Texas Health and Human Services / Texas Health Steps

Pharmacy Participation in Dispensing Mosquito Repellent

Mosquito repellent may be dispensed using a valid prescription from the recipient’s health-care provider. The prescription is valid for one year from the date it is issued.

Promote Mosquito Repellent with a Poster

Download the Texas Health and Human Services mosquito repellent benefit flyer to display in your pharmacy

Covered Mosquito Repellent Products

The VDP selected its covered mosquito repellents based on guidance from the Centers for Disease Control and Prevention (CDC). Covered products include the recommended amount of one of these active ingredients: DEET, IR3535 (Insect Repellent 3535), oil of lemon eucalyptus or picaridin (a subset of the CDC list), all of which are registered with the federal Environmental Protection Agency.

  • Each container of repellent is expected to last at least 15 days.

  • Pharmacies should dispense one container per person at a time, with a limit of two containers dispensed per person per calendar month.

For a list of approved repellent products, consult the Vendor Drug Program Formulary Search. Scroll to “Product Search,” check “Mosquito repellent” and click “Search Products” to view a list of covered products.

Vendor Drug Program Formulary Product Search

VDP product search form

Treat Mosquito Repellent as a Generic Product

Each mosquito repellent product’s 12-digit universal product code (UPC) has been converted to an 11-digit national drug code (NDC) for claims submission. The code is included in the product listing provided on the Vendor Drug Program Formulary Search.

Mosquito repellent is treated as a generic product. Pharmacies have the authority to dispense any covered product, unless the prescriber has stated “do not substitute” to specify the active ingredient.

Reimbursement

Medicaid reimburses the usual and customary price to the public or up to $6.50 per container of mosquito repellent, for a maximum of $13 per calendar month per patient.

  • Delivery fees or incentive fees are not eligible for reimbursement.

  • Reimbursement may vary among Medicaid managed care organizations but may not exceed $6.50 per container of mosquito repellent.

  • Pharmacies are required to submit their usual and customary costs for mosquito repellent products.

Contact Information

For traditional Medicaid and HTW, contact the Pharmacy Benefits Access Help Desk at 800-435-4165.

For Medicaid managed care or CHIP, refer to the MCO Search to find contact information.

For the CSHCN program, contact the Prior Authorization Call Center at 800-252-8023, option 2.

Main Menu