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:

What you need to know about your medications 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.

Your prescriptions are covered by Mercy Care only if you do NOT have Medicare.

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).

 

Over-the-counter product list

October 2019

Additions:

  • Aimovig Inj 70mg/ml (Prior Authorization Required)
  • Aquadeks Chw
  • Aquadeks Dro
  • Budesonide Sus 1mg/2ml (Age Limit)
  • Bupren/Nalox Sub 2-0.5mg Tab
  • Bupren/Nalox Sub 8-2mg Tab
  • Dekas Cap Essential
  • Dekas Liq Essential
  • Dekas Plus Chw
  • Dekas Plus Liq
  • Dexmethylph Tab 10mg (Age Limit, Quantity Level Limit)
  • Dexmethylph Tab 2.5mg (Age Limit, Quantity Level Limit)
  • Dexmethylph Tab 5mg (Age Limit, Quantity Level Limit)
  • Dyanavel XR Sus 2.5mg/ml (Age Limit, Quantity Level Limit)
  • Emgality Inj 120mg/ml (Prior Authorization Required)
  • Emgality Inj 120mg/ml (Prior Authorization Required)
  • Multivitamin Chw Children
  • Mvw Complete Chw
  • Mvw Complete Chw
  • Otezla Tab 10/20/30 (Prior Authorization Required)
  • Otezla Tab 30mg (Prior Authorization Required)
  • Pifeltro Tab 100mg
  • Sofos/Velpat Tab 400-100 (Prior Authorization Required)
  • Sublocade Inj 100/0.5 (Prior Authorization Required)
  • Sublocade Inj 300/1.5 (Prior Authorization Required)
  • Symjepi Inj 0.15mg (Quantity Level Limit)
  • Symjepi Inj 0.3mg (Quantity Level Limit)
  • Tudorza Pres Aer 400/Act (Quantity Level Limit)
  • Vitamax Chw
  • Vitamax Ped Dro
  • Xarelto Tab 2.5mg (Quantity Level Limit)
  • Xeljanz Tab 10mg (Prior Authorization Required)
  • Xeljanz Tab 5mg (Prior Authorization Required)

Removals:

  • Advair Disku Aer 100/50
  • Advair Disku Aer 250/50
  • Advair Disku Aer 500/50
  • Aripiprazole Sol 1mg/ml
  • Aripiprazole Tab 10mg ODT
  • Aripiprazole Tab 15mg ODT
  • Dextroamphet Cap 10mg ER
  • Dextroamphet Cap 15mg ER
  • Dextroamphet Cap 5mg ER
  • Epinephrine Inj 0.15mg (Generic Adrenaclick)
  • Focalin Tab 10mg
  • Focalin Tab 2.5mg
  • Focalin Tab 5mg
  • Pulmicort Sus 1mg/2ml
  • Saphris Sub 10mg
  • Saphris Sub 2.5mg
  • Saphris Sub 5mg

Other Updates:

  • None

 

September 2019

Additions:

  • Febuxostat Tab (Quantity Level Limit, Step Therapy)
  • Multiple Vitamin
  • Pediatric Multiple Vitamin
  • Pregabalin Cap (Prior Authorization Required)
  • Pregabalin Sol (Prior Authorization Required)

Removals:

  • Uloric Tab
  • Lyrica Cap
  • Lyrica Sol

 

August 2019

Additions:

  • Adcirca – Brand only (Prior Authorization Required)
  • Alendronate Sodium Soln
  • Bicillin L-A 1200000 Unit/2ml
  • Bicillin L-A 2400000 Unit/4ml
  • Bicillin L-A 600000 Unit/ml
  • Bivigam (Prior Authorization Required)
  • Carimune NF Nanofiltered (Prior Authorization Required)
  • Cerdelga (Prior Authorization Required)
  • Elelyso (Prior Authorization Required)
  • Farxiga (Prior Authorization Required)
  • Flebogamma Dif (Prior Authorization Required)
  • Fulphila (Prior Authorization Required)
  • Gamastan S-D (Prior Authorization Required)
  • Gammagard S-D (Prior Authorization Required)
  • Gleevec – Brand only (Prior Authorization Required)
  • Hizentra (Prior Authorization Required)
  • Imbruvica Tablets (Prior Authorization Required)
  • Invokana (Prior Authorization Required)
  • Letairis – Brand only (Prior Authorization Required)
  • Leukeran (Prior Authorization Required)
  • Lidocaine Patch 4% (Quantity Level Limit)
  • Lorcaserin HCl Tab ER 24hr 20mg (Prior Authorization Required, Quantity Level Limit)
  • Miglustat (Prior Authorization Required)
  • Nplate (Prior Authorization Required)
  • ProAir – Brand only
  • Retacrit (Prior Authorization Required)
  • Revatio solution – Brand only (Prior Authorization Required for age > 12)
  • Tracleer – Brand only (Prior Authorization Required)
  • Udenyca (Prior Authorization Required)
  • Vpriv (Prior Authorization Required)

Removals:

  • Arcapta Neohaler
  • Bosentan Tab For Oral Susp 32mg
  • Bupropion HCl Tab EERr 24hr 450mg
  • Butalbital-Acetaminophen-Caffeine Cap 50-300-40mg
  • Butalbital-Acetaminophen-Caffeine Cap 50-325-40mg
  • Desvenlafaxine Succinate ER
  • Emsam
  • Epinastine HCl Ophth Soln 0.05%
  • Epogen
  • Erythromycin Ethylsuccinate For Susp
  • Escitalopram Oxalate Soln
  • Etidronate Disodium
  • Etodolac Tab ER 24hr
  • Fluoxetine DR
  • Fluvoxamine Maleate ER
  • Glipizide-Metformin
  • Iclusig
  • Imatinib
  • Isocaboxazid
  • Jakafi
  • Marplan
  • Melphalan
  • Nefazodone HCl
  • Neulasta
  • Ofloxacin Otic
  • Olopatadine HCl Ophth Soln 0.2%
  • Opsumit
  • Paroxetine ER
  • Paxil Sus 10mg/5ml
  • Pexeva
  • Phenelzine Sulfate
  • Prefest
  • Procrit
  • Purixan Solution
  • Riomet
  • Segluromet
  • Steglatro
  • Striverdi Respimat
  • Tasigna
  • Thalomid
  • Tranylcypromine Sulfate
  • Tymlos
  • Tyvaso
  • Ventavis
  • Ventolin HFA
  • Viibryd
  • Zolinza

Other Updates:

  • Azelastine Ophth Soln 0.2% (Added Quantity Level Limit)
  • Baraclude Oral Soln 0.05 mg/ml (Prior Authorization Required)
  • Butalbital-Acetaminophen-Caffeine Tab 50-325-40mg (Added Quantity Level Limit)
  • Calcipotriene Soln 0.005%, Calcipotriene cream 0.005%, Calcipotriene Oint 0.005% (Prior Authorization Required)
  • Citalopram Hydrobromide Oral Soln 10mg/5ml (Added Age Limit)
  • Evotaz Tablet 300-150mg (Added Quantity Level Limit)
  • Fluoxetine HCl Solution 20mg/5ml (Added Age Limit)
  • Sertraline HCl Oral Concentrate for Solution 20mg/ml (Added Age Limit)

 

July 2019

Additions:

  • Avastin Inj
  • Cefixime Cap 400mg (Quantity Level Limit)
  • Erlotinib Tab 150mg (Prior Authorization Required)
  • Herceptin Inj
  • Mesalamine Cap 400mg DR (Quantity Level Limit)
  • Penicillamine Capsule
  • Sildenafil Sus 10mg/ml (Prior Authorization Required)

Removals:

  • Benziq Wash Liq 5.25%
  • Bio-Statin Cap 1000000
  • Bio-Statin Cap 500000 U
  • Bio-Statin Pow
  • Bocasal Pow
  • Calcium Carb Pow Ppt/Heav
  • Cuprimine Capsule
  • Delzicol Cap 400mg DR
  • Ergocal Cap 2500unit
  • Fluorabon Dro
  • Fluoroplex Cre 1%
  • Flura-Drops Dro 4drp=1mg
  • Gentamicin Pow Sulfate
  • Homatropine Sol 5% Op
  • Nature-Throi Tab 2gr
  • Revatio Sus 10mg/ml
  • Sod Fluoride Tab 0.5mg F
  • Sod Fluoride Tab 1mg F
  • Suprax Cap 400mg
  • Tarceva Tab 150mg

Other Updates:

  • None


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

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

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) 1-866-602-1982 (7 a.m. to 6 p.m. Monday-Friday) 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).