Effective April 7, 2025: Pharmacy Coverage Updates for COVID-19 Test Kits and Vaccines
Date: 03/13/25
Superior HealthPlan would like to inform providers of the following upcoming changes for COVID-19 Test Kits and Vaccines:
- COVID-19 At-Home Test Kits
- Currently, Superior Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS) and CHIP members are allowed to receive four at-home COVID-19 tests and an additional four at-home COVID-19 tests through prior authorization, for a total of eight per month.
- Effective April 7, 2025, Texas Medicaid is reducing the quantity of at-home COVID-19 tests available per Medicaid and CHIP member, to four per month without a prior authorization. This change is due to the expiration of the federal American Rescue Plan Act of 2021 (ARPA).
- COVID-19 Vaccines
- Additionally, Effective April 7, 2025, COVID-19 vaccines obtained at the pharmacy will now be only covered for members 19 years and older.
- Any members 18 years and younger will need to obtain the COVID-19 vaccine through Texas Department of State Health Services (DSHS) Vaccine for Children (VFC) Program.
- For more information, please visit DSHS’s Texas VFC – Texas Public Health Region 7 webpage.
- Additionally, Effective April 7, 2025, COVID-19 vaccines obtained at the pharmacy will now be only covered for members 19 years and older.
For any questions, please call Centene Pharmacy Services at 1-866-768-7147.