Pharmacy Benefit
Texas covers select mosquito repellents for people in the following programs:
- Medicaid (both managed care and fee for service)
- Children's Health Insurance Program (CHIP)
- Children with Special Health Care Needs (CSHCN) Services Program
- Healthy Texas Women (HTW) 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. Parikh | 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 formulary.
News
Downloads
Notices
- for Clients (English) (PDF)
- for Clients (Español) (PDF)
- for Pharmacies (English) (PDF)
- for Prescribers (English) (PDF)