Texas Health and Human Services / Texas Health Steps

Overview of Mosquito-Borne Diseases and the Medicaid Mosquito Repellent Benefit

Mosquito-borne diseases are preventable with the use of mosquito repellent. Preventing diseases such as malaria, West Nile virus and Zika virus also controls their spread.

Diseases that are spread by mosquitos, which can be serious, are passed to humans through bites from the infected insects. Some diseases may then be transmitted among humans.

Most people with mosquito-borne disease in the United States come from countries where local transmission is common, but the diseases also can be contracted in Texas year-round.

Symptoms of mosquito-borne illnesses are flu-like and include aches, fatigue and fever. Sometimes people have mild or no symptoms.


The Power of Prevention

The last cases of local Zika virus transmission in the contiguous United States occurred in Florida and Texas in 2016 through 2017 (CDC, 2022).

After an increase in incidences of Zika, organizations promoted simple steps to prevent it, which are applicable to all mosquito-borne diseases:

  • Apply Environmental Protection Agency (EPA)–approved insect repellent, such as one that contains the recommended amount of one of these active ingredients:

    • DEET
    • Insect Repellent 3535 (IR3535)
    • Oil of lemon eucalyptus
    • Para-menthane-diol
    • Picaridin
    • 2-undecanone

  • Wear clothing and socks that cover the skin, including hats with mosquito netting.

  • Remove standing water from outdoor items and containers where mosquitoes lay eggs and proliferate, such as:

    • Buckets
    • Plant pots
    • Rain gutters
    • Toys
    • Unused tires

Additionally, individuals exposed to Zika should practice safe sex by abstaining or using condoms, especially during pregnancy.

Texas Medicaid makes mosquito repellent available year-round to eligible individuals at risk of contracting Zika virus that could be transmitted to a pregnant person or fetus. Pharmacies enrolled in the Texas Vendor Drug Program (VDP) can dispense mosquito repellent to eligible recipients with a valid prescription from a Medicaid-enrolled prescribing provider.

Eligibility and Benefit Limits

Under the prescription, mosquito repellent is available year-round to:

  • Girls and women ages 10 through 55 years and pregnant women of any age
  • Boys and men ages 14 years and older

To receive the mosquito repellent benefit, individuals must be eligible for Medicaid (traditional or managed care), the Healthy Texas Women (HTW) program (including the Family Planning Program), the Children with Special Health Care Needs (CSHCN) program, the Children’s Health Insurance Program (CHIP) or the Title V Prenatal Medical Fee-for-Service Program.

Mosquito repellent is provided at no cost to individuals eligible for Medicaid, HTW, the CSHCN program and the Title V Prenatal Medical Fee-for-Service Program.

  • Individuals enrolled in CHIP may be subject to a co-payment depending on family income, but the co-pay must not exceed the cost of the product.

The prescription provides two cans or bottles (containers) of approved mosquito repellent per calendar month.

  • Only one container may be dispensed at a time.

  • One optional refill may be dispensed in the same calendar month.

  • Mosquito repellent does not count against the limit of three prescriptions per month for individuals enrolled in traditional Medicaid.

Clinics Can Dispense Mosquito Repellant

Individuals who are enrolled in the Family Planning Program or Title V Fee-for-Services Program with a health-care provider who participates in the benefit program can receive mosquito repellant through their clinic.

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