1. Mosquito Repellent Benefit
Texas HHS covers mosquito repellents for the prevention of the Zika virus. HHS initially offered the benefit between Aug. and Dec. 2016 and again between April and Dec. 2017. Mosquito repellents became a year-round benefit as of Feb. 2018.
1.1 Eligible Populations
The eligible populations for the mosquito repellent benefit include:
- Females ages 10-55 years old and pregnant females of any age
- Males ages 14 and older
Coverage of mosquito repellents is limited to two cans or bottles per calendar month. Pharmacies should dispense only one can or bottle per fill, with one optional refill available per calendar month.
Mosquito repellent claims do not count against a person’s monthly three-prescription limit for people enrolled in traditional Medicaid.
1.3 Client Responsibility
Approved claims for people eligible for Medicaid, HTW program, and CSHCN Services Program are provided at no cost.
People enrolled in CHIP may be subject to a copay depending upon family income. Any potential copays should not exceed the cost of the product.
1.4 Covered Products
Texas HHS selected products based on guidance from the Centers for Disease Control and include the recommended amount of the active ingredient DEET, IR3535, oil of lemon eucalyptus, or Picaridin effective against the Zika virus.
|NDC||Product Name||Product UPC||Package Size||Unit of Measure||Active Ingredient|
|11423000338||Repel Sportsmen Max 40% spray||011423003387||184||GM||DEET|
|11423094109||Repel Lemon Eucalyptus 30% spray||011423941092||118||ML||Oil of Lemon Eucalyptus|
|11423094133||Repel Sportsmen Dry 25% spray||011423941337||113||GM||DEET|
|11423094137||Repel Sportsmen 25% spray||011423941375||184||GM||DEET|
|11423094139||Repel Hunter's 25% spray||011423941399||184||GM||DEET|
|46500071764||Off Deep Woods Dry 25% spray||046500717642||113||GM||DEET|
|46500001842||Off Deep Woods 25% spray||046500018428||170||GM||DEET|
|46500001859||Off Deep Woods 25% spray||04650001859X||311||GM||DEET|
|46500021845||Off Deep Woods 25% spray||046500218453||177||ML||DEET|
|46500022930||Off Deep Woods 25% spray||04650022930X||255||GM||DEET|
|46500061851||Off Deep Woods Sportsmen 30% spray||046500618512||170||GM||DEET|
|46500072131||Off Deep Woods Dry 25% spray||04650072131X||113||GM||DEET|
|46500072925||Off Deep Woods 25% spray||046500729256||266||ML||DEET|
|46500081846||Off Deep Woods Sportsmen 25% spray||046500818462||177||ML||DEET|
|51131067777||Ultrathon 25% repellent spray||051131677777||170||GM||DEET|
|68093007514||Coleman High-Dry 25% spray||368093075146||113||GM||DEET|
|68093007732||Coleman Botanicals insect spray||368093077324||118||ML||Oil of Lemon Eucalyptus|
|71121096014||Cutter Lemon Eucalyptus spray||071121960146||118||ML||Oil of Lemon Eucalyptus|
|71121096280||Cutter Backwoods 25% spray||071121962805||170||GM||DEET|
|71121096283||Cutter Backwoods 25% spray||071121962836||311||GM||DEET|
|71121096284||Cutter Backwoods 25% spray||071121962843||177||ML||DEET|
|71121096435||Cutter Backwoods Dry 25% spray||071121964359||113||GM||DEET|
|44224006878||Natrapel 20% spray||044224068781||177||ML||Picaridin|
|50716000544||Insect Repellent 20% spray (Sawyer)||050716005448||118||ML||Picaridin|
Pharmacies should process refills per the prescription detail if operating under written prescription or the Texas Medicaid Standing Order for Mosquito Repellent. If you operate under the standing order, contacting or faxing the physician listed on the standing order is unnecessary for refill requests or fax refill requests.
1.6 Other Medicaid Benefits
Other Medicaid benefits available in response to Zika virus prevention include oral contraceptives and long-acting reversible contraceptive products that help to prevent pregnancy. These are available as a Medicaid benefit to eligible individuals. Other covered benefits include family planning services, diagnostic testing, targeted case management, physical therapy, long-term services and support, acetaminophen and oral electrolytes for Zika virus symptoms, and potential coverage for additional ultrasounds for pregnant women.