Mercy Care Advantage - Prescription Drug

PRESCRIPTION DRUG INFORMATION FOR MEMBERS

What is the Mercy Care Advantage Formulary?

A formulary is a list of drugs selected by Mercy Care Advantage in consultation with a team of health care providers, which represents the prescription therapies believed to be a necessary part of a quality treatment program. Mercy Care Advantage will generally cover the drugs listed in our formulary as long as the drug is medically necessary, the prescription is filled at a Mercy Care Advantage network pharmacy, and other plan rules are followed. We contract with over 500 pharmacies in Maricopa County and over 100 pharmacies in Pima county.

The formulary is continuously under review and as changes occur, the version on the Web site is updated. The Web site has the most current and up-to-date version available.

For more detailed information about the Mercy Care Advantage prescription drug coverage, please review the Mercy Care Advantage Evidence of Coverage and other member materials, or contact Customer Service at (800) 624-3879 24 hours a day, 7 days a week.

2007	2008
Member Materials	Member Materials
2007 Evidence of Coverage	2008 Evidence of Coverage
2007 Abridged (partial) Formulary	2008 Abridged (partial) Formulary
2007 Annual Notice of Change	2008 Annual Notice of Change
2007 Summary of Benefits	2008 LIS (Low Income Subsidy) Rider
2007 Comprehensive Formulary	2008 Comprehensive Formulary
Formulary Updates	2008 Summary of Benefits (English)
	2008 Summary of Benefits (Español)

Part D Information
Preferred Drug List Process
Mail Order Drugs
Medication Therapy Management Program
Out of Network Coverage
Pharmacy Transition of Care
Find a Pharmacy
Pharmacy Prior Authorization Form

Prescription Drug Exception and Appeals Process

Coverage Determination Request Form

Appointment of Representative Instructions & Form

LIS (Low Income Subsidy) Information

Mercy Care Advantage has a contract with the Centers for Medicare & Medicaid Services (CMS). This contract renews each year. At the end of the year, the contract is reviewed and either Mercy Care Advantage or CMS can decide to end it. If this happens, you will receive a 90 day advance notice. Please see the Evidence of Coverage for more information.