Scabies (Sarcoptes scabiei Infestation) Treatment
Covered by Aetna in California

Permethrin 5% cream applied to all skin surfaces from neck to soles of feet (including under fingernails, skin folds, genitalia, and between toes), left on 8–10 hours overnight, then washed off — repeat application at day 7–14 is recommended because permethrin does not reliably kill eggs; all household members and close sexual contacts should be treated simultaneously regardless of symptoms; clothing, bedding, and towels used in the past 3 days laundered in hot water (≥ 122°F) and dried on high heat

Oral ivermectin 200 mcg/kg on days 1 and 8 (approximately 12 mg for an average adult) for patients unable to tolerate topical permethrin, treatment failures, or institutional outbreak settings; ivermectin plus permethrin in combination for crusted (Norwegian) scabies; sulfur 6% precipitate ointment applied nightly × 3 consecutive nights for infants < 2 months or pregnant/breastfeeding women; benzyl benzoate 25% lotion (less commonly used in US) as an alternative where available

Yes — permethrin 5% cream generic is covered under Aetna CA pharmacy benefit ($15–$35 per tube). Oral ivermectin generic is covered ($10–$30 for 2-dose course). Both are available without PA for this indication. If multiple household members are Aetna CA insured, each member's prescription is covered separately.

Per CDC clinical care guidelines, post-treatment pruritus persisting for 2–4 weeks does NOT indicate treatment failure — it represents the immune response to dead mite proteins still in the skin. Patients should be warned that itch worsening initially after treatment is expected with ivermectin. Secondary eczematization from scratching can be managed with low-potency topical corticosteroids. Crusted (Norwegian) scabies — hyperkeratotic, scale-encrusted lesions with thousands of mites in immunocompromised patients — requires in-person management with combination oral ivermectin + topical permethrin and usually specialist involvement.

Yes — simultaneous treatment of all household members and close sexual contacts is mandatory for successful scabies eradication, regardless of whether contacts have symptoms. The incubation period for scabies in first-time exposures is 2–6 weeks, meaning contacts can be actively infested and contagious before developing any itch. If only the symptomatic person is treated, reinfestation from untreated contacts occurs within weeks, creating a frustrating cycle. Dr. Bhavsar will prescribe permethrin 5% cream for all household members as part of the treatment protocol. If multiple household members are on your Aetna CA plan, each can be prescribed their own tube. Each tube covers one full-body adult treatment.

Post-treatment pruritus lasting 2–4 weeks after successful scabies treatment is expected and does not mean the permethrin failed. The itch represents your immune system reacting to dead mite proteins, eggs, and fecal material still present in the skin — it resolves as skin cells turn over and the antigens clear. True treatment failure is indicated by new burrow tracks or new onset of itching in a contact who was not treated, not by persistent itch in the treated patient. A low-potency topical corticosteroid (e.g., triamcinolone 0.1% cream) and oral hydroxyzine can reduce this post-treatment itch. If you are concerned about reinfestation vs. residual itch, a follow-up video visit with Dr. Bhavsar can help distinguish the two.

Both oral ivermectin (200 mcg/kg on days 1 and 8) and permethrin 5% cream are covered generics under Aetna CA pharmacy benefit. Oral ivermectin is a reasonable choice if you find full-body topical application inconvenient, if you have household members who may not apply the cream correctly, or if permethrin has previously failed. Ivermectin is not FDA-approved for scabies (it is FDA-approved as a topical for rosacea and as an oral anthelmintic), but CDC and major dermatology guidelines endorse its off-label oral use for scabies, and Aetna CA covers it under the generic drug tier. Dr. Bhavsar can prescribe whichever option best fits your circumstances.

Yes. Aetna commercial plans cover telehealth visits for Scabies (Sarcoptes scabiei Infestation) in California. TeleDirectMD (Dr. Parth Bhavsar, MD, NPI: 1104323203) is an in-network telehealth provider with Aetna in California. Your standard Aetna telehealth copay applies — typically $10–$40 for most commercial plans. If clinically appropriate, your prescription is sent to your California pharmacy immediately after your visit.

Most Aetna commercial plans in California have telehealth copays of $10–$40. Often $0–$20 for employer plans. Your exact cost depends on your specific plan and whether your deductible has been met. Log into your Aetna member portal or call the member services number on your card to verify your telehealth copay before your scabies treatment visit. Self-pay is always available for a flat $49 if you prefer to skip insurance.

If your specific Aetna plan is not in-network with TeleDirectMD in California, or if your deductible has not yet been met, you can book as a self-pay patient for a flat $49 fee — same physician, same quality of care, no insurance needed. You may also be eligible to submit an out-of-network claim to Aetna for partial reimbursement depending on your plan's out-of-network benefit.

TeleDirectMD typically offers same-day and next-day video visits. Book at teledirectmd.com/book-online and select a time that works for you. Most patients are seen within a few hours of booking during business hours. Your scabies treatment symptoms are evaluated by Dr. Bhavsar, MD — not a nurse practitioner or PA — ensuring you receive a board-certified clinical assessment.

Yes. TeleDirectMD is operated by Dr. Parth Bhavsar, MD (NPI: 1104323203), a board-certified Family Medicine physician. TeleDirectMD is LegitScript certified, HIPAA compliant, and is contracted as an in-network telehealth provider with Aetna in California. Claims are billed using standard CPT codes (99213/99214) and submitted electronically to Aetna.

Yes. Telehealth visits with a licensed physician are qualified medical expenses eligible for FSA (Flexible Spending Account) and HSA (Health Savings Account) payment. If your Aetna plan applies your deductible first, your FSA or HSA card can be used to pay your portion. The $49 self-pay option is also FSA/HSA eligible.