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:

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.

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).

Formulary updates

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)
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
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:

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:

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:

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

Removals:

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

Other Updates:

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

June 2018

Additions:

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

Removals:

Biltricide
Prevacid Solu Tab

May 2018

Additions:

Colchicine capsules
Firvanq
Jardiance (Step Therapy Required)
Ritonavir tablets
Symfilo
Synjardy, Synjardy XR (Step Therapy Required)

Removals:

Norvir tablets

Other Updates:

Rosuvastatin (Prior Authorization Removed, Step Therapy Added)

April 2018

Additions:

Aprepitant combo pack
Biktarvy
Pulmicort Flexhaler
Tramadol ER (Prior Authorization Required)

Removals:

Emend combo pack

March 2018

Additions:

Efavirenz Tab
Methergine

Removals:

Sustiva Tab

February 2018

Additions:

BD Pen needles
Efavirenz
Estradiol 0.01% vaginal cream
One Touch Verio High
Tenofovir
Vancomycin capsules (Prior Authorization Required-use First Vancomycin compounding kit)

Removals:

Other Updates:

Brimonidine 0.2% ophthalmic (Added Quantity Level Limit)
Combigan ophthalmic (Added Step Therapy)
Fentanyl lozenge (Added Prior Authorization)
Halobetasol topical (Added Quantity Level Limit)
Sprycel (Added Quantity Level Limit)
Timolol ophthalmic gel (Added Step Therapy)

January 2018

Additions:

Armodafinil (Prior Authorization Required, Quantity Level Limit)
Carboxymethycellulose sodium ophth solun 0.25%
Cardura XL
Epinephrine 0.15 mg and 0.3mg Auto-Inject (Mylan)
Opsumit (Prior Authorization Required)
Oseltamivir suspension
Xtampza ER(Prior Authorization Required)

Removals:

Other Updates:

Suboxone Film (Removed Prior Authorization)
Vivitrol (Removed Prior Authorization)

December 2017

Additions:

Abacavir solution
Mavyret (Prior Authorization Required per AHCCCS)

Removals:

Ziagen Solution

Other Updates:

Tretinoin cream/gel (Removed Step Therapy per AHCCCS)

November 2017

Additions:

Humulin R U-500 added PA per AHCCCS
Fosamprenavir

Removals:

Lamotrigine IR QLL removed
Lexiva

Other Updates:

Lamotrigine IR (Removed Quantity Level Limit)

October 2017

Additions:

Aptensio XR (Age Edit, Quantity Level Limit)
Clonidine patch (Age Edit, Quantity Level Limit)
Doxepin HCL capsules and concentrate (Quantity Level Limit)
Doxylamine succinate 25mg
Enoxaparin (Quantity Level Limit)
Eszopiclone (Age Edit, Quantity Level Limit)
Lamotrogine XR
Meprobamate (Age Edit, Quantity Level Limit)
Novolog 100 unit/ml Flexpen
Novolog 100unit/ml cartridge
Novolog 100unit/ml vial
Novolog Mix 70/30 Flexpen
Novolog Mix 70/30 vial
Paroxetine solution (Quantity Level Limit)
Paxil suspension (Quantity Level Limit)
Pyridoxine 25mg
Silenor (Prior Authorization required)
Triazolam (Age Edit, Quantity Level Limit)
Vitamin B12 SL
Xarelto starter pack
Zolpidem CR (Prior Authorization Required)
Zolpidem SL (Prior Authorization Required)
Zolpimist (Prior Authorization Required)
Zolpimist (Prior Authorization Required)

Removals:

Diclegis
Lovenox
Metadate CD
Somnote (drug no longer marketed)

Other Updates:

Anxiolytics (Added Age Edit)
Bupropion tablets, XR, SR (Added Quantity Level Limit)
Buspirone (Added Age Edit)
Estazolam (Added Age Edit)
Flurazepam (Added Age Edit)
Hydroxyzine hcl tablets (Added Quantity Level Limit)
Hydroxyzine pamoate (Added Quantity Level Limit)
Hydroxyzine syrup (Added Quantity Level Limit)
Mirtazapine tab, ODT (Added Age Edit)
Nefazodone (Added Quantity Level Limit)
Rozerem (Added Age Edit)
Sertraline solution (Added Quantity Level Limit)
Temazepam (Added Age Edit)
Trazodone (Added Quantity Level Limit)
Tybost (Prior Authorization Removed)
Venlafaxine ER (Added Quantity Level Limit)
Venlafaxine IR (Added Quantity Level Limit)
Zaleplon (Added Age Edit)
Zolpidem (Added Age Edit)

September 2017

Additions:

Artificial tears ointment OTC
Mesalamine 1.2GM
Moxifloxacin 0.5% ophthalmic
Sevelamer

Removals:

Renvela
Vigamox

Other Updates:

Ceftriaxone inj. (Removed Quantity Level Limit)

August 2017

Additions:

Adcirca (Step Therapy Required - use sildenafil)
Albenza (Step Therapy Required - use ivermectin or pyrantel)
Corlanor (Step Therapy Required - use beta blocker AND ACEI or ARB)
Ergocal 2500 Unit cap
Extavia (Prior Authorization Required)
Isentress HD 600mg tablet
Letairis (Quantity Level Limit)
Lidocaine Patch (Prior Authorization Required)
Malathion (Step Therapy Required - permethrin or pyrethrin)
Melphalan 2mg
Multaq (Step Therapy Required - use other antiarrhythmics first)
Olopatadine 0.1% and 0.2% (Step Thearapy Required - use Ketotifen OTC)
Permethrin lotion1% (Quantity Level Limit)
Tracleer (Quantity Level Limit)

Removals:

Alkeran 2mg
Econazole cream
Potassium chloride 10%, 20% solution
Potassium chloride packet 20meq, 25meq
Ulesfia

July 2017

Additions:

Bydureon pen and vial (Prior Authorization Required)
Kombiglyze XR (Prior Authorization Required)
Lidocaine 3% (Step Thearapy Required - use Aspercreme OTC)
Lidocaine 5% (Step Thearapy Required - use Aspercreme OTC)
Onglyza (Prior Authorization Required)

June 2017

Additions:

Apriso
Desvenlafaxine ER (Prior Authorization Required, Age Limit)
Dofetilide (Prior Authorization Required

Removals:

Meloxicam liquid
Pristiq brand
Tikosyn brand

Other Updates:

Adapalene cream, gel (Added Step Therapy - use Differin Gel OTC)
Tretinoin cream, gel (Added Step Therapy - use Differin Gel OTC)

May 2017

Additions:

Odefsey

Other Updates:

Abilify Maintenna (Quantity Level Limit Added)
Abreva (Quantity Level Limit Removed)
Alendronate (Quantity Level Limit Removed)
Arcapta (Quantity Level Limit Removed)
Aristada QLL (Quantity Level Limit Added)
Desmopressin nasal spray (Quantity Level Limit Removed)
Estradiol patches (Quantity Level Limit Removed)
Estring (Quantity Level Limit Removed)
Fexofenadine (Quantity Level Limit Changed)
Medroxyprogesterone IM (Quantity Level Limit Removed)
Mupirocin cream (Quantity Level Limit Removed)
Paroxetine solution (Quantity Level Limit Removed)
Polyethylene glycol 3350 (Quantity Level Limit Removed)
Prenatal vitamins (Quantity Level Limit Removed)
Pseudoephedrine (Quantity Level Limit Removed)
Rimantadine (Quantity Level Limit Removed)
Risperidone Consta (Quantity Level Limit Added)
Sertraline solution (Quantity Level Limit Removed)
Spinosad suspension (Quantity Level Limit Removed)
Tretinoin topical (Quantity Level Limit Removed)
Vancomycin oral (Quantity Level Limit Removed)
Ventolin HFA (Quantity Level Limit Removed)

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.

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).