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Contact us
Questions? Check your member handbook. Or call Member Services at ${MS_phone_1} or ${MS_phone_2} (TTY 711) We’re here for you ${MS_hours}.
Medicine your plan covers

Medicine your plan covers
Prescription medicine
We cover prescription medicine when you:
- Have a prescription for a medicine on our formulary (preferred drug list or PDL)
- Have a prescription that is medically necessary — you need it to manage a health condition
- Fill the prescription at a network pharmacy (Walgreens isn’t in our network)
You can check the formulary.
You can also use the formulary search tool. Search by the name or type of medicine.
- Status (on the formulary)
- Generic versions of the same medicine
- Any requirements, quantity limits, age limits or prior authorization (PA)
Some medicines need PA or permission in advance. Your provider will follow a process for coverage approval. Just ask them to complete PA. They can also call ${MS_phone_1} or ${MS_phone_2} (TTY 711).
Our formulary can change any time, so you’ll want to check for updates. And ask your doctor to prescribe medicines from this list. For monthly changes, you can review the formulary updates later on this page.
Ask your provider to:
- Prescribe a similar one that’s on the formulary
- Get PA for coverage if you can’t take another medicine
- The preferred glucose meter and test strips are Lifescan OneTouch® products.
- The preferred lancets and lancing devices are Lifescan OneTouch Delica® and Delica® Plus.
Non-preferred diabetes supplies need PA.
Still not sure if we cover your medicine? Just call ${MS_phone_1} or ${MS_phone_2} (TTY 711). When you call, have a list of your prescription medicines ready. We can check them for you.
We also cover some over-the-counter (OTC) products (PDF) at no cost when you:
- Meet any added requirements (for some medicines)
- Get a prescription from your provider
- Fill your OTC prescription at a network pharmacy (Walgreens isn’t in our network)
Still not sure if we cover your medicine? Just call ${MS_phone_1} or ${MS_phone_2} (TTY 711). When you call, have a list of your OTC medicines ready. We can check them for you.
CVS Specialty® fills your specialty medicine. They also have other special services for you:
- Access to a pharmacist 24 hours a day, 7 days a week
- Counseling about your drug and disease
- Coordination of care with you and your doctor
- Delivery of specialty medicine to your home or doctor’s office at no cost
- Use of any CVS Pharmacy® (including those inside Target stores) for prescription drop-off and medicine pickup
Call CVS Specialty at 1-800-237-2767 (TTY 1-800-863-5488) for help. You can also check the specialty drug list (PDF) to see your options.
Get medicine and refills
Get medicine and refills
If you need medicine, your provider will write you a prescription for one on our formulary. You’ll want to:
- Ask your provider to make sure the medicine is on our formulary
- Take your prescription to a network pharmacy (Walgreens isn’t in our network)
- Show your plan member ID card at the pharmacy
Your doctor can also send prescriptions to pharmacies electronically. This can help save you time and an extra trip. Ask your doctor if this is an option.
Your medicine label notes how many refills you have. Call your pharmacy to order a refill well before you run out of medicine. If you’re out of refills, check with your provider at least 5 days before you run out of medicine. They may want to see you before adding refills. And you can only get one refill at a time.
Fill your prescriptions at a network pharmacy (Walgreens isn’t in our network). In some cases, AHCCCS members have copays for prescriptions. For example, ACC-RBHA members pay $2.30 for generics and $2.30 for brands.
Do you have other insurance? We can only pay copays if your medicine is on our formulary. If you pay for a copay and it wasn’t required, we won’t be able to pay you back.

Fill your prescriptions
In person
You can fill your prescriptions at any network pharmacy (Walgreens isn’t in our network). We can’t cover medicines that you fill at other pharmacies. Need help finding a network pharmacy? Call ${MS_phone_1} or ${MS_phone_2} (TTY 711). Or search online:
By mail
Save time with mail-order prescription drugs. Do you take medicine on a regular basis for an ongoing condition, like high blood pressure or arthritis? Then you may be able to join our mail-order maintenance prescription drug program. This service delivers medicine to your home.
Get started with mail service
Download the form
Download, complete and return the form to the address on the form: English (PDF) | Español (PDF).
Go online
Register with CVS Caremark. You’ll be able to order refills, renew your prescription and check the status of your order.
Call us
We can also send you the form. Just ask for the form at ${MS_phone_1} or ${MS_phone_2} (TTY 711). We’re here for you ${MS_hours}.
Understand your medicine

Understand your medicine
Providers may prescribe medicine to help you manage a health condition. Understand what your medicine is for and how to take it.
Before you leave the office, get answers to these questions:
- Why am I taking this medicine?
- How does it help me?
- How and when do I take the medicine?
- For how many days?
- What are the possible side effects or allergic reactions?
- What should I do if a side effect happens?
- What will happen if I don’t take this medicine?
Tell all your providers, including your dentist, about everything you take:
- Prescription medicine
- Over-the counter medicine
- Vitamins
- Supplements
Some medicines can cause harm when you take them together. When providers know what you’re taking, they can help prevent this problem.
Read the info from the pharmacy when you fill your prescription. It will explain what to do and not do, as well as side effects to watch for.
Questions about medicine? Talk with the pharmacist or your provider. You can also review our patient checklist (PDF) with your provider.
Formulary updates
November 2023
Additions: None
Removals
Proctofoam HC 1% to 1% rectal foam
Other updates
Haloperidol 0.5 mg tablet (age limit updated)
Haloperidol 1 mg tablet (age limit updated)
Haloperidol 10 mg tablet (age limit updated)
Haloperidol 2 mg tablet (age limit updated)
Haloperidol 20 mg tablet (age limit updated)
Haloperidol 5 mg tablet (age limit updated)
Haloperidol lactate 2 mg per mL oral concentrate (age limit updated)
Haloperidol lactate 5 mg per mL solution injection (age limit updated)
Loxapine succinate 10 mg capsule (age limit updated)
Loxapine succinate 25 mg capsule (age limit updated)
Loxapine succinate 5 mg capsule (age limit updated)
Loxapine succinate 50 mg capsule (age limit updated)
Nayzilam 5mg per 0.1 mL nasal spray (quantity limit updated, age limit added)
Perphenazine 16 mg tablet (age limit updated)
Perphenazine 2 mg tablet (age limit updated)
Perphenazine 4 mg tablet (age limit updated)
Perphenazine 8 mg tablet (age limit updated)
Pimozide 1 mg tablet (age limit updated)
Pimozide 2 mg tablet (age limit updated)
Thioridazine HCl 10 mg tablet (age limit updated)
Thioridazine HCl 100 mg tablet (age limit updated)
Thioridazine HCl 25 mg tablet (age limit updated)
Thioridazine HCl 50 mg tablet (age limit updated)
Thiothixene 1 mg capsule (age limit updated)
Thiothixene 10 mg capsule (age limit updated)
Thiothixene 2 mg capsule (age limit updated)
Thiothixene 5 mg capsule (age limit updated)
Trifluoperazine HCl 1 mg tablet (age limit updated)
Trifluoperazine HCl 10 mg tablet (age limit updated)
Trifluoperazine HCl 2 mg tablet (age limit updated)
Trifluoperazine HCl 5 mg tablet (age limit updated)
Valtoco 10 mg nasal spray (quantity limit updated, age limit added)
Valtoco 15 mg nasal spray (quantity limit updated, age limit added)
Valtoco 20 mg nasal spray (quantity limit updated, age limit added)
Valtoco 5 mg nasal spray (quantity limit updated, age limit added)
October 2023
Additions
Dexmethylphenidate extended release 10 mg capsule (quantity limit, age limit)
Dexmethylphenidate extended release 15 mg capsule (quantity limit, age limit)
Dexmethylphenidate extended release 20 mg capsule (quantity limit, age limit)
Dexmethylphenidate extended release 25 mg capsule (quantity limit, age limit)
Dexmethylphenidate extended release 30 mg capsule (quantity limit, age limit)
Dexmethylphenidate extended release 35 mg capsule (quantity limit, age limit)
Dexmethylphenidate extended release 40 mg capsule (quantity limit, age limit)
Dexmethylphenidate extended release 5 mg capsule (quantity limit, age limit)
Gvoke Kit 1 mg per 0.2 mL solution (quantity limit)
Gvoke prefilled syringe 0.5 mg per 0.1 mL solution (quantity limit)
Gvoke prefilled syringe 1 mg per 0.2 mL solution (quantity limit)
Infliximab 100 mg intravenous solution (prior authorization)
Lintera 10% wash
Naloxone 4 mg per 0.1 mL nasal liquid (OTC)
Octagam 25 gm per 500 mL (5%) intravenous solution (prior authorization)
Spiriva Respimat 1.25 mcg per inhalation solution
Spiriva Respimat 2.5 mcg per inhalation solution
Zegalogue auto-injector 0.6 mg per 0.6 mL solution (quantity limit)
Removals
Aimovig auto-injector 140 mg per mL solution
Aimovig auto-injector 70 mg per mL solution
Avsola 100 mg reconstituted solution
Ergotamine tartrate 2 mg and caffeine 100 mg suppository
Focalin XR 10 mg capsule
Focalin XR 15 mg capsule
Focalin XR 20 mg capsule
Focalin XR 25 mg capsule
Focalin XR 30 mg capsule
Focalin XR 35 mg capsule
Focalin XR 40 mg capsule
Focalin XR 5 mg capsule
Makena 250 mg per mL oil
Makena auto-injector 275 mg per 1.1 mL solution
Pradaxa 100 mg packet
Pradaxa 150 mg packet
Pradaxa 20 mg packet
Pradaxa 30 mg packet
Pradaxa 40 mg packet
Pradaxa 50 mg packet
Other updates
Levocarnitine 330 mg tablet (prior authorization removed)
September 2023
Additions: None
Removals: None
Other updates: None
August 2023
Additions
Tranexamic acid 650 mg tablet (prior authorization)
Removals
Imbruvica 140 mg tablet (prior authorization)
Tranexamic acid 650 mg tablet (prior authorization)
Vogelxo 50 mg per 5 gram gel packet (prior authorization)
Other updates: None
July 2023
Additions
Gefitinib 250 mg tablet (prior authorization)
Kalydeco 13.4 mg packet (prior authorization)
Lurasidone 120 mg tablet (quantity limit, age limit)
Lurasidone 20 mg tablet (quantity limit, age limit)
Lurasidone 40 mg tablet (quantity limit, age limit)
Lurasidone 60 mg tablet (quantity limit, age limit)
Lurasidone 80 mg tablet (quantity limit, age limit)
Mekinist 0.05 mg per mL solution (prior authorization)
Tafinlar 10 mg tablet (prior authorization)
Trikafta 100 mg/50 mg/75 mg/75 mg therapy pack (prior authorization)
Trikafta 80 mg/40 mg/60 mg/59.5 mg therapy pack (prior authorization)
Removals
Esomeprazole magnesium delayed release 40 mg capsule
Iressa 250 mg tablet
Latuda 120 mg tablet
Latuda 20 mg tablet
Latuda 40 mg tablet
Latuda 60 mg tablet
Latuda 80 mg tablet
Omega-3 ethyl esters 1 gm capsule
Sucraid 8500 unit per mL solution
Other updates: None
June 2023
Additions
First-metronidazole 50 mg/mL suspension (age limit)
Tinidazole 250 mg tablet
Tinidazole 500 mg tablet
Vancomycin 25 mg per mL oral solution
Vancomycin 50 mg per mL oral solution
Removals
Firvanq 25 mg per mL oral solution
Firvanq 50 mg per mL oral solution
Repatha prefilled syringe 140 mg per mL solution
Repatha Pushtronex cartridge 420 mg per 3.5 mL solution
Repatha SureClick auto-injector 140 mg per mL solution
Other updates: None
May 2023
Additions
Gilenya 0.25 mg capsule (prior authorization, quantity limit)
Trikafta 100 mg/50 mg/75 mg/150 mg tablet (prior authorization)
Trikafta 50 mg/25 mg/37.5 mg/75 mg tablet (prior authorization)
Removals
Capsaicin 0.1% cream
Lidocaine 4% cream
Triamcinolone acetonide powder
Other updates
Fexofenadine 30 mg per 5 mL (changed quantity limit)
Fingolimod 0.5 mg capsule (added quantity limit)
Freestyle Libre 14 Day Sensor (changed quantity limit)
Freestyle Libre 2 Sensor (changed quantity limit)
Freestyle Libre 3 Sensor (changed quantity limit)
April 2023
Additions
Ambrisentan 10 mg tablet (prior authorization)
Ambrisentan 5 mg tablet (prior authorization)
Aranesp 10 mcg per 0.4 mL prefilled syringe solution (prior authorization)
Aranesp 100 mcg per 0.5 mL prefilled syringe solution (prior authorization)
Aranesp 150 mcg per 0.3 mL prefilled syringe solution (prior authorization)
Aranesp 200 mcg per 0.4 mL prefilled syringe solution (prior authorization)
Aranesp 25 mcg per 0.42 mL prefilled syringe solution (prior authorization)
Aranesp 300 mcg per 0.6 mL prefilled syringe solution (prior authorization)
Aranesp 40 mcg per 0.4 mL prefilled syringe solution (prior authorization)
Aranesp 500 mcg per 1 mL prefilled syringe solution (prior authorization)
Aranesp 60 mcg per 0.3 mL prefilled syringe solution (prior authorization)
Armour Thyroid 120 mg tablet
Armour Thyroid 15 mg tablet
Armour Thyroid 30 mg tablet
Armour Thyroid 60 mg tablet
Armour Thyroid 90 mg tablet
Bivigam 5 gm per 50 mL intravenous solution (prior authorization)
Bosentan 125 mg tablet (prior authorization)
Bosentan 62.5 mg tablet (prior authorization)
Fylnetra 6 mg per 0.6 mL prefilled syringe (prior authorization)
Nivestym 300 mcg per mL solution (prior authorization)
Nivestym 480 mcg per 1.6 mL solution (prior authorization)
Octagam 1 gm per 200 mL (5%) intravenous solution (prior authorization)
Octagam 10 gm per 100 mL (10%) intravenous solution (prior authorization)
Octagam 10 gm per 200 mL (5%) intravenous solution (prior authorization)
Octagam 2 gm per 20 mL (10%) intravenous solution (prior authorization)
Octagam 20 gm per 200 mL (10%) intravenous solution (prior authorization)
Octagam 30 gm per 300 mL (10%) intravenous solution (prior authorization)
Octagam 5 gm per 100 mL (5%) intravenous solution (prior authorization)
Octagam 5 gm per 50 mL (10%) intravenous solution (prior authorization)
Pradaxa 110 mg pellet packet (quantity limit)
Pradaxa 150 mg pellet packet (quantity limit)
Pradaxa 20 mg pellet packet (quantity limit)
Pradaxa 30 mg pellet packet (quantity limit)
Pradaxa 40 mg pellet packet (quantity limit)
Pradaxa 50 mg pellet packet (quantity limit)
Testosterone 50 mg per 5 gm (1%) gel (prior authorization) (limited to one NDC)
Xembify 1 gm per 5 mL (20%) solution vial (prior authorization)
Xembify 10 gm per 50 mL (20%) solution vial (prior authorization)
Xembify 2 gm per 10 mL (20%) solution vial (prior authorization)
Xembify 4 gm per 20 mL (20%) solution vial (prior authorization)
Ziextenzo 6 mg per 0.6 mL prefilled syringe (prior authorization)
Zovirax 5% ointment (quantity limit)
Removals
Acyclovir 5% ointment
Aubagio 14 mg tablet
Aubagio 7 mg tablet
Fulphila 6 mg per 0.6 mL prefilled syringe
Imbruvica 140 mg capsule
Imbruvica 140 mg tablet
Imbruvica 280 mg tablet
Imbruvica 420 mg tablet
Imbruvica 560 mg tablet
Imbruvica 70 mg capsule
Imbruvica 70 mg per mL suspension
Jakafi 10 mg tablet
Jakafi 15 mg tablet
Jakafi 20 mg tablet
Jakafi 25 mg tablet
Jakafi 5 mg tablet
Lenalidomide 10 mg capsule
Lenalidomide 15 mg capsule
Lenalidomide 20 mg capsule
Lenalidomide 25 mg capsule
Lenalidomide 5 mg capsule
Letairis 10 mg tablet
Letairis 5 mg tablet
Leukeran 2 mg tablet
Myleran 2 mg tablet
Neupogen 300 mcg per 0.5 mL prefilled syringe
Neupogen 300 mcg per 0.5 mL vial
Neupogen 480 mcg per 0.8 mL prefilled syringe
Neupogen 480 mcg per 1.6 mL vial
Nyvepria 6 mg per 0.6 mL prefilled syringe
Provida OB 20 mg/20 mg/1.5 mg capsule
Revlimid 10 mg capsule
Revlimid 15 mg capsule
Revlimid 2.5 mg capsule
Revlimid 20 mg capsule
Revlimid 25 mg capsule
Revlimid 5 mg capsule
Rydapt 25 mg capsule
Salicylic acid 6% cream
Salicylic acid 6% shampoo
Sprycel 100 mg tablet
Sprycel 140 mg tablet
Sprycel 20 mg tablet
Sprycel 50 mg tablet
Sprycel 70 mg tablet
Sprycel 80 mg tablet
Tabloid 40 mg tablet
Tamiflu 30 mg capsule
Tamiflu 45 mg capsule
Tamiflu 6 mg per mL suspension
Tamiflu 75 mg capsule
Tracleer 125 mg tablet
Tracleer 62.5 mg tablet
Udenyca 6 mg per 0.6 mL prefilled syringe
Venclexta 10 mg tablet
Venclexta 100 mg tablet
Venclexta 50 mg tablet
Venclexta starting pack
Xofluza 40 mg therapy pack
Xofluza 80 mg therapy pack
Other updates
None
March 2023
Additions
Guaifenesin 100 mg/codeine 6.33 mg per 5 mL solution (quantity limit, age limit, OTC)
Removals: None
Other updates
Advair Diskus 100 mcg/50 mcg per actuation (removed step therapy)
Advair Diskus 250 mcg/50 mcg per actuation (removed step therapy)
Advair Diskus 500 mcg/50 mcg per actuation (removed step therapy)
Advair HFA 115 mcg/21 mcg per actuation (removed step therapy)
Advair HFA 230 mcg/21 mcg per actuation (removed step therapy)
Advair HFA 45 mcg/21 mcg per actuation (removed step therapy)
Dulera 100 mcg/5 mcg per actuation (removed step therapy)
Dulera 200 mcg/5 mcg per actuation (removed step therapy)
Dulera 50 mcg/5 mcg per actuation (removed step therapy)
Pregabalin 100 mg capsule (removed prior authorization, updated quantity limit)
Pregabalin 150 mg capsule (removed prior authorization, updated quantity limit)
Pregabalin 20 mg per mL solution (removed prior authorization, updated quantity limit)
Pregabalin 200 mg capsule (removed prior authorization, updated quantity limit)
Pregabalin 225 mg capsule (removed prior authorization, updated quantity limit)
Pregabalin 25 mg capsule (removed prior authorization, updated quantity limit)
Pregabalin 300 mg capsule (removed prior authorization, updated quantity limit)
Pregabalin 50 mg capsule (removed prior authorization, updated quantity limit)
Pregabalin 75 mg capsule (removed prior authorization, updated quantity limit)
Symbicort 160 mcg/4.5 mcg per actuation (removed step therapy)
Symbicort 80 mcg/4.5 mcg per actuation (removed step therapy)
February 2023
Additions
Dificid 200 mg tablet (prior authorization)
Dificid 40 mg/mL suspension (prior authorization)
Ethacrynic acid 25 mg tablet
Fluocinolone acetonide 0.01% otic oil (quantity limit, OTC)
Lactobacillus extra strength capsule (OTC)
Miconazole nitrate vaginal suppository 1200 mg and 2% cream kit (OTC)
Phenylephrine 10 mg/dextromethorphan 18 mg/guaifenesin 200 mg per 15 mL liquid (quantity limit, OTC)
Pramoxine hydrochloride (perianal) 1% foam (quantity limit, OTC)
Probiotic capsule (OTC)
Pseudoephedrine 30 mg/dexchlorpheniramine 1 mg/chlophedianol 5 mg per 5 mL liquid (quantity limit, OTC)
Refresh Relieva 0.5/1% preservative free ophthalmic solution (OTC)
Sodium fluoride 1.1%/5% gel
Xifaxan 550 mg tablet (prior authorization)
Removals
Benzocaine 20 mg/docusate sodium 283 mg rectal enema
Bisacodyl 10 mg/30 mL enema (OTC)
Brimonidine tartrate 0.2%/timolol 0.5% ophthalmic solution
Celontin 300 mg capsule
Colchicine 0.6 mg capsule
Ibrance 100 mg tablet
Ibrance 125 mg tablet
Ibrance 75 mg tablet
Levofloxacin 0.5% ophthalmic solution
Magnesium hydroxide concentrate 2400 mg/10 mL
Naproxen delayed release, enteric coated 500 mg tablet
Pirfenidone 267 mg capsule
Potassium citrate 550 mg/sodium citrates 500 mg/citric acid 334 mg per 5 mL solution
Other updates
Azelastine HCl 0.05% ophthalmic solution (removed step therapy)
Celecoxib 100 mg capsule (removed step therapy)
Celecoxib 200 mg capsule (removed step therapy)
Celecoxib 400 mg capsule (removed step therapy)
Celecoxib 50 mg capsule (removed step therapy)
Vancomycin HCl 125 mg capsule (removed prior authorization, added quantity limit)
Vancomycin HCl 250 mg capsule (removed prior authorization, added quantity limit)
January 2023
Additions
Dupixent pen-injector 200 mg/1.14 mL solution (prior authorization)
Dupixent pen-injector 300 mg/2 mL solution (prior authorization)
Dupixent prefilled syringe 100 mg/0.67 mL solution (prior authorization)
Dupixent prefilled syringe 200 mg/1.14 mL solution (prior authorization)
Dupixent prefilled syringe 300 mg/2 mL solution (prior authorization)
Eucrisa 2% ointment (prior authorization)
Pimecrolimus 1% cream (prior authorization)
Berinert kit 500 unit (prior authorization)
Cinryze vial 500 unit (prior authorization)
Firazyr syringe 30 mg/3 mL (prior authorization)
Kalbitor vial 10 mg/mL (prior authorization)
Orladeyo 110 mg capsule (prior authorization)
Orladeyo 150 mg capsule (prior authorization)
Symfi Lo 400 mg/300 mg/300 mg tablet
Symfi 600 mg/300 mg/300 mg tablet
Triumeq PD 60 mg/5 mg/30 mg soluble tablet
Vfend 40 mg/mL suspension
Ella 30 mg tablet (quantity limit)
Tafluprost (PF) ophthalmic 0.0015% suspension
Removals
Invirase 200 mg capsule
Invirase 500 mg tablet
Stavudine 15 mg capsule
Stavudine 20 mg capsule
Stavudine 30 mg capsule
Stavudine 40 mg capsule
Viracept 250 mg tablet
Viracept 625 mg tablet
Zioptan ophthalmic 0.0015% solution
All Non-OneTouch Delica and Delica Plus Lancets and Lancet Devices
Other updates: None
December 2022
Additions
Accutane 10 mg capsule
Accutane 20 mg capsule
Accutane 30 mg capsule
Accutane 40 mg capsule
Amnesteem 10 mg capsule
Amnesteem 20 mg capsule
Amnesteem 40 mg capsule
Flonase nasal suspension 50 mcg/act
Histex PD 0.938 mg/mL liquid (OTC)
Removals: None
Other updates: None
November 2022
Additions
Imbruvica Susp 70 mg/mL (prior authorization, quantity limit)
Orkambi Granule 75 to 94 mg (prior authorization)
Removals: None
Other updates: None
Recalls and alerts
Need info about medicine recalls? Just call the U.S. Food and Drug Administration (FDA) at 1-888-463-6332.
You can also get info about drug safety alerts.