Addition of Adult Vaccines on the Medicaid Formulary Begins June 2026

Date: June 1, 2026

Attention: All Providers

Effective Date: June 1, 2026

Call to action: Texas Children’s Health Plan (TCHP) would like to inform providers that Texas Health and Human Services Commission (HHSC) added adult vaccines to the Medicaid formulary for eligible clients 19 years and older on June 1, 2026. The list of vaccines is available here. While adult vaccines were previously only covered under the Medicaid medical benefit, this rollout allows Medicaid to reimburse pharmacies for both the vaccine ingredient and administration costs for adults ages 19 and older.

State law requires pharmacies to have a collaborative practice agreement (CPA) in place with a prescribing provider to administer vaccines. The CPA acts like a prescription: if a pharmacy does not have a CPA in place with a provider, then the client will need an actual prescription from their doctor’s office to receive the vaccine.

Refer to the updated Pharmacy Vaccine Coverage chart below, which includes adult vaccine coverage through the pharmacy benefit (the full list of vaccines is available here).

Next step for providers: Providers should share this information with their staff.

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

For access to all provider alerts: www.texaschildrenshealthplan.org/provideralerts.