Cough and Cold Products
HHSC provides coverage for certain cough and cold products for Medicaid clients. Covered products in this category include analgesics, antihistamines, antitussives, decongestants, and expectorants.
Cough and cold combination products for children less than 2 years are not covered. This excludes single entity antihistamines. Other uses of cough and cold products for children less than 6 years are subject to clinical prior authorization. Products containing acetaminophen, ibuprofen, or narcotics for children less than 6 years are not covered.
Products require prior authorization if the product is not indicated for the person’s age. Products containing a narcotic will require prior authorization if a child is between 6 and 12 years old.