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AmeriHealth Mercy covers medically necessary, Food and Drug Administration (FDA)-approved medicines prescribed by your health care provider to treat you when you are sick. AmeriHealth Mercy gives your health care provider a tool, called a drug formulary, to help him or her prescribe drugs for you. A drug formulary is a list of brand and generic drugs covered by AmeriHealth Mercy. AmeriHealth Mercy members can request a copy of a drug formulary by calling Member Services. If you have questions about whether or not a medication is covered, you can call your health care provider, pharmacist or Member Services. Both brand name and generic drugs are on the drug formulary. AmeriHealth Mercy requires that generic drugs be used, when available. There are no co-pays for generic drugs. If a specific medication is not listed on the drug formulary, your health care provider or pharmacist may request it through AmeriHealth Mercy's prior authorization process.
When you are trying to fill a prescription for a medication that is in the prior authorization process:
- If you have not already been taking the medicine, you will receive a 5-day temporary supply of the medicine, as long as the Pennsylvania Medical Assistance Program covers it, and the medicine is safe for you to take.
- If you have already been taking the medicine, you will receive a 15-day temporary supply of the medicine, as long as the Pennsylvania Medical Assistance Program covers it, and the medicine is safe for you to take.
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