Does Healthy Texas Women Cover Prescriptions? Covered Drugs and Limits

Yes. Healthy Texas Women does cover prescriptions, and eligible enrollees pay nothing out of pocket for them, as long as the drug falls within the program’s covered health categories: contraception, certain chronic conditions (diabetes, hypertension, high cholesterol), sexually transmitted infection treatment, and postpartum depression.¹² A significant expansion of the drug list takes effect July 1, 2026.

How to Fill a Covered Prescription

Bring your Your Texas Benefits card, sometimes called the pink card, to any pharmacy that participates in the Texas Vendor Drug Program. There is no copay and no cost-sharing on covered HTW services, prescriptions included.¹ You can search for a participating pharmacy at txvendordrug.com.³

If a provider writes you a prescription for something outside HTW’s covered benefits, you may have to pay for it yourself.³

Which Drugs Are Covered

HTW uses its own formulary maintained through the Texas Vendor Drug Program, and it includes both prescription and over-the-counter products. You can look up a specific drug through the online formulary search at txvendordrug.com or download the full list as a spreadsheet.⁴⁵

Covered categories:

Contraceptives, including oral pills, patches, vaginal rings, shots, IUDs, implants, diaphragms, cervical caps, spermicides, and condoms. Some long-acting reversible contraceptives are dispensed through designated specialty pharmacies.⁶⁷
Medications for hypertension, diabetes, and high cholesterol.²
Treatments for chlamydia, gonorrhea, syphilis, herpes, trichomoniasis, candida, and gardnerella.²
Postpartum depression medications, along with diagnostic evaluation and follow-up visits.⁸

What HTW Will Not Pay For

The program does not cover emergency contraception, and it does not cover any service related to elective abortion.² HTW is also not full Medicaid. Its drug coverage stays inside the program’s defined health categories, so a medication for a condition outside that scope (say, asthma or thyroid disease) is not covered even after the 2026 expansion.⁹ If your HTW provider finds a condition outside the program’s scope, you will be referred to an outside provider and may be responsible for that care.¹⁰

Extra Coverage Under HTW Plus After Pregnancy

HTW Plus is an enhanced benefit package for the first 12 months after a pregnancy. It adds prescription coverage in three areas beyond standard HTW:

Cardiovascular and coronary drugs, including anticoagulants, antiplatelets, and antihypertensives, plus blood pressure monitoring equipment.¹¹
Substance use disorder treatment, including medication-assisted treatment for drug, alcohol, and tobacco misuse, outpatient counseling, and smoking cessation services.¹⁰
Mental health services, including individual, family, and group psychotherapy and peer specialist services.¹⁰

How Much You Can Get at Once

Family planning drugs and supplies get preferential treatment. They are exempt from the general three-prescriptions-per-month limit that applies to Vendor Drug Program pharmacies, and providers can dispense up to a six-month supply under that exemption. Providers with the right pharmacy license can be reimbursed for dispensing up to a full year of contraceptives within a 12-month period.²

Non-family-planning prescriptions, like your diabetes or hypertension medications, do not get that exemption. The HTW handbook applies it only to family planning.²

What Changes on July 1, 2026

Starting July 1, 2026, HTW will cover all Medicaid-eligible drugs within the same health care categories it already covers. That is a much larger selection than the current, narrower formulary.⁹

At the same time, the Texas Health and Human Services Commission will apply the Medicaid Preferred Drug List and clinical prior authorization requirements to HTW drugs. Some medications that used to be dispensed without prior authorization will now need one, and the preferred drug list will determine which drugs in a therapeutic class are available without extra approval steps.¹² Questions about a specific drug under the new rules can go to the Texas Medicaid Pharmacy and Technical Call Center at 800-435-4165, Monday through Friday, 7 a.m. to 7 p.m. Central.

Who Qualifies for This Coverage

To use HTW prescription benefits you need to be enrolled. Eligibility requires being female, ages 15 to 44, a Texas resident, a U.S. citizen or qualifying immigrant, not currently pregnant, and at or below 204.2 percent of the federal poverty level in household income. You cannot already have full Medicaid, Medicare Part A or B, CHIP, or other insurance that covers family planning.¹³ Minors aged 15 through 17 need a parent or legal guardian to apply for them, and married minors in that age range are not eligible.¹⁴ Applications go through YourTexasBenefits.com or by calling 2-1-1, and approval comes with 12 months of continuous eligibility.²

1
Texas Health and Human Services. Healthy Texas Women FAQs
2
Texas Medicaid and Healthcare Partnership. HTW Program Handbook
3
HealthyTexasWomen.org. HTW Questions and Answers
4
Texas Vendor Drug Program. Formulary
5
Texas Vendor Drug Program. Data Files
6
HealthyTexasWomen.org. Family Planning and Birth Control Options
7
Texas Medicaid and Healthcare Partnership. HTW Program Handbook
8
Texas Health and Human Services. Texas Clinicians Postpartum Depression Toolkit
9
Texas Vendor Drug Program. Reminder: Healthy Texas Women Drug Expansion New Prior Authorizations Begins July 1, 2026
10
HealthyTexasWomen.org. HTW Benefits
11
Texas Medicaid and Healthcare Partnership. HTW Program Handbook
12
Texas Medicaid and Healthcare Partnership. Expanded Drug List and New Prior Authorizations for HTW Effective July 1, 2026
13
Texas Health and Human Services. Texas Works Handbook – W-110 Healthy Texas Women
14
Texas Health and Human Services. Texas Works Handbook – W-510 General Policy