Pharmacy Benefit

Texas covers select mosquito repellents for people in the following programs:

  • Medicaid (both traditional and managed care)
  • Children's Health Insurance Program
  • Children with Special Health Care Needs Services Program
  • Healthy Texas Women Program

Pharmacy Claims

Claims for mosquito repellent must use the appropriate prescriber National Provider Identifier (NPI) as directed in the Pharmacy Claims Submission table, below.

Prescriber NPI Medicaid CHIP CSHCN HTW
Zika, Zika No No No Yes
Dr. Glenn (ends Apr. 30, 2019) Yes Yes No No
Dr. Van Ramshorst  (begins May 1, 2019) Yes Yes No No
Client's Healthcare Provider Yes Yes Yes Yes

Covered Products

Covered products have been selected based on guidance from the Centers for Disease Control and Prevention and include the recommended active ingredients that are effective against the Zika virus. Refer to the Mosquito Repellent Products Assistance Chart (PDF) for covered products. The chart may change as additional mosquito repellents are added to the formulary.