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Medicaid covers mosquito repellents to help prevent spread of Zika

As of early September, 20 cases of the Zika virus have been confirmed in Mississippi since the first case of an infected resident was verified in March. Although all of those cases are related to people who have traveled to countries where the mosquito-borne virus is widespread – mostly in Central and South America – experts say Mississippi is home to one of the species of mosquitoes known to carry the virus.

In an effort to prevent spread of the disease, in June the Centers for Medicare and Medicaid Services (CMS) issued guidelines for how Medicaid agencies can help prevent, detect and respond to the Zika virus, including efforts to prevent its transmission and address health risks to beneficiaries. Effective Aug. 1, 2016, the Division of Medicaid (DOM) will cover mosquito repellents when prescribed by an enrolled Medicaid provider and billed by a Medicaid pharmacy provider.

Providers should be aware that point of sale will be allowed, effective Aug. 8 with a retroactive begin date of Aug. 1. Prescription claims for insect repellents will not count toward the five-prescription monthly service limit. A maximum of two containers per month per beneficiary will be allowed for all beneficiaries aged 13 and over.

There is no vaccine for Zika, but mosquito repellents applied to the skin can help prevent a Zika-virus infection. The Centers for Disease Control and Prevention (CDC) recommends people use Environmental Protection Agency (EPA)-registered insect repellents with one of the following active ingredients: DEET, picaridin, IR3535, oil of lemon eucalyptus, or para-menthane-diol.

According to the CDC, symptoms of Zika virus are generally mild and can include fever, joint pain, rash and conjunctivitis, but it can also cause the birth defect microcephaly in a child born from an infected mother.

For a list of current covered insect repellents which have been assigned National Drug Code (NDC) numbers by national drug databases with prices provided by manufacturers, visit https://medicaid.ms.gov/pharmacy-provider-information-regarding-the-zika-virus/.

If you have questions, please contact us toll-free at 800-421-2408 or 601-359-6050. Learn more about the Mississippi Division of Medicaid at http://medicaid.ms.gov.