April 21, 2017
The Texas Health and Human Services (HHS) will renew the mosquito repellent benefit for statewide use in 2017 beginning May 1, 2017. The benefit will remain available through December 31, 2017.
The benefit will be available to clients in Medicaid fee-for-service (FFS) and managed care (MCO), Children's Health Insurance Program (CHIP), CHIP-Perinatal, Healthy Texas Women, Children with Special Health Care Needs Services (CSHCN), and Family Planning Programs. Eligible clients include pregnant women of any age, females ages 10-55 years, and males ages 14 and older in the aforementioned programs.
Coverage of mosquito repellents will be limited to two cans/bottles per calendar month: only one (1) can/bottle may be dispensed per fill, with one optional refill available per calendar month. Mosquito repellent claims will not count against clients' monthly three prescription limit. (FFS only).
The 2017 Texas Medicaid Standing Order for Mosquito Repellent is available for use with the 2017 mosquito repellent benefit for clients in Medicaid (FFS and MCO) and CHIP. The 2017 standing order has been revised. Please note, due to the changes in the eligible population, the previously issued standing order from 2016 must be replaced by the newly issued standing order for 2017. Pharmacies may directly obtain a copy of the 2017 Texas Medicaid Standing Order for Mosquito Repellent upon request by email to firstname.lastname@example.org.
A prescription from a valid healthcare provider is required for any pharmacy/pharmacist not operating under a standing order, for the dispensing of mosquito repellent to Medicaid or CHIP clients. Clients in the Healthy Texas Women program do not require a prescription. Clients in the CSHCN program require a prescription for mosquito repellent from a health care provider.