Pharmacy Benefit

Providers can prescribe and obtain LARC products on the Medicaid and Healthy Texas Women (HTW) Program formularies from certain specialty pharmacies for women participating in those programs.  LARC products are only available through these specialty pharmacies working with LARC manufacturers.  Providers who prescribe and obtain LARC products through these specialty pharmacies will be able to return unused and unopened LARC products to the manufacturer's third-party processor. Providers may continue to obtain products through the existing buy-and-bill process.

Review the Long-Acting Reversible Contraception Products document (PDF) for detailed information regarding prescribing, pharmacy participation, obtaining LARC products, Medicaid managed care participation, and the LARC buy-back program.

The following products are currently available:

Long-acting reversible contraception products
Manufacturer Drug Name National Drug Code (NDC)
Bayer Kyleena 50419042401
Bayer Mirena 50419042101
Bayer Mirena 50419042301
Bayer Skyla 50419042201
Merck Nexplanon 00052433001
Cooper Surgical Paragard 59365512801