Plan Documents
Select the name of the plan you are enrolled in to view your plan-specific documents — Summary of Benefits, Evidence of Coverage, and Annual Notice of Changes. You can find your plan name on your member ID card.
Other Coverage Information
Prior Authorization list (effective 01/01/2026)
Medicare Part D Drugs Prior Authorization Criteria and Step Therapy
Medicare Part B Drugs Prior Authorization Criteria and Step Therapy
Preferred Diabetic Testing Supplies
Over-the-Counter (OTC) Catalog
Provider Directory
MercyOne Health Plan offers a large network of high-quality providers. You can use the Provider/Pharmacy Directory below to find network providers and pharmacies in your area. You can also search the directory on the Find a Provider page of our website.
Provider and Pharmacy Directory (last updated 01/02/2026)
Dental and Vision Directory (last updated 01/09/2026)
At any time, you can request a printed copy of the Provider/Pharmacy Directory by calling Member Services. You can also call Member Services for more information about our network providers, including their qualifications and any changes in the pharmacy network.