Texas Medicaid now covers certain mosquito repellent products as a Medicaid benefit for the prevention of Zika virus. Zika can cause severe birth defects in unborn children whose mothers are infected while pregnant. Because there is not a vaccine to prevent the disease or medicine to treat it, it is important for women to use repellent to protect themselves and unborn babies.
Who is covered?
Females ages 10‐45 and Pregnant women of any age in the following programs:
- Medicaid
- Children's Health Insurance Program (CHIP)
- CHIP‐Perinate o Healthy Texas Women
- Children with Special Health Care Needs Services Program (CSHCN)
Benefit details:
- One can/bottle of mosquito repellent is permitted per prescription fill, with one refill allowed per calendar month.*
- This benefit ends on October 31st, 2016.
- Prescriptions for mosquito repellent will not count against the monthly 3 prescription limit for those clients with a monthly limit.
- Repellent will be provided at no cost to Medicaid clients.
- CHIP members may pay the generic copay or less, if the cost of the repellent is less than the copay.
- All CSHCN clients require a prescription.
How to get repellent:
Many pharmacies will be able to provide you with mosquito repellent without needing to get a prescription from your doctor. Contact your favorite pharmacy to make sure they are participating in this benefit. To find your pharmacy's phone number, you may use the Provider Lookup feature on our website: www.txvendordrug.com. If you are enrolled in an MCO, please refer to that MCO's website, or call the Member Services number on the back of your Member ID card.
If your pharmacy recommends getting a prescription, or you are enrolled in CSHCN, contact your healthcare provider, and then ask them to send the prescription to your pharmacy.
Your provider can send a prescription to your pharmacy via phone, fax, or e‐prescription.
Do not request an office visit only to request a prescription for mosquito repellent unless required by the healthcare provider.
Have this prescription filled at your pharmacy.
Where can I find more information about Zika and Zika prevention?
Department of State Health Services: www.TexasZika.org and www.TexasZika.org/prevention
Centers for Disease Control and Prevention: www.cdc.gov/zika/
