Correction to December 19, 2024, “Urgent Changes to COVID for the Pharmacy Benefit” Notice

Date: February 27, 2025

Attention: Pharmacies and Primary Care Providers, General Practitioners

Call to action:The purpose for this communication is to inform Texas Children’s Health Plan providers of the changes to COVID and influenza pharmacy benefit. Guidance from Health and Human Services Commission (HHSC) includes the following.

COVID-19 Vaccines: FDA-approved COVID-19 vaccines included on the Vendor Drug Program (VDP) formulary are available for Medicaid members aged 19 and older.

Influenza Vaccines: Influenza vaccines included on the VDP formulary are available for Medicaid members aged 3 and older.

How this impacts prescribers:

Starting January 1, 2025, COVID-19 tests must be prescribed by a licensed provider and are subjected to VDP formulary in order for patients to receive them.

Next step for Providers: Prescribers should share this communication with their staff.

If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org. 

For access to all provider alerts: https://www.texaschildrenshealthplan.org/providers/provider-news/provider-alerts