Answers to Common Questions

Below are common questions our members ask. If you don't find the answer to your question, call Member Services.

Q. How do I contact Mercy Care Plan Member Services Department?
A. Call (602) 263-3000 or (800) 624-3879. Member Services for the hearing impaired can be reached at TTY/TDD (866) 602-1982.

Q. What should I do if I lose my member ID card or don't get one?
A. Call AHCCCS at (602) 417-7000 or (800) 962-6690 to get a new ID card. DD members can call Member Services at (602) 263-3000 or (800) 624-3879 to get a new card.

Q. How will I know the name of my PCP?
A. Mercy Care Plan will send you a welcome packet when you join. Your welcome letter will have the name and telephone number of your assigned PCP. You can also call member services for the name of your PCP.

Q. Can I change my PCP if I need to?
A. Yes. Please try talking to your PCP before changing. Your PCP and your case manager may be able to solve the problem without you having to change. If the problem cannot be fixed, your case manager will help you choose a new PCP.

Q. How do I know which services are covered and which are not?
A. Lists of services that are covered and not covered can be found in your Member Handbook. Call your case manager if you have questions about covered services.

Q. How can I check the status of my authorization?
A. Your case manager can find out the status of authorizations for you.

Q. How do I find out who my case manager is?
A. You can call Mercy Care Member Services at 602-263-3000 or toll free at 1-800-624-3879 if you do not have your case manager's number.

Q. What does my case manager do for me?
A. Your case manager will visit you where you live to talk to you about what kind of long-term care services you need. Your case manager will order the services for you and check to make sure that you are getting them. Your case manager will visit you regularly to talk about how you are doing and if you need more or different services.

Q. When should I call my case manager?
A. You can call your case manager whenever you have a question or a problem with any of your services or you think you need different services.

Q. What should I do if I get a bill?
A. If you get a bill, call the health care provider and give them your Mercy Care Plan information. If you get a bill for services that are covered by Mercy Care do not pay the bill. If they continue to bill you, please call Member Services or your case manager for help.

Q. I need help getting to my doctor. What can I do?
A. Check first with neighbors, friends or relatives for a ride. If you are not able to find a ride, please call Member Services for help. You must call at least three (3) days in advance to get a ride. If you have many appointments scheduled, or if you have regular appointments for visits like physical therapy or dialysis, Mercy Care Plan can set up rides all at once.

Q. Which hospitals can I use?
A. Mercy Care Plan uses many hospitals. Use our website to Find A Provider (1.1.10), or check your provider directory. You can get emergency health care services without the approval of your PCP or Mercy Care Plan when you have a medical emergency. You may go to any emergency room or other setting for emergency care. If you have to be hospitalized for any reason, you may go to the hospital your doctor sends you to.

Q. What is an emergency?
A. An emergency is a medical condition that could cause serious health problems or even death if not treated immediately. Learn more about when to go to the emergency room and when to see your doctor (1.1.9).

Q. Do you have urgent care if I need it?
A. Mercy Care Plan has urgent care centers. Your case manager has a list of urgent care centers in your area or click Find A Provider (1.1.10) to see our list of urgent care centers.

Q. What is urgent care?
A. This is when you need care right away but you are not in danger of lasting harm or of losing your life. Examples of these situations include if you have a sore throat, flu, a cut that may need stitches or migraine.

Q. How to I get medications if I only have Mercy Care Plan?
A. Mercy Care Plan has a list of covered medications for your doctor to use. Your doctor will choose one from the list. There are no copayments for medications that your doctor orders for you from this list.

Q. How do I get medications if I have other insurance besides Mercy Care Plan?
A. If you have other insurance that covers prescriptions, you will get your medications through that insurance plan. Mercy Care will pay the copays only if the drug is also on Mercy Care Plan drug list. The pharmacy should process the prescriptions through Mercy Care Plan for you. Do not pay any copayments yourself. Mercy Care Plan may not be able to pay you back.

Q. How do I get medications if I am on Medicare?
A. If you are on Medicare, you will need to pay the designated copay for each of your prescriptions.

Q. How do I see a specialist?
A. Your PCP will make a referral to a specialist when necessary.

Q: Where can I get behavioral health services?
A: Behavioral health services are available to you under Mercy Care Plan. You do not need a referral from your doctor for behavioral health services. Call your case manager for a list of current providers or for help in setting up an appointment

Q. If I have a behavioral health emergency, whom do I call?
A. If you think you might hurt yourself or someone else, call 911. You can also get help by calling the Mercy Care Plan crisis line at (800) 876-5835.

Q. What if I have an emergency while in another state?
A. Go to the nearest emergency room and present your Mercy Care Plan member ID card. Do not pay for the services. The emergency department should bill MCP using the information on the back of your ID card.