Insect Repellents Covered Via Pharmacy POS Claims
June 1, 2016 the Centers for Medicare and Medicaid Services (CMS) issued an Informational Bulletin informing Medicaid Agencies how Medicaid services can help states and territories prevent, detect, and respond to the Zika virus, including efforts to prevent the transmission and address health risks to beneficiaries. The Informational Bulletin may be found at https://www.medicaid.gov/federal-policy-guidance/downloads/cib060116.pdf
Insect Repellents – Mosquito repellents applied to the skin can aid in preventing Zika virus infection. The Centers for Disease Control (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.
Effective August 1, 2016, DOM will cover mosquito repellents when prescribed by an enrolled Medicaid provider and billed by a Medicaid pharmacy provider. (Note: POS billing will be allowed, effective 8/8/16 with a retroactive begin date of 8/1/2016).
Prescription claims for insect repellents will not count toward the five (5) prescription monthly service limit.
A maximum of two (2) containers per month per beneficiary will be allowed for all beneficiaries aged 13 and over.
Click here 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.