Pharmacy

Prescription drug benefits

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:

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.

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. However, in some cases, AHCCCS members are required to pay co-payments for prescriptions (for example AHCCCS Care - $2.30 for Generic and $2.30 for Brand). 

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, 7 a.m. to 6 p.m at 602-263-3000 or toll-free 1-800-624-3879 (TTY/TDD 711).

June 2019

Additions:

  • Docosanol Cream 10%
  • Melatonin Tab 1 Mg
  • Melatonin Tab 3 Mg
  • Melatonin Tab 5 Mg

Removals:

  • Abreva Cream 10%

Other Updates:

  • None

 

May 2019

Additions:

  • Concerta Tab ER (Age Limit, Quantity Limit)
  • Erythrom Eth Sus 400/5ml
  • Ranolazine Tab 1000mg ER (Prior Authorization Required)
  • Sirolimus Sol 1mg/ml

Removals:

  • EryPed 400 Sus 400/5ml
  • Methylphenidate Tab ER
  • Methylphenidate Tab ER
  • Ranexa Tab 1000mg ER
  • Rapamune Sol 1mg/ml

Other Updates:

  • None

 

April 2019

Additions:

  • Ranolazine Tab ER 500mg (Prior Authorization)
  • Ritalin LA Cap 20mg, 30mg, 40mg (Age Limit, Quantity Level Limit)
  • Treprostinil Sol 1mg/mL, 2.5mg/mL, 5mg/mL, 10mg/mL (Prior Authorization)

Removals:

  • Ranexa Tab ER 500mg
  • Remodulin Sol 1mg/mL, 2.5mg/mL, 5mg/mL, 10mg/mL

 

March 2019

Additions:

  • Aminocaproic 500mg, 1000mg Tab
  • Carbidopa 25mg Tab
  • Cinacalcet HCL 30mg, 60mg, 90mg Tab added with PA
  • Mesalamine Supp 1000mg added with QL 30/30 days
  • Toremifene Citrate 60mg Tab added with PA

Removals:

  • Amicar 500mg, 1000mg Tab
  • Canasa 1000mg Supp
  • Fareston 60mg Tab
  • Norethin Ace & Estrad-FE (24)
  • Sensipar 30mg, 60mg, 90mg Tab

 

February 2019

Additions:

  • Calcipotriene cre 0.005% QLL added 200gm/30days
  • Calcipotriene oint 0.005% QLL added 200gm/30days
  • Calcipotriene soln 0.005% (50 mcg/ml) QLL added (200ml/30days)
  • Clonidine HCL ER 0.1mg Tab
  • Flebogamma added with PA
  • Gammagard added with PA
  • Gammaked added with PA
  • Gamunex-C added with PA
  • Jardiance PA added
  • Nitrofurantoin Suspension PA > 12 years added
  • Prenatal mv & min w/fe fumarate-fa-dha 28-0.8-200mg pack added with QLL 100/90 days
  • Prenatal vit w/ docusate-fe fumarate-folic acid 29-1mg tab added with QLL 100/90 days
  • Prenatal vit w/ ferrous fumarate-folic acid 27-0.8mg tab added with QLL 100/90 days
  • Prenatal vit w/ ferrous fumarate-folic acid 27-1mg tab added with QLL 100/90 days
  • Prenatal vit w/ ferrous fumarate-folic acid 28-1mg tab added with QLL 100/90 days
  • Prenatal vit w/ ferrous fumarate-folic acid 29-1mg chew tab added with QLL 100/90 days
  • Prenatal vit w/ ferrous fumarate-folic acid 29-1mg tab added with QLL 100/90 days
  • Prenatal without a vit w/ fe fumarate-folic acid 29-1mg chew tab added with QLL 100/90 days
  • Prenatal without a vit w/ fe fum-iron polysacch complex –fa 130-92.4-1mg cap added with QLL 100/90 days
  • Prenatal without a vit w/ fe fum-iron polysacch complex –fa 20-20-1.25mg cap added with QLL 100/90 days
  • Segluromet added with ST and QLL 60/30 days
  • Steglatro added with ST and QLL 30/30days

Removals:

  • Condolyx gel
  • Dihydroergotamine Nasal Solution
  • Elidel Cream 1%
  • Ergomar SL Tablet
  • Invokana tablet
  • Invokanamet tablet
  • Jardiance ST removed
  • Kapvay ER 0.1mg Tab
  • Levonor/ethi tab estradio
  • Lidocaine/hc kit 20x7gm
  • Lidocaine/hc kit 3%-1%
  • Lo Loestrin tablet
  • Nitro-bid 2% packets
  • Prenatal multivitamins & minerals w/ l-methylfolate-fa 0.6-0.4mg chew tab
  • Prenatal mv & min w/fe polysaccharide complex-fa-dha 29-1mg & 250mg pack
  • Prenatal vit w/ ferrous fumarate-folic acid 65-1mg tab
  • Prenatal vit w/ ferrous fumarate-l methylfolate-folic acid 27-0.6-0.4mg tab
  • Prenatal vit w/ iron carbonyl-fe aspart glyc-fa-omega 3 27-1mg cap
  • Prenatal vit w/ iron carbonyl-folic acid 50-1.25mg tab
  • Prenatal vit w/ iron polysaccharide complex-folic acid 29-1 chew tab
  • Prenatal w/o vit a w/ fe carbonyl-fe asp glyc-methfol-fa-dha 18-0.6-0.4-350mg cap
  • Prenatal w/o vit a w/ fe carbonyl-fe gluconate-dss-fa-dha 27-1mg & 250mg pack
  • Prenatal w/o vit a w/ fe fumarate-dss-fa-dha 27-1.25-300mg cap
  • Prenatal without a w/ fe fumarate-l methylfolate-fa-dha 27-0.6-0.4-300mg cap
  • Prenatal without a w/ fe fumarate-l methylfolate-fa-omega 3 28-0.6-0.4-340mg cap
  • Synjardy and Synjardy XR tablet
  • Terconazole vaginal suppos 80 mg
  • Trimethobenzamide hcl cap 300 mg

 

January 2019

Additions:

  • Albendazole 200mg tab added with Step

Changes:

  • Celecoxib 50mg, 100mg caps QL 60/30 days

Removals:

  • Synagis 50mg/0.5mL solution
  • Synagis 100mg/mL solution
  • Albenza 200mg tab

 

December 2018

Additions:

  • Apriso ER 24hr 0.375gm cap
  • Budesonide 32mcg nasal suspension
  • Canasa 1000mg suppository
  • Candesartan Cilexetil HCTZ tabs
  • Candesartan tabs
  • Cetirizine 5mg, 10mg chew tabs
  • Cetirizine 5mg, 10mg tabs
  • Citalopram 20mg, 40mg tab
  • Delzicol DR 400mg cap
  • Diazepam 5mg/5mL solution
  • Dipentum 250mg cap
  • Duloxetine DR 60mg caps
  • Fexofenadine HCL 30mg/5mL suspension
  • Fluoxetine 20mg, 40mg caps
  • Fluoxetine 20mg/5mL solution
  • Fluvoxamine 100mg tab
  • Mesalamine 4gm enema
  • Mesalamine DR 800mg tab
  • Olanzapine 2.5mg, 7.5mg tabs
  • Pentasa caps
  • Sertraline 100mg tab
  • Sulfasalazine 500mg tab
  • Sulfasalazine DR 500mg tab
  • Vyvanse caps

Changes:

  • Famciclovir 125mg, 250mg, 500mg tabs added with PA
  • Femring 0.05mg/24hr added with PA
  • Femring 0.1mg/24hr added with PA
  • Testosterone 40.5mg/2.5gm (1.62%) gel added with PA
  • Travatan Z 0.0004% opth solution added with PA

Removals:

  • Advanced Allergy Kit 2.5%
  • Armour Thyroid 1.5GR Tab
  • Armour Thyroid 1/2GR Tab
  • Armour Thyroid 1/4GR Tab
  • Armour Thyroid 1GR Tab
  • Armour Thyroid 2GR Tab
  • Benazepril-HCTZ 5-6.25mg tab
  • BPO 4% gel
  • Carafate 1gm/10mL suspension
  • Lanoxin 0.125mg Tab
  • Lanoxin 0.25mg Tab
  • Lotrimin 2% AF Aerosol
  • Menest 2.5mg tab
  • MG217 Psoriasis Anti-itch 1% gel
  • MultiNatal Plus 30-1mg tab
  • MultiNatal Plus 40-1mg chew
  • Omeprazole-Sodium Bicarbonate 20-1100mg cap
  • Sulfacetamide Sodium-Sulfur 10-5% emulsion

 

November 2018

Additions:

  • Albendazole added with STEP

Removals:

  • Clotrimazole ointment – no longer marketed
  • Cytra-K all NDCs on market are DESI
  • Albenza

 

October 2018

Additions:

  • Arcapta added with QLL 30capsules for inhalation per 30days
  • Aristada Initio added with QLL 2 per year, age < 18 requires PA
  • Atomoxetine capsules
  • Cyanocobalamin injection
  • Dutasteride 0.5mg
  • Fluocinonide cream
  • Glatopa 40mg added with PA
  • Loratadine chew 5mg added with QLL 60/30days
  • Lotrimin Ultra cream
  • Metoprolol 75mg tab
  • Prasugrel added with QLL 30/30days
  • Procrit added with PA
  • Striverdi Respimat added with QLL 1 inhaler per 30days
  • Tadalafil added with step
  • Tazarotene 0.1% cream added with QLL 90gm/30days
  • Tymlos added with PA and QLL 1 pen/30days
  • Vyvanse chewable tablets added with QLL 30/30days

 

Removals:

  • Acebutolol cap
  • Adcirca
  • Alclometasone dip cream and ointment
  • Betamethasone dp Aug lotion, gel and ointment
  • Betamethasone dp cream, ointment
  • Cardura XL
  • Ciclopirox gel and shampoo
  • Clobetasol foam, lotion, gel, shampoo
  • Clotrimazole/betamethasone lotion
  • Copaxone 40mg
  • Desonide cream, lotion, ointment
  • Diltiazem 24hr ER tab
  • Flucytosine
  • Fluocinolone solution, cream, ointment
  • Fluocinonide E 0.05% cream
  • Fluticasone prop lotion
  • Griseofulvin ultra
  • Hydrocortisone butyr cream, ointment
  • Hydrocortisone val cream, ointment
  • Isradipine
  • Itraconazole
  • Ketoconazole tab
  • Methylphenidate chew tabs
  • Nicardipine
  • Nimodipine
  • Nisoldipine
  • Noxafil
  • Nystatin topical powder
  • Pindolol
  • Prednicarbate ointment
  • Strattera
  • Timolol tab
  • Triamcinolone spray
  • Trianex oil
  • Voriconazole

 

Changes:

  • Antipsychotics: PA removed for Acute (ACC), age edits and QL still apply
  • Ondansetron 4mg QLL changed to 90/30days
  • Valgancyclovir PA removed, added QLL 60/30days

 

September 2018

Additions:

  • Eliquis starter pack added with QLL 74/30days
  • Makena 275mg /1.1ml Auto Inj added with PA
  • Phosphorous 250mg powder for solution
  • PYRETHRINS-PIPERONYL BUTOXIDE GEL
  • Symtuza added with QLL #30/30days

 

Removals:

  • Eurax PA removed

 

Changes:

  • Eliquis starter pack QLL changed to 74/30days

 

August 2018

Additions:

  • Aripiprazole ODT added for ALTCS, QLL = 30/30days
  • Aripiprazole solution added for ALTCS, QLL = 150ml/30days
  • Baraclude solution added QLL 600ml/30days
  • Diazepam rectal gel added QLL of 2/rx
  • Diclofenac gel 1% added with QLL 200gm/30days
  • Elmiron added PA
  • Hydrocod-homatropin tab age < 18 requires PA
  • Omega-3 (1gram) cap added with Step and QLL 120/30days
  • Premarin Vaginal Cream added PA
  • Telmisartan added with QLL 30/30days
  • Testosterone cypionate added PA
  • Vemlidy added with QLL 30/30days
  • Verzenio added with PA and QLL 60/30days

 

Removals:

  • Amlodipine-valsartan-hctz
  • Chlorpropamide
  • Coumadin Brand
  • Duetact
  • Fenofibric acid
  • Lidocaine 3% cream
  • Meclofenamate
  • Methitest
  • Ondansetron solution
  • Premphase
  • Pyrethrin (drug no longer marketed)
  • Tolazamide
  • Tolbutamide
  • Topical lice products removed QLLs

 

Changes:

  • Amlodipine 2.5mg and 5mg increased QLL to 60/30days
  • Hydrocod-homatropine syrup increased QLL to 900ml/30days
  • Lidocaine 5% ointment changed STEP to PA

 

July 2018

Additions:

  • Baclofen 5mg
  • Bevespi Aerosphere (Added Prior Authorization)
  • Diphenhydramine liq 6.25mg
  • Glyxambi (Added Prior Authorization)
  • Levalbuterol solution (Prior Authorization) not required for (Age Limit) < 4
  • Naratriptan added with (Quantity Level Limit) 9/30days
  • Norvir powder
  • Pediatric MVI with iron 11mg/ml
  • Phytonadione tab
  • Prescription opioid cough and cold products (Age Limit) < 18 requires (Prior Authorization)
  • Renagel (Added Prior Authorization)
  • Renvela (brand only) (Added with Prior Authorization)
  • Servent Diskus (Added Prior Authorization)
  • Stiolto Respimat (Added Prior Authorization)
  • Zolmitriptan added with (Quantity Level Limit) 9/30days

Removals:

  • Sevelamer
  • Albuterol solution (Step Therapy) removed
  • Arcapta
  • Estazolam
  • Eszopiclone
  • Flurazepam
  • Foradil
  • Fosrenol
  • Mephyton
  • Meprobamate
  • Metaproterenol
  • Silenor
  • Striverdi
  • Triazolam
  • Zafirlukast
  • Zaleplon
  • Zolpidem ER
  • Zolpidem SL
  • Zolpimist

Other Updates:

  • Montelukast granules changed to (Prior Authorization) required for (Age Limit) > 4
  • Rizatriptan (Quantity Level Limit) changed from 12/30days to 9/30days
  • Rozerem- must use temazepam and zolpidem first
  • Sildenafil specialist requirement removed

 

June 2018

Additions:

  • Lansoprazole ODT (Prior Authorization, Quantity Level Limit)
  • Praziquantel
  • Symfi (Quantity Level Limit)

Removals:

  • Biltricide
  • Prevacid Solu Tab

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.

Save time with mail-order prescription drugs Do you take medications on a regular basis for an ongoing condition, like high blood pressure or arthritis? 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 Member Services at 602-263-3000 or 1-800-624-3879 (TTY/TDD 711), Monday through Friday, 7 a.m. to 6 p.m. to request a mail-order form, or you can register online with CVS Caremark. Once registered, you will be able to order refills, renew your prescription and check the status of your order.

Fill out the Mail Service Order Form (English | Español).