Prescription Medicine
Keystone Mercy covers medically necessary, Food and Drug Administration
(FDA)-approved medicines prescribed by your health care provider to treat
you when you are sick. Keystone 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 Keystone
Mercy. Keystone Mercy members can request a copy of a drug formulary by
calling Member Services at 1-800-521-6860.
 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. Keystone 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 Keystone 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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