April 21, 2017: HHS will renew the mosquito repellent benefit for 2017 for statewide use effective May 1, 2017.  Pharmacy staff should refer to the pharmacy notice to learn about claim submission.

Pharmacy Benefit

Texas covers select mosquito repellents for poeple in the follwing 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.

Pharmacy Claims Submission
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. The Zika Products Pharmacy Assistance Chart (PDF) includes covered products.  The chart may change as additional mosquito repellents are added to formulary.