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.

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.

Download the Mercy Care Long Term Care Formulary.

You can also call Member Services to get a printed copy of our drug list.

You can reach Member Services at:

  • 602-263-3000 or 1-800-624-3879
    Hearing impaired (TTY/TDD 711)
  • Click on the "Contact Us" link on the Home Page

Legend:

  • QLL: Quantity Limit Criteria
  • PA: Prior Authorization

 

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)
  • Sevelamer

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 added with QLL
  • Praziquantel
  • Lansoprazole ODT added with PA and QLL       

 

June 2018 Removals:

  • Biltricide          
  • Sensipar removed smart edit for specialist



May 2018 Additions:

  • Colchicine capsules
  • Jardiance added with STEP
  • Synjardy, Synjardy XR added with STEP
  • Ritonavir tablets
  • Firvanq
  • Symfilo

 

May 2018 Removals:

  • Rosuvastatin removed PA, added STEP
  • Norvir tablets



April 2018 Additions:

  • Tramadol ER added with PA
  • Aprepitant combo pack
  • Pulmicort Flexhaler
  • Biktarvy

 

April 2018 Removals:

  • Emend combo pack



March 2018 Additions:

  • Efavirenz tab
  • METHERGINE

 

March 2018 Removals:

  • Sustiva Tab



February 2018 Additions:

  • vancomycin capsules added PA (use First Vancomycin compounding kit)
  • halobetasol topical added QLL 50gm/30days
  • BD Pen needles
  • Sprycel added QLL 30/30days
  • brimonidine 0.2% ophthalmic added QLL 10ml/30days
  • timolol ophthalmic gel added STEP (use solution)
  • Combigan ophthalmic added STEP (use brimonidine or timolol)
  • Tenofovir
  • Efavirenz
  • Estradiol 0.01% vaginal cream
  • One Touch Verio High
  • Fentanyl lozenge added PA

 

February 2018 Removals:

  • amcinonide topical
  • desoximethasone topical
  • pramasone HC cream 1-1%
  • prednicarbate topical
  • albuterol tabs (use syrup)
  • terbutaline (use albuterol syrup)
  • gatifloxacin ophthalmic solution
  • neomycin/polymyxin HC ophthalmic
  • modafinil
  • cefaclor ER tabs
  • ciprofloxacin ER tabs
  • brimonidine 0.15% ophthalmic  
  • betoptic S ophthalmic
  • FML forte ophthalmic
  • oxymorphone IR
  • Viread
  • Sustiva
  • Estrace Vaginal cream



January 2018 Additions:

  • Xtampza ER added with PA
  • EPINEPHRINE 0.15 MG and 0.3MG AUTO-INJCT (Mylan)
  • Cardura XL
  • Opsumit added with PA
  • armodafinil added with PA and QLL
  • carboxymethycellulose sodium ophth solun 0.25%
  • oseltamivir suspension      

 

January 2018 Removals:

  • Viekira, Viekira XR
  • Epclusa
  • Harvoni
  • Technivie
  • Zepatier
  • Hysingla ER
  • Oxycontin
  • Epi Pen, Epi Pen jr.
  • Suboxone Film and Vivitrol PA removed
  • Tamiflu suspension



December 2017 Additions:

  • Mavyret added with PA per AHCCCS
  • Abacavir solution

 
December 2017 Removals:

  • Ziagen Solution
  • Tretinoin cream/gel STEP removed per AHCCCS



2017 November Additions:

  • Humulin R U-500 added PA per AHCCCS
  • fosamprenavir

 

2017 November Removals:

  • Lamotrigine IR QLL removed
  • Lexiva

October 2017 Additions:

  • Aptensio XR added with QLL and age edit
  • Xarelto starter pack
  • Enoxaparin added with QLL
  • Novolog Mix 70/30 Flexpen
  • Novolog Mix 70/30 vial
  • Novolog 100unit/ml vial
  • Novolog 100 unit/ml Flexpen
  • Novolog 100unit/ml cartridge
  • Clonidine patch added with QLL and age edit
  • Buspirone added age edit
  • Hydroxyzine pamoate QLL added
  • Hydroxyzine hcl tablets and syrup QLL added
  • Anxiolytics added age edit
  • Mirtazapine tab, ODT added age edit
  • Bupropion tablets, XR, SR added QLL
  • Paroxetine solution added QLL
  • Sertraline solution added QLL
  • Nefazodone added QLL
  • Trazodone added QLL
  • Zolpimist added with PA
  • Added Silenor with PA
  • Estazolam added age edit
  • Eszopiclone added with age edit and QLL
  • Flurazepam added age edit
  • Meprobamate added with age edit and QLL
  • Temazepam added age edit
  • Triazolam added with QLL and age edit
  • Rozerem added age edit
  • Zaleplon added age edit
  • Zolpidem added age edit
  • Zolpidem CR added with PA
  • Zolpidem SL added with PA
  • Zolpimist added with PA
  • Venlafaxine ER added QLL
  • Venlafaxine IR added QLL
  • Doxepin HCL capsules and concentrate added QLL
  • Lamotrogine XR
  • Vitamin B12 SL
  • Paxil suspension added with QLL
  • Pyridoxine 25mg
  • Doxylamine succinate 25mg

 

October 2017 Removals:

  • Metadate CD
  • Lovenox
  • Somnote (drug no longer marketed)
  • Tybost PA removed
  • Diclegis


September 2017 Additions:

  • mesalamine 1.2GM
  • moxifloxacin 0.5% ophthalmic
  • sevelamer
  • Artificial tears ointment OTC
     

September 2017 Removals:

  • ceftriaxone inj. QLL removed
  • Vigamox
  • Renvela


August 2017 Additions:

  • Lidocaine Patch added PA
  • Extavia added with PA
  • Olopatadine 0.1% and 0.2% added with STEP (use Ketotifen OTC)
  • Isentress HD 600mg tablet
  • Ergocal 2500 Unit cap
  • Melphalan 2mg
  • Malathion added STEP (use permethrin or pyrethrin)
  • Permethrin lotion1% added QLL #120ml/30days
  • Albenza added STEP (use ivermectin or pyrantel)
  • Corlanor added with STEP (use beta blocker AND ACEI or ARB)
  • Multaq added STEP (use other antiarrhythmics first)
  • Letairis added QLL #30/30days
  • Tracleer added QLL #60/30days
  • Adcirca added STEP (use sildenafil)

 

August 2017 Removals:

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

 

July 2017 Additions:

  • Kombiglyze XR added with PA
  • Onglyza added with PA
  • Bydureon pen and vial added with PA
  • Lidocaine 5% added STEP (use Aspercreme OTC)
  • Lidocaine 3% added STEP (use Aspercreme OTC)

 

July 2017 Removals:

  • none


June 2017 Additions:

  • Apriso added
  • Dofetilide added with PA
  • Desvenlafaxine ER added with age < 6 requires PA
  • Adapalene cream, gel added STEP (use Differin Gel OTC)
  • Tretinoin cream, gel added STEP (use Differin Gel OTC)

June 2017 Removals:

  • Meloxicam liquid
  • Tikosyn brand
  • Pristiq brand


May 2017 Additions:

  • Fexofenadine QLL changed to 1 per day
  • Odefsey
  • Risperidone Consta QLL added of 2 per 30days
  • Abilify Maintenna QLL added of 1 per 30days
  • Aristada QLL added of 1 per 30days

 

May 2017 Removals:

  • QLL on prenatal vitamins removed
  • QLL on Ventolin HFA removed
  • QLL on alendronate removed
  • QLL on Desmopressin nasal spray removed
  • QLL on Abreva removed
  • QLL on estradiol patches removed
  • QLL on Estring removed
  • QLL on Arcapta removed
  • QLL on medroxyprogesterone IM removed
  • QLL on mupirocin cream removed
  • QLL on paroxetine solution removed
  • QLL on polyethylene glycol 3350 removed
  • QLL on pseudoephedrine removed
  • QLL on rimantadine removed
  • QLL on sertraline solution removed
  • QLL on spinosad suspension removed
  • QLL on tretinoin topical removed
  • QLL on vancomycin oral removed


April 2017 Additions:

  • Acyclovir ointment added QLL of #15gm/30days
  • Rizatriptan ODT
  • Clobetasol added QLL #60gm/30days (cream) 100gm/30days (foam) 118ml/30days (lotion)
  • Betamethasone aug. dip added QLL #50gm/30days
  • Fluocinonide ointment/gel added QLL #60gm/30days
  • Tobradex ointment added QLL #3.5gm/7days
  • Bacitracin ophth ointment added QLL #3.5gm/7days
  • Aspercreme with lidocaine 4%
  • Aripiprazole
  • Fareston added with PA
  • Inlyta added with PA
  • Xalkori added with PA
  • Afinitor added with PA
  • Afinitor disperz added with PA
  • Iclusig added with PA
  • Jakafi added with PA
  • Caprelsa added with PA
  • Zelboraf added with PA
  • Bexarotene capsules added with PA
  • Alferon N added with PA
  • Sylatron added with PA
  • Matulane added with PA
  • Etoposide capsules added with PA
  • Savella added with STEP
  • Vitamin D3 5,000 units chew OTC
  • Levalbuterol HFA added with STEP
  • Reese’s Pinworm Medicine

 

April 2017 Removals:

  • Venlafaxine ER tablets
  • Fluoxetine tablets
  • Temazepam 7.5mg and 22.5mg
  • Amiodarone 400mg
  • Benazepril/HCTZ
  • HCTZ 12.5mg capsules
  • Denavir
  • ERY-TAB
  • ERYC
  • E.E.S.
  • Doryx
  • Adoxa
  • Monodox
  • Minocycline tablets
  • Tetracycline
  • Naratriptan
  • Cyclobenzaprine 7.5mg
  • Tizanidine capsules
  • Diflorasone topical
  • Desoximetasone
  • Aplenzin
  • Metronidazole cream
  • Cordran tape
  • Abilify

 

March 2017 Additions:

  • Lopinivir/ritonavir solution
  • Ezitimibe added with STEP
  • ethynodiol diacetate and ethinyl estradiol

 
March 2017 Removals:

  • Kaletra solution
  • Zetia
  • Zovia 1/50


February 2017 Additions:

  • Lidocaine ointment added QLL of #90gm/30days
  • Lidocaine patch added QLL of #90patches/30days
  • Lidocaine-prilocaine cream added QLL of #240gm/30days
  • Montelukast granules added PA for age > 2years
  • Albuterol neb solution 0.63mg/3ml and 1.25mg/3ml added STEP for age > 18
  • Kylena added with QLL of #1/999 days
  • IUDs added QLL of #1/999days
  • Chlorzoxazone
  • Orphenadine
  • Adapalene added QLL of #45gm/30days and PA required for age > 35
  • Tretinoin cream and gel added QLL of #45gm/30days and PA required for age > 35
  • Zenatane, Myorisan added QLL of #60/30days and lifetime limit of 10 months
  • Imbruvica added with PA and QLL #120/30days
  • Tecfidera added with PA and QLL of #60/30days
  • Coumadin AHCCCS preferred drug
  • Belviq added with PA
  • Benphetamine added with PA
  • Contrave added with PA
  • Diethylpropion added with PA
  • Orlistat added with PA
  • Phendimetrazine added with PA
  • Qsymia added with PA
  • Yuvafem
  • oseltamivir

 

February 2017 Removals:

  • Tacroliumus topical age limit removed
  • Elidel age limit removed
  • Metaxalone removed
  • carisoprodol 250mg
  • lidocaine lotion
  • Procrit
  • Doxycycline monohydrate
  • Nystatin/triamcinolone cream and ointment
  • Cipro HC otic
  • Naproxen sodium 550mg
  • Clindamycin aerosol
  • Clindamycin/Benzoyl Peroxide
  • Erythromycin/Benzoyl Peroxide
  • Sulfacetamine/sulfur
  • Absorica
  • Claravis
  • Farxiga
  • Urea
  • Humulin N Kwikpen
  • Tamiflu
  • Vagifem

If you live in a nursing home, the staff will take care of managing your medications and getting refills for you.

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

If your doctor has not ordered refills for you, be sure to call at least five (5) days before your medicine runs out and ask about getting a refill. Your PCP 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? If so, you may be able to join our mail-order maintenance prescription drug program. This service delivers your drugs to your home or PCP’s office.

To start the mail-order process or to request a mail-order form, call Member Services Monday-Friday from 7 a.m. to 6 p.m. at 602-263-3000 or toll-free 1-800-624-3879 (TTY/TDD 1-866-602-1982). 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.

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