Pharmacy

Whether it’s pain medications after an injury or medication to manage a health condition, getting the prescription drugs you need is an important part of your health care. We want to make it as convenient for you as possible.

Learn more about your prescription drug benefits:

Save time with mail-order prescription drugs
Do you take medications on a regular basis for an ongoing condition? Then you may be able to join Mercy Care’s mail-order maintenance prescription drug program. This service delivers your drugs to your home or doctor’s office.

To start the mail-order process, call Mercy Care DCS CHP Member Services at 602-212-4983 or 1-833-711-0776 (TTY/TDD 711), Monday through Friday, 8 a.m. to 5 p.m. to request a mail-order form. Or, you can download the Mail Service Order Form. English | Español.

You can also register online with CVS Caremark. Once registered, you will be able to order refills, renew your prescription and check the status of your order.

 

To help you with a medical issue, your doctor or dentist may prescribe a medication. Be sure to let your doctor know about any other medications you are taking. This includes those from another doctor and medications or herbal supplements that you buy on your own. Some drugs can cause harm if taken together. Telling your doctor what you are taking can help prevent harmful reactions. Before you leave the office, ask these questions:

  • Why am I taking this medication?
  • What is it supposed to do for me?
  • How should the medicine be taken?
  • When?
  • For how many days?
  • What are the possible side effects or allergic reactions of the medicine?
  • What should I do if a side effect happens?
  • What will happen if I don’t take this medication?

Carefully read the drug information the pharmacy gives you when you fill your prescription. It will explain what you should and should not do and possible side effects.

Many doctors can now electronically send prescriptions directly to pharmacies. This can help save you time and an extra trip. Ask your doctor if e‑Prescribing is an option for you.

Mercy Care specialty drugs are filled by CVS Specialty Pharmacy. A specialty pharmacy fills drugs and has other services to help you. The Specialty Drug Program has special services for you:

  • You can talk 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 drugs to your home or doctor’s office at no cost to you
  • You can drop off your prescription and pick up your drug at any CVS Pharmacy (including those inside Target stores)

You can call CVS Specialty Pharmacy toll-free at 1-800-237-2767; TTY/TDD: 1-800-863-5488. CVS Specialty Pharmacy will help you with filling your specialty drug. The specialty drug list lists all the specialty drugs available.

 

Download the Mercy Care formulary

You now have the ability to use the new Formulary Search Tool to find out which medications are on the formulary drug lists. You can search by drug name or drug class. The search tool will show formulary status, generic alternatives and if there are any requirements, such as prior authorization, quantity limits or age limits. The formularies can change.

Is your prescription covered?

If you need medicine, your doctor will choose one from Mercy Care’s list of covered drugs. Ask your doctor to make sure the drug is on the list.

Not sure if a certain drug is covered? Check the Preferred Drug List (PDL). This is a list of drugs that are typically covered if they are medically necessary. To search for a particular drug, click on the binocular icon in the left-hand margin and type the word you are looking for in the search box.

If you need medicine that’s not on the list and you can’t take another kind, your doctor can ask for an exception. Some medicines that don’t need a prescription are also covered when your doctor asks for them.

Prescriptions should be filled at a pharmacy that is part of the Mercy Care network. See if your pharmacy is in our network. You do not have to pay for medicines.

Do not make any copayments because Mercy Care cannot pay you back. If you have other insurance, Mercy Care will only pay the copay if the drug is on the Mercy Care drug list.

For more detailed information about your Mercy Care prescription drug coverage, please review your Member Handbook and other plan materials. If you have questions please call Member Services, Monday through Friday, 8 a.m. to 5 p.m at 602-212-4983 or 1-833-711-0776 (TTY/TDD 711).

Over-the-counter product list

October 2021

Additions:

  • Aimovig 140mg/ml Autoinjector (Prior Authorization Required)
  • Aimovig 70mg/ml Autoinjector (Prior Authorization Required
  • Anoro Ellipta 62.5-25mcg Inhaler (Prior Authorization Required)
  • Cafergot Tablet 1-100mg (Brand Only)
  • Enbrel 25mg/0.5ml Vial (Prior Authorization Required)
  • Jentadueto XR 2.5-1000mg (Prior Authorization Required)
  • Jentadueto XR 5-1000mg (Prior Authorization Required)
  • Kazano 12.5-1000mg Tablet (Brand Only, Prior Authorization Required)
  • Kazano 12.5-500mg Tablet (Brand Only, Prior Authorization Required)
  • Nesina 12.5mg Tablet (Brand Only, Prior Authorization Required)
  • Nesina 25mg Tablet (Brand Only, Prior Authorization Required)
  • Nesina 6.25mg Tablet (Brand Only, Prior Authorization Required)
  • Oseni 12.5-15mg Tablet (Brand Only, Prior Authorization Required)
  • Oseni 12.5-30mg Tablet (Brand Only, Prior Authorization Required)
  • Oseni 12.5-45mg Tablet (Brand Only, Prior Authorization Required)
  • Oseni 25-15mg Tablet (Brand Only, Prior Authorization Required)
  • Oseni 25-30mg Tablet (Brand Only, Prior Authorization Required)
  • Oseni 25-45mg Tablet (Brand Only, Prior Authorization Required)
  • Perseris ER 120mg Syringe (Age Limit)
  • Perseris ER 90mg Syringe (Age Limit)
  • Proglycem 50mg/ml (Brand Only)
  • Ubrelvy 100mg Tablet (Prior Authorization Required)
  • Ubrelvy 50mg Tablet (Prior Authorization Required)
  • Ritalin LA 10mg Capsule (Brand Only)
  • Ritalin LA 20mg Capsule (Brand Only)
  • Ritalin LA 30mg Capsule (Brand Only)
  • Ritalin LA 40mg Capsule (Brand Only)
  • Avsola 100mg Vial (Prior Authorization Required)
  • Ivermectin 3mg Tablet (Quantity Limit)

 

Removals:

  • Aptensio XR 10mg Capsule
  • Aptensio XR 15mg Capsule
  • Aptensio XR 20mg Capsule
  • Aptensio XR 30mg Capsule
  • Aptensio XR 40mg Capsule
  • Aptensio XR 50mg Capsule
  • Aptensio XR 60mg Capsule
  • Bevespi Aerosphere Inhaler 9-4.8mcg/act
  • Depo-Provera 400mg/ml Vial
  • Gvoke Hypopen 1mg/0.2ml
  • Humulin N 100Unit/ml Kwikpen
  • Humalog Mix 50-50 Kwikpen
  • Methylphenidate LA 60mg Capsule
  • Norethindrone 5mg Tablet
  • Renflexis 100mg Vial
  • Vyvanse 10mg Chewable Tablet
  • Vyvanse 20mg Chewable Tablet
  • Vyvanse 30mg Chewable Tablet
  • Vyvanse 40mg Chewable Tablet
  • Vyvanse 50mg Chewable Tablet
  • Vyvanse 60mg Chewable Tablet

 

Other Updates:

  • None

 

 

September 2021

Additions:

  • None

Removals:

  • None

Other Updates:

  • None

 

August 2021

Additions:

  • Endari Powder 5mg (Prior Authorization Required)
  • Insulin Aspart 100u/ml Cartridge
  • Insulin Aspart 100u/ml Pen
  • Insulin Aspart 100u/ml Vial
  • Insulin Aspart Mix 70/30 Pen
  • Insulin Aspart Mix 70/30 Vial
  • Insulin Lispro 100u/ml Pen
  • Insulin Lispro 100u/ml Vial
  • Insulin Lispro Jr 100u/ml Pen
  • Insulin Lispro Jr 100u/ml Vial
  • Insulin Lispro Mix 75/25 Pen
  • Insulin Lispro Mix 75/25 Vial
  • Nayzilam (Prior Authorization Required, Quantity Level Limit)

Removals:

  • Caffeine Powder Citrated
  • Humalog 100u/ml Kwikpen
  • Humalog 100u/ml Vial
  • Humalog Jr 100u/ml Kwikpen
  • Ibrance 100mg Cap
  • Ibrance 125mg Cap
  • Ibrance 75mg Cap
  • Lidocaine- Hydrocortisone Cream Rectal 3-0.5%
  • Methoxsalen Cap 10mg
  • Novolog 100u/ml Flexpen
  • Novolog 100u/ml Penfill
  • Novolog 100u/ml Vial
  • Novolog Mix 70/30 Vial

Other Updates:

  • None

 

July 2021

Additions:

  • None

Removals:

  • BP Foam Aer 9.8%

Other Updates:

  • None

 

June 2021

Additions:

  • Renflexis 100 Mg Vial (Prior Authorization Required)

Removals:

  • Tretinoin Cream 0.025%
  • Tretinoin Cream 0.05%
  • Tretinoin Cream 0.1%
  • Tretinoin Gel 0.01%
  • Tretinoin Gel 0.025%

Other Updates:

  • Sumatriptan Succinate Inj 6 Mg/0.5ml (Quantity Level Limit)
  • Sumatriptan Succinate Solution Auto-Injector 4 Mg/0.5ml (Quantity Level Limit)
  • Sumatriptan Succinate Solution Auto-Injector 6 Mg/0.5ml (Quantity Level Limit)
  • Sumatriptan Succinate Solution Cartridge 4 Mg/0.5ml (Quantity Level Limit)
  • Sumatriptan Succinate Solution Cartridge 6 Mg/0.5ml (Quantity Level Limit)

 

May 2021

Additions:

  • None

Removals:

  • None

Other Updates:

  • None

The label on your medication bottle tells you how many refills your doctor has ordered for you. If your doctor has ordered refills, you may only get one refill at a time.

If your doctor has not ordered refills, you must call him/her at least five (5) days before your medication runs out. The doctor may want to see you before giving you a refill.