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Mutual of Omaha Rx Premier (PDP)

Health Insurance Company: Mutual of Omaha Rx

Medicare Prescription Drug Part D Plan Details

Mutual of Omaha Rx
$73 /mo
monthly premium
Mutual of Omaha Rx Premier (PDP)
Coverage
Overall Star Rating (2024)
  • Rx
1.5
out of 5 stars

General Plan Details

Prescription Drug Deductible
$349
Preferred Generic copay
$8
Preferred Brand copay
$47
Eligible for Low Income Subsidy
No

Rx Drug Coverage - Preferred Retail Cost

Tier 1: Preferred Generic

$1.00 copay (30-day supply)
$3.00 copay (90-day supply)

Tier 2: Generic

$10.00 copay (30-day supply)
$30.00 copay (90-day supply)

Tier 3: Preferred Brand

$47.00 copay (30-day supply)
$141.00 copay (90-day supply)

Tier 4: Non-Preferred Drug

49% coinsurance (30-day supply)

Tier 5: Specialty Tier

28% coinsurance (30-day supply)

Rx Drug Coverage - Standard Retail Cost

Tier 1: Preferred Generic

$8.00 copay (30-day supply)
$24.00 copay (90-day supply)

Tier 2: Generic

$17.00 copay (30-day supply)
$51.00 copay (90-day supply)

Tier 3: Preferred Brand

$47.00 copay (30-day supply)
$141.00 copay (90-day supply)

Tier 4: Non-Preferred Drug

50% coinsurance (30-day supply)

Tier 5: Specialty Tier

28% coinsurance (30-day supply)

Rx Drug Coverage - Standard Mail Order Cost

Tier 1: Preferred Generic

$2.50 copay (90-day supply)

Tier 2: Generic

$25.00 copay (90-day supply)

Tier 3: Preferred Brand

$117.50 copay (90-day supply)

Tier 4: Non-Preferred Drug

50% coinsurance (30-day supply)

Tier 5: Specialty Tier

28% coinsurance (30-day supply)

Rx Drug Coverage - Preferred Mail Order Cost

Tier 1: Preferred Generic

$2.50 copay (90-day supply)

Tier 2: Generic

$25.00 copay (90-day supply)

Tier 3: Preferred Brand

$117.50 copay (90-day supply)

Tier 4: Non-Preferred Drug

49% coinsurance (30-day supply)

Tier 5: Specialty Tier

28% coinsurance (30-day supply)

Plan Links

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Where This Plan is Available

Additional Plan Info

Plan Year:
2024
Insurance Company Website:
Mutual of Omaha Rx

Health Insurance Companies Offering Plans

Medicare Advantage and Part D plans and benefits offered by the following insurance companies:

  • Aetna Medicare
  • Anthem Blue Cross Blue Shield
  • Anthem Blue Cross
  • Anthem Blue Cross and Blue Shield
  • Aspire Health Plan
  • Baylor Scott & White Health Plan
  • Capital Blue Cross
  • Cigna Healthcare
  • Dean Health Plan
  • Devoted Health
  • Florida Blue Medicare
  • Freedom Health
  • GlobalHealth
  • Health Care Service Corporation
  • Healthy Blue
  • HealthSun
  • Humana
  • Molina Healthcare
  • Mutual of Omaha
  • Medica Central Health Plan
  • Optimum HealthCare
  • Premera Blue Cross
  • SCAN Health Plan
  • Simply
  • UnitedHealthcareⓇ
  • Wellcare
  • WellPoint