member Health Benefits" section below.

The following milestones are also important to help you assess your child’s development in the first two years:

By 3 months of age does your child:

Motor Skills

lift head when held at your shoulder

lift head and chest when lying on his stomach

turn head from side to side when lying on his stomach

follow a moving object or person with his eyes

often hold hands open or loosely fisted

grasp rattle when given to her

wiggle and kick with arms and legs

Sensory and Thinking Skills

turn head toward bright colors and lights

turn toward the sound of a human voice

recognize bottle or breast

respond to your shaking a rattle or bell

Language and Social Skills

make cooing, gurgling sounds

smile when smiled at

communicate hunger, fear, discomfort (through crying or facial expression)

usually quiet down at the sound of a soothing voice or when held

anticipate being lifted

react to "peek-a-boo" games

By 6 months of age does your child:

Motor Skills

hold head steady when sitting with your help

reach for and grasp objects

play with his toes

help hold the bottle during feeding

explore by mouthing and banging objects

move toys from one hand to another

shake a rattle

pull up to a sitting position on her own if you grasp her hands

sit with only a little support

sit in a high chair

roll over

bounce when held in a standing position

Sensory and Thinking Skills

open his mouth for the spoon

imitate familiar actions you perform

Language and Social Skills

babble, making almost sing-song sounds

know familiar faces

laugh and squeal with delight

scream if annoyed

smile at herself in a mirror

By 12 months of age does your child:

Motor Skills

drink from a cup with help

feed herself finger food like raisins or bread crumbs

grasp small objects by using her thumb and index or forefinger

use his first finger to poke or point

put small blocks in and take them out of a container

knock two blocks together

sit well without support

crawl on hands and knees

Pull himself to stand or take steps holding onto furniture

stand alone momentarily

walk with one hand held

cooperate with dressing by offering a foot or an arm

Sensory and Thinking Skills

copy sounds and actions you make

respond to music with body motion

try to accomplish simple goals (seeing and then crawling to a toy)

look for an object she watched fall out of sight (such as a spoon that falls under the table)

Language and Social Skills

babble, but it sometimes "sounds like" talking

say his first word

recognize family members' names

try to "talk" with you

respond to another's distress by showing distress or crying

show affection to familiar adults

show mild to severe anxiety at separation from parent

show apprehension about strangers

raise her arms when she wants to be picked up

understand simple command

When children have -- or are at risk of having -- physical, developmental, behavioral, or emotional conditions that are permanent or that last a long time, they can have Special Health Care Needs. These children may need health care and other services that are more than or different from what other children need.

Health Right will check to see if your child has Special Health Care Needs. Please be sure your child has been checked for this. If your child has not been checked to see if they have special healthcare needs, call Member Services at 202-218-0380.

If your child has Special Health Care Needs, your child has the right to have a PCP who is a specialist Be sure your child with a special health care need has a Treatment Plan. Call Health Right Member Services to ask for a treatment plan for your child.

Immunizations (shots) are important to keep your child healthy! When your child is very young, your child will need shots every few months. The shots start at birth. These shots protect them from diseases.

Your PCP and Health Right will schedule appointments for your child's shots. Shots are free. The shot schedule for children is:

All dental health checkups and treatments are free for Health Right Members under age 21. Dentists can prevent cavities and teach you and your child how to care for their teeth.

From birth up to age 3, your child's PCP may provide dental care during regular check-ups. The PCP may decide to send the child to a dentist.

Beginning at age 3, all children should see a dentist in the Health Right network for a checkup every year. Look in the Health Right's Provider Directory or online at www.healthright-dc.com to pick a dentist near you. Please call the dentist's office for an appointment.