October 10, 2018
2019 Mercy Care Advantage benefit changes

Applicable to: Mercy Care Advantage
Effective January 1, 2019, Mercy Care Advantage (MCA) will have changes to the Supplemental Benefits and Part D prescription drug coverage offered. These change were recently communicated in the Annual Notice of Changes (ANOC) mailed to our existing MCA members the week of September 24th. Below is a summary of the MCA Supplemental Benefit changes communicated to our members:
  • Chiropractic care up to 12 visits every calendar year at no cost to the member.
  • Emergency Care 0% or 20% of the total cost (up to $90). Members eligible for Medicare cost-sharing assistance under AHCCCS (Medicaid), pay 0% of the total cost.
  • $55 monthly allowance towards Over-the-Counter non-prescription medicine and personal health care items.
  • Transportation 26-one way trips or 13-round trips every calendar year to access covered supplemental benefits such as chiropractic, dental, vision at no cost to the member.
  • $275 allowance for contact lenses and eyeglasses (frames and lenses). Allowance is limited to every two years.
The 2019 MCA Part D Formulary will have changes. Providers are encouraged to review the MCA formulary and Part D utilization management criteria when prescribing medications. If a member's drug is not covered on the MCA formulary in 2019, they will get a one-time transition fill of their drug and will be notified. The member will either need to be transitioned to a covered drug or providers will need to request a Part D coverage determination exception request for approval for their existing medication. A copy of the 2019 MCA formulary and the Annual Notice of Changes are available on our Mercy Care Advantage Member website at https://www.mercycareplan.com/members/mca/materials.
We hope this information assists providers in answering questions you may receive from your MCA patients.  
As always, don't hesitate to contact your Mercy Care Provider Relations Representative with any questions or comments. You can find this notice and all other provider notices on our Mercy Care website .

Thanks for all you do!