Zika Medicaid Benefit

 

 

Texas covers certain mosquito repellent products for the prevention of Zika virus as a year-round benefit in Medicaid and other state programs.

Who is Covered?

Pregnant women of any age, women and girls ages 10-55, and men and boys 14 and older in the following programs:

  • Medicaid
  • Children's Health Insurance Program (CHIP)
  • CHIP-Perinatal
  • Healthy Texas Women
  • Children with Special Health Care Needs (CSHCN) Services Program
  • Family Planning Program
  • Title V Prenatal Medical Fee for Service Program

What Will I Receive?

  • One can or bottle of mosquito repellent is permitted per pharmacy fill, with one refill allowed per month.
  • Mosquito repellent won't count against the monthly three-prescription limit for those clients with a monthly limit.

What Will it Cost?

  • There is no cost to Medicaid or Healthy Texas Women clients.
  • CHIP members may pay the generic copay or less, if the cost of the repellent is less than the copay.

How Do I Get the Mosquito Repellent?

Contact your favorite pharmacy to make sure they are participating in this benefit. To find your pharmacy's phone number, you can use the Pharmacy Search on the Vendor Drug Program website. If you are enrolled in managed care, please refer to that health plan's website, or call the Member Services number on the back of your Member ID card.

Contact your healthcare provider and ask them to send a prescription to your pharmacy.

  • Your provider can send a prescription to your pharmacy via phone, fax, or e-prescription.
  • Don't ask for an office visit only to get a prescription for mosquito repellent unless your healthcare provider requires it.
  • Have this prescription filled at your pharmacy.

If you get services from the Family Planning Program, and your healthcare provider offers this benefit, you can pick up mosquito repellent at a participating Family Planning Program clinic.

If you receive Title V Fee for Services, and your healthcare provider offers this benefit, you can pick up mosquito repellent at a participating Title V Prenatal Medical Fee for Service clinic.

Where Can I Find More Information?