The Texas Health and Human Services Commission has renewed the mosquito repellent benefit for Zika virus prevention for all programs previously covered by the benefit, including Fee for Service Texas Medicaid, Medicaid Managed Care (MCO), Children’s Health Insurance Program (CHIP), the Healthy Texas Women (HTW) Program, and the Children with Special Health Care Needs (CSHCN) Program. This also includes the Texas Standing Order for Medicaid and CHIP eligible individuals.
The renewed benefit begins May 1, 2017 and continues through December 31, 2017.
For more detailed guidance on Prescriber, Member, Pharmacy and Covered Products information please visit:
- Prescriber Information –how to prescribe mosquito repellent for Tx Medicaid clients unable to access a pharmacy operating under a standing order for the dispensing
- Client Information – provides member benefit and how to obtain and fill a Rx
- Pharmacy Information – provides benefit information and claims processing guidance
- Covered Products – Covered products have been selected based on guidance from the Centers for Disease Control and include the recommended amount of the active ingredient.
- Zika Virus Testing – Zika virus testing requires modifier U4 on claims.
Because there is no vaccine available to prevent the disease or medicine to treat it, it is important for women to use repellent to protect themselves and unborn babies.
If you have any questions regarding this information please contact Provider Relations at 1-877-532-3778 x1507 Monday – Friday from 8am-5pm.