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Mutual of Omaha Rx
Premier
Premier
Mutual of Omaha Rx
Plus
Plus
$24.90
premium/month
$85.50
premium/month
| Starting with a low monthly premium, our Premier plan delivers affordable coverage and a $0 deductible for tier 1-2 drugs. | Our Plus plan is our basic plan that covers a broad choice of prescriptions while offering low-cost generic drug choices. |
Deductible |
Deductible |
|
$0
Tiers 1 & 2 $445
Tiers 3 - 5 |
$445 |
Preferred Network |
Preferred Network |
| CVS, CVS/Target, Walmart, Sam's Club, and regional Rx networks. | CVS, CVS/Target, Walmart, Sam's Club, and regional Rx networks. |
| This plan works best for the cost conscious, healthy population. | This plan works best for people that take multiple medications. |
Cost Share by Tier and Network
| Preferred Retail 30 Days |
Preferred Retail 90 Days |
Preferred Home Delivery 90 Days |
||||
|---|---|---|---|---|---|---|
|
Tier 1: Preferred Generic*
These are the most commonly prescribed and affordable prescriptions.
|
$0 | $0 | $0 | $0 | $0 | $0 |
|
Tier 2: Generic*
These are a little more expensive than Tier 1, but still generic medicines.
|
$2 | $6 | $6 | $2 | $6 | $6 |
|
Tier 3: Preferred Brand*
Tier 3 drugs are brand-name or higher-priced generic prescriptions.
|
23% | 23% | 23% | 20% | 20% | 20% |
|
Tier 4: Non-Preferred Brand*
These are more expensive brand-name drugs.
|
44% | N/A | 44%** | 38% | N/A | 38%** |
|
Tier 5: Specialty*
These are the most expensive drugs. They treat very complex conditions like cancer.
|
25% | N/A | 25%** | 25% | N/A | 25%** |
|
Tier 1: Preferred Generic*
These are the most commonly prescribed and affordable prescriptions.
|
||||||
|
Preferred Retail 30 Days |
$0 | $0 | ||||
|
Preferred Retail 90 Days |
$0 | $0 | ||||
|
Preferred Home Delivery 90 Days |
$0 | $0 | ||||
|
Tier 2: Generic*
These are a little more expensive than Tier 1, but still generic medicines.
|
||||||
|
Preferred Retail 30 Days |
$2 | $2 | ||||
|
Preferred Retail 90 Days |
$6 | $6 | ||||
|
Preferred Home Delivery 90 Days |
$6 | $6 | ||||
|
Tier 3: Preferred Brand*
Tier 3 drugs are brand-name or higher-priced generic prescriptions.
|
||||||
|
Preferred Retail 30 Days |
23% | 20% | ||||
|
Preferred Retail 90 Days |
23% | 20% | ||||
|
Preferred Home Delivery 90 Days |
23% | 20% | ||||
|
Tier 4: Non-Preferred Brand*
These are more expensive brand-name drugs.
|
||||||
|
Preferred Retail 30 Days |
44% | 38% | ||||
|
Preferred Retail 90 Days |
N/A | N/A | ||||
|
Preferred Home Delivery 90 Days |
44%** | 38%** | ||||
|
Tier 5: Specialty*
These are the most expensive drugs. They treat very complex conditions like cancer.
|
||||||
|
Preferred Retail 30 Days |
25% | 25% | ||||
|
Preferred Retail 90 Days |
N/A | N/A | ||||
|
Preferred Home Delivery 90 Days |
25%** | 25%** | ||||
*The copay and cost-sharing depends on where you get your prescription filled.
**30 Day Home Delivery Only
**30 Day Home Delivery Only
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