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Mutual of Omaha Rx
Value
Value
Mutual of Omaha Rx
Plus
Plus
$25.80
premium/month
$55.80
premium/month
| Starting with a low monthly premium, our Value 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 $435
Tiers 3 - 5 |
$435 |
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 | $10 | $30 | $30 |
|
Tier 3: Preferred Brand*
Tier 3 drugs are brand-name or higher-priced generic prescriptions.
|
$27 | $81 | $81 | $42 | $126 | $126 |
|
Tier 4: Non-Preferred Brand*
These are more expensive brand-name drugs.
|
48% | N/A | 48%** | 48% | N/A | 48%** |
|
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 | $10 | ||||
|
Preferred Retail 90 Days |
$6 | $30 | ||||
|
Preferred Home Delivery 90 Days |
$6 | $30 | ||||
|
Tier 3: Preferred Brand*
Tier 3 drugs are brand-name or higher-priced generic prescriptions.
|
||||||
|
Preferred Retail 30 Days |
$27 | $42 | ||||
|
Preferred Retail 90 Days |
$81 | $126 | ||||
|
Preferred Home Delivery 90 Days |
$81 | $126 | ||||
|
Tier 4: Non-Preferred Brand*
These are more expensive brand-name drugs.
|
||||||
|
Preferred Retail 30 Days |
48% | 48% | ||||
|
Preferred Retail 90 Days |
N/A | N/A | ||||
|
Preferred Home Delivery 90 Days |
48%** | 48%** | ||||
|
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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