Medicaid Will Pay for Mosquito Repellent to Fight Zika

Eligible Texas women on Medicaid can go straight to their pharmacist to pick up mosquito repellent, Texas Health and Human Services Commission (HHSC) Executive Commissioner Charles Smith announced. Texas Medicaid has issued a standing order for mosquito repellent prescriptions for women who are between the ages of 10 and 45 or pregnant. Texas is the first state in the nation to implement such an order to slow the spread of the Zika virus. Eligible patients no longer need to call or visit their doctor for a prescription for mosquito repellent. The benefit will expire on Oct. 31. 

Women in Medicaid, Children's Health Insurance Program (CHIP), and CHIP-Perinate can pick up the repellent from participating pharmacies. HHSC encourages women  to call the pharmacy ahead of time because supply will vary by location.

In addition, women covered under the Healthy Texas Women program no longer require a prescription to obtain repellent. Eligible women can get up to two cans per month through October. 

Zika can cause severe birth defects in unborn children whose mothers are infected while pregnant.

"The best way to protect yourself from Zika is by avoiding mosquito bites," Commissioner Smith said. "There is currently no vaccine to prevent the disease or drug to treat it, making it essential that people use mosquito repellent to protect women and unborn babies."

Visit the HHSC website for a list of products that are eligible for reimbursement, as well as mosquito repellent prescription recommendations.

Women in the following programs are covered:  

  • Medicaid,
  • CHIP,
  • CHIP-Perinate,
  • Healthy Texas Women, and
  • Family Planning.   

Eligible women can get up to two cans per month through Oct. 31. HHSC says office visits should be required only if there is a medical necessity.

HHSC has determined the following Zika-related items also are covered under current Texas Medicaid benefits:  

  • Family planning services,
  • Contraceptives,
  • Diagnostic testing,
  • Targeted case management,
  • Physical therapy,
  • Long-term services and support,
  • Acetaminophen and oral electrolytes for Zika symptoms, and
  • Potential coverage for additional ultrasounds for pregnant women.

To build a strong infrastructure to help protect Texans from Zika, DSHS says it is spending more than $6 million in state and federal funds on disease surveillance, expanded lab testing capabilities, public education and awareness, Zika prevention kits, and other efforts.

Texas has reported 93 cases of Zika virus disease — all related to travel abroad to areas with active Zika transmission, DSHS says, adding that no local transmission through mosquito bite has been detected yet in Texas. State efforts have been under way since January to delay and minimize the impact of Zika on Texas.

DSHS has identified and exercised eight state public health Zika response teams that are ready to deploy upon local transmission of the virus in Texas. These teams, DSHS says, will be able to help local entities investigate possible cases, evaluate environments for mosquito activity, provide door-to-door education, and offer other response efforts.

While local transmission in Texas remains likely at some point, DSHS says public health officials do not expect widespread transmission across large geographic areas of the state. Small pockets of cases are more likely. DSHS bases this assessment on the state's past experience with dengue, a similar virus spread by the same mosquitoes, and on the prevalent use of window screens, air conditioning, insect repellent, and other mosquito control efforts in Texas.

DSHS says it has approved more than 1,200 human specimens for Zika virus testing by the DSHS laboratory and the U.S. Centers for Disease Control and Prevention. Other labs across the state now have the ability to test for Zika. In late July, DSHS added the more complex serologic testing for human specimens to detect Zika infection in people who may not have had symptoms. Texas also has the capability to test mosquito specimens for Zika, as warranted for identified high-risk areas, though DSHS says the best indicator of Zika prevalence is human case detection.

For more information, visit www.TexasZika.org.

Action Special Issue, Aug. 4, 2016

Last Updated On

October 11, 2016