The mosquito repellent benefit is available for people enrolled in the following programs:
- Medicaid (traditional and managed care)
- Children's Health Insurance Program and CHIP-Perinatal
- Healthy Texas Women program (HTW)
- Children with Special Health Care Needs services program
HHSC issued the Texas Medicaid Standing Order for Mosquito Repellent for use by people enrolled in Medicaid, CHIP and HTW. This order serves as a prescription and allows pharmacists to dispense mosquito repellent under the terms of the order. Pharmacies are encouraged to use this order instead of contacting the person’s healthcare providers for individual prescriptions for mosquito repellent. A prescription from a valid healthcare provider is required for any pharmacy or pharmacist not operating under the standing order.
Pharmacy staff request a copy of the standing order by emailing firstname.lastname@example.org.
The Mosquito Repellent Standing Order Prescription Template (HHS Form 1404) is available on the VDP website. The template is used only in the processing of claims for mosquito repellent for people enrolled in Texas Medicaid, CHIP and HTW under the standing order for mosquito repellent. Any unauthorized use of the prescriber information within the template is referred to the HHS Inspector General as potential fraud.
A prescription is required for people enrolled in the CSHCN services program. Contact the person’s health care provider to obtain a prescription for mosquito repellent.