2023 COVID-19 Vaccine Currently Not Covered on Texas Medicaid and CHIP Formulary

Date: November 3, 2023
 
Attention: All Providers

Call to action:  
As of November 1, 2023, COVID vaccines are currently unavailable on the Medicaid and CHIP Formulary at this time. Texas Health and Human Services Commission (HHSC) is working on ways to add the COVID-19 vaccines to the pharmacy benefit. Texas Children’s Health Plan (TCHP) will provide more information as it becomes available. 

Next steps for providers:  

In the meantime, should your patient inquire about the COVID-19 vaccine, please encourage your patients to receive their vaccines at your practice. For any updates or changes to the formulary, please direct them to visit the Texas Vendor Drug program website at www.txvendordrug.com. 

What if a patient paid out of pocket for their COVID-19 vaccine? 

If your patient states they paid out of pocket for the COVID-19 vaccine, please let them know to submit a reimbursement request through the TCHP website under Pharmacy Services section and choose Pharmacy Reimbursement request form.  

When completing the form, please let patients know: 

• Fill out the entire form and upload the required documents. 

• Once the request is submitted online, a TCHP representative will contact them regarding reimbursement and payment.  

If you have any questions, please email TCHP Pharmacy at: TCHPPharmacy@texaschildrens.org.  
 

For access to all provider alerts,log into:  
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.