Pharmacy Prior Authorization Guidelines

Some prescription drugs require prior authorization from Mercy Care Long Term Care before they can be filled. To learn more about the prior authorization guidelines for these medications, see the list below. Simply click on the medication name to download the prior authorization guidelines for that drug.

4350 E. Cotton Center Blvd.,
Bldg D, Phoenix,
Arizona 85040
Member Services
7 a.m. to 6 p.m. Monday-Friday
602-263-3000,
Toll-free 1-800-624-3879
(TTY/TDD)
Toll-free: 1-866-602-1982

If you or a family member has a medical emergency, dial 911.