Long-acting Reversible Contraception Products

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 that work 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:

Manufacturer Resources

Bayer

• Specialty Pharmacy Prescription Request Form (PDF)
• Abandoned Unit Program FAQ/Return Form (PDF)

Merck

• Abandoned Unit FAQ (PDF)
• Abandoned Unit Form (PDF)

Teva

• Patient Authorization Form
  Patient Referral Form
• Abandoned Unit Process (PDF)