Mercyhealth Partners

Welcome to MercyCare!

 

Find all of your MercyCare insurance resources below:

 

Find a Doctor

  • Select your network:
    • Mercyhealth Partners EPO or EPO HDHP-T3
    • Mercyhealth Partners PPO or PPO HDHP T8

Prescription Benefit Portal

  • Find a pharmacy
  • Pharmacy claim information
  • Drug information
  • Drug pricing
  • Medical condition information
  • Copay information
  • Explanation of benefits for prescription drug benefits
  • Drug spend amount for prescription drug benefits

Summary of Benefits and Coverage/ Plan Benefit Documents- Located on  your MyPlan

Uniform Glossary For SBC

EPO & PPO HDHP Formulary-2 Tier

EPO & PPO Formulary-4 Tier

Two-tiered drug plan

This drug plan has an extensive list of covered prescription medications divided into two tiers. Tier-1 is the lowest co-pay level and includes preferred generics and over-the-counter medications. Tier-2 is the higher co-pay level and includes preferred brands.  All medications listed in the formulary have been reviewed for safety and effectiveness and are chosen by a committee of physicians and pharmacists.

Four-tiered drug plan

This four-tiered drug plan incorporates four levels of benefits. Tier 1 is for preferred generic drugs, preferred tier 1 brand name drugs, and covered over-the-counter (OTC) drugs, and has the lowest co-payment. Tier 2 covers selected generic drugs and our preferred tier 2 brand name drugs, and has the second lowest co-payment. Tier 3 represents all non-preferred drugs, except specialty drugs, and has the third lowest co-payment. Tier 4 covers only selected generic drugs, selected brand name drugs, specialty drugs, and clinically-appropriate non-covered drugs by approval, and has the highest co-payment. This drug plan is a closed formulary, which means that only those drugs listed in the formulary are available to our members. All medications listed in the formulary are reviewed for safety and effectiveness and chosen by a committee of physicians and pharmacists. Other changes may occur to this formulary as determined by MercyCare.

Take your HRA

  • A health risk assessment (HRA) is a short, confidential survey designed to assess your true health status

Stay Healthy Reimbursement Form


MercyCare Health Plans Contact Information

580 N. Washington St.
PO Box 550
Janesville, WI 53547-0550

Customer Service: (800) 895-2421, M-F 8:00 am-4:30 pm