Texas now covers mosquito repellents for the prevention of Zika virus. The following notice describes claims processing, eligibility, and benefit information specific to the mosquito repellent benefit for the below programs. The last page of this document contains a prescription template for claims processing.

On June 1, 2016 the Centers for Medicare & Medicaid Services (CMS) issued an informational bulletin about Medicaid benefits available for the prevention, detection, and response to the 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.

Starting August 9, 2016, Texas will cover select mosquito repellents under the Medicaid Fee For Service (FFS) and managed care organizations (MCO), Children's Health Insurance Plan (CHIP) and Healthy Texas Women programs. Neither the Kidney Health Care (KHC) nor Children with Special Health Care Needs (CSHCN) Services programs will cover these products. The following describes the benefit details, eligibility, benefit specifics, and claims processing for mosquito repellent, and information about Zika virus.

Notice to Pharmacies

On June 1, 2016 the Centers for Medicare & Medicaid Services (CMS) issued an informational bulletin about Medicaid benefits available for the prevention, detection, and response to the 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.

Starting August 9, 2016, Texas will cover select mosquito repellents under the Medicaid Fee For Service (FFS) and managed care organizations (MCO), Children's Health Insurance Plan (CHIP) and Healthy Texas Women programs. Neither the Kidney Health Care (KHC) nor Children with Special Health Care Needs (CSHCN) Services programs will cover these products. The following information describes the benefit details, including eligibility, benefit specifics, and claims processing and information about Zika virus.