Over-the-counter Drugs

HHSC provides coverage for over-the-counter (OTC) products for Medicaid clients. Specific coverage exceptions for OTC products include the following items when an OTC is an economical and therapeutic alternative to a prescription drug item:

  • Analgesics
  • Anti-emetics
  • Anti-inflammatory agents
  • Anti-parasitics
  • Dermatological agents
  • Enzyme replacements
  • Gastrointestinal agents, including:
    • Antacids
    • H-2 antagonists
    • Laxatives
    • Proton pump inhibitors
  • Insulin
  • Ophthalmic agents
  • Opiate dependence treatments
  • Oral contraceptives
  • Otic agents
  • Respiratory agents

Traditional Medicaid, CSHCN Services Program, and KHC Program

HHSC covers some OTC drugs, except for clients residing in a nursing facility. 

CHIP

Insulin, diabetic supplies, and mosquito repellant are the only covered OTC items.