Pharmacy

Mail-order prescriptions

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).

About your medications

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.

e-Prescribing

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.

Specialty Pharmacy

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.

View our Frequently Asked Questions for answers to common questions.

Formulary (Covered Medication List)

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

Over-the-counter product list

Formulary updates

April 2020

Additions:

• Erlotinib Hcl Tab 100 Mg (Prior Authorization Required)
• Erlotinib Hcl Tab 25 Mg (Prior Authorization Required)
• Ferrous Fumarate Tab 325 Mg
• Forteo Inj 600 Mcg/2.4ml (Prior Authorization Required)
• Glycerin Suppos 2.1 Gm
• Ibandronate Sodium 150 Mg Tab
• Imatinib Mesylate 100 Mg Tab (Prior Authorization Required)
• Imatinib Mesylate 400 Mg Tab (Prior Authorization Required)
• Mesalamine Cap ER 24hr 0.375 Gm (Quantity Level Limit)
• Nevirapine Susp 50 Mg/5ml
• Orkambi Granules 100-125 Mg (Prior Authorization Required)
• Orkambi Granules 200-125 Mg (Prior Authorization Required)
• Orkambi Tab 100-125 Mg (Prior Authorization Required)
• Orkambi Tab 200-125 Mg (Prior Authorization Required)
• Omeprazole Tablet Delayed Release Disintegrating 20 Mg (Quantity Level Limit)
• Prolia Syringe 60 Mg/Ml (Prior Authorization Required)
• Tramadol Hcl Tab 100mg (Quantity Level Limit)
• Zinc Oxide Oint 40%

Removals:

• Apriso Cap ER 24Hr 0.375GM
• Bivigam Solution
• Carimune Nf Inj
• Diphenhydramine HCl Liquid 6.25 Mg/mL
• Ferrous Sulfate Syrup 300 Mg/5ml (60 Mg/5ml Elemental)
• Gleevec Tab
• Konsyl Daily Fiber Packet 100%
• Levalbuterol HCL Sol Nebulizer
• Polyethylene Glycol 3350 Oral Packet
• Sennosides Tab 17.2 Mg
• Sodium Bicarbonate Powder
• Tarceva Tab
• Viramune Susp 50mg/ml

Other Updates:

• Valacyclovir Tab 1gm (Termed Quantity Limit)
• Valacyclovir Tab 500mg (Termed Quantity Limit)

 

March 2020

Additions:

• None

Removals:

• Fluoritab Dro 0.125mg
• Prenatal Without A Vit W/ Fe Fumarate-Folic

Other Updates:

• None

 

February 2020

Additions:

• Bimatoprost Sol 0.03% (Step Therapy Required)
• Ethinyl Estradiol 0.015mg and Etonogestrel 0.12mg Ring
• Everolimus Tab 2.5mg (PA Required)
• Everolimus Tab 5mg (PA Required)
• Everolimus Tab 7.5mg (PA Required)
• Flebogamma Dif 5% Vial (PA Required)
• Hydrocortisone 1% Ointment
• Travoprost Dro 0.004% (PA Required)
• Triamcinolone 0.05% Ointment

Removals:

• Afinitor Tab 2.5mg
• Afinitor Tab 5mg
• Afinitor Tab 7.5mg
• First-Vanco Sol 25mg/ml
• First-Vanco Sol 50mg/ml
• Kyleena
• Methyclothiazide Tab 5mg
• Mirena
• NuvaRing 0.12-0.015mg/24hr
• Phospholine (Echothiophate Iodide) Opth Solution 0.125%
• Rabeprazole EC 20 Mg Cap
• Skyla
• Travatan Z Solution 0.004%

Other Updates:

• Combigan Sol 0.2/0.5% (Added Quantity Level Limit)
• Ibandronate Inj 3mg/3ml (Added Quantity Level Limit)
• Levofloxacin Sol 0.5% (Added Quantity Level Limit)
• Memantine Tab HCl 10mg (Added Quantity Level Limit)
• Memantine Tab HCl 5mg (Added Quantity Level Limit)
• Tazarotene Cre 0.1% (Added Step Therapy Required)

 

January 2020

Additions:

• Anusol-HC Cream 2.5%
• Calc Acetate Tab 667mg
• Clobetasol Gel 0.05% (Quantity Level Limit)
• Derma-Smoothe/FS Oil 0.01% Body
• Derma-Smoothe/FS Oil 0.01% Scalp
• Eszopiclone Tab 1mg (Age Limit, Quantity Level Limit)
• Eszopiclone Tab 2mg (Age Limit, Quantity Level Limit)
• Eszopiclone Tab 3mg (Age Limit, Quantity Level Limit)
• Imitrex Spr 20mg/ACT (Quantity Level Limit)
• Imitrex Spr 5mg/ACT (Quantity Level Limit)
• Metoprolol Tab 37.5mg
• Sevelamer Tab 800mg
• Zomig Spr 2.5mg (Quantity Level Limit)
• Zomig Spr 5mg (Quantity Level Limit)

Removals:

• Calc Acetate Tab 668mg
• Clobetasol Lot 0.05%
• Fluocinolone Acet Oil 0.01% Body
• Fluocinolone Acet Oil 0.01% Sc
• Nadolol Tab 20mg
• Nadolol Tab 40mg
• Nadolol Tab 80mg
• Nadolol/Bend Tab 40-5mg
• Renagel Tab 800mg
• Renagel Tab 400mg
• Renvela Tab 800mg
• Scalpicin Sol 1%
• Sumatriptan Inj 6mg/0.5
• Sumatriptan  Spr 20mg/Act
• Sumatriptan  Spr 5mg/Act
• Verapamil Cap 360mg Sr

Other Updates:

• None

 

November 2019

Additions:

• Aminocaproic Acid Sol 0.25gm/ml

Removals:

• Amicar Sol 0.25gm/ml

Other Updates:

• None

 

December 2019

Additions:

• Synagis Inj 100mg/ml (Age Limit, Quantity Level Limit)
• Synagis Inj 50mg/0.5ml (Age Limit, Quantity Level Limit)

Removals:

• Benzoyl Peroxide Liq 7%

Other Updates:

• None

 

November 2019

Additions:

• Aminocaproic Acid Sol 0.25gm/ml

Removals:

• Amicar Sol 0.25gm/ml

Other Updates:

• None

 

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

Other Updates:

• None

 

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

Refills

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.