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Mutual of Omaha Rx Premier (PDP)

Health Insurance Company: Mutual of Omaha Rx

Medicare Prescription Drug Part D Plan Details

$73 /mo

monthly premium

Mutual of Omaha Rx Premier (PDP)

Coverage

Overall Star Rating (2024)

1.5

out of 5 stars

General Plan Details

Prescription Drug Deductible

$349

Preferred Generic copay

Preferred Brand copay

$47

Eligible for Low Income Subsidy

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

Plan Link

Doctor Lookup

Drug Link

Ready to Enroll Online?

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Mon-Fri: 8am-10pm, Sat-Sun: 8am-9pm ET

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Where This Plan is Available

State:

Alabama

Counties:

Autauga, Baldwin, Barbour, Bibb, Blount, Bullock, Butler, Calhoun, Chambers, Cherokee, Chilton, Choctaw, Clarke, Clay, Cleburne, Coffee, Colbert, Conecuh, Coosa, Covington, Crenshaw, Cullman, Dale, Dallas, De Kalb, Elmore, Escambia, Etowah, Fayette, Franklin, Geneva, Greene, Hale, Henry, Houston, Jackson, Jefferson, Lamar, Lauderdale, Lawrence, Lee, Limestone, Lowndes, Macon, Madison, Marengo, Marion, Marshall, Mobile, Monroe, Montgomery, Morgan, Perry, Pickens, Pike, Randolph, Russell, Saint Clair, Shelby, Sumter, Talladega, Tallapoosa, Tuscaloosa, Walker, Washington, Wilcox, Winston

View all plans in your Alabama County

Additional Plan Info

Plan Year:

2024

Insurance Company Website:

Mutual of Omaha Rx

Mutual of Omaha Rx Premier (PDP)

Medicare Prescription Drug Part D Plan Details

General Plan Details

Rx Drug Coverage - Preferred Retail Cost

Tier 1: Preferred Generic

Tier 2: Generic

Tier 3: Preferred Brand

Tier 4: Non-Preferred Drug

Tier 5: Specialty Tier

Rx Drug Coverage - Standard Retail Cost

Tier 1: Preferred Generic

Tier 2: Generic

Tier 3: Preferred Brand

Tier 4: Non-Preferred Drug

Tier 5: Specialty Tier

Rx Drug Coverage - Standard Mail Order Cost

Tier 1: Preferred Generic

Tier 2: Generic

Tier 3: Preferred Brand

Tier 4: Non-Preferred Drug

Tier 5: Specialty Tier

Rx Drug Coverage - Preferred Mail Order Cost

Tier 1: Preferred Generic

Tier 2: Generic

Tier 3: Preferred Brand

Tier 4: Non-Preferred Drug

Tier 5: Specialty Tier

Plan Links

Where This Plan is Available

Additional Plan Info

Health Insurance Companies Offering Plans