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Mutual Income Solutions Product Guide


A strategic alliance in Medicare excellence

As a customer-focused company, Mutual of Omaha is committed to offering a comprehensive suite of senior health products that help meet customers' individual needs.

We're excited to announce that Mutual of Omaha and Wellcare have continued their strategic alliance to deliver high quality Medicare Advantage plans in 2025.

Mutual of Omaha and Wellcare will be offering MAPD PPO plans in Georgia, South Carolina, Washington, and in the Dallas-Fort Worth and Houston markets in Texas.

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Resources

Supplementary learning and training resources to help you sell Medicare Advantage

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Product Information

Dallas/Ft. Worth

Available in Collin, Dallas, Denton, Ellis, Fannin, Hamilton, Hill, Hood, Jack, Johnson, Mills, Parker, Rockwall, Somervell, Tarrant and Wise counties.

Wellcare Mutual of Omaha Simple Secure Open (PPO)

Contract Number
 

H7323011000

 
INN/OON/Tier

INN

 

OON

Total Premium (Part C Part D)
 

$0.00

 
Inpatient Acute

$305 copay per day
for days 1-5
$0 copay per day
for days 6-90
No additional hospital days

 

$525 copay per day
for days 1-5
$0 copay per day
for days 6-90
No additional hospital days

Plan Deductible
 

No

 
Maximum Out of Pocket (MOOP) INN

$4,900

 

N/A

Maximum Out of Pocket (MOOP) Combined
 

$9,000

 
PCP Office Visits

$0

 

$25

Specialist Office Visits

$5

 

$50

Wellcare Spendables™
 

OTC Allowance of $30 per quarter for covered items

 
Fitness
 

$0

 
Dental Benefits

Preventive dental care and services ($0 copay)

 

Preventive dental care and services (50% cost share)

Vision Benefits

$0 copay for a routine exam, plus get up to $100 for unlimited contacts, glasses, lenses, and/or frames per year

 

40% coinsurance for a routine exam, 40% coinsurance for eyewear/services and get up to $100 towards unlimited contacts, glasses, lenses, and/or frames per year

Hearing Allowance
 

$350 - hearing aids per ear every year ($0 copay INN/40% cost share OON)

 
Lab Services

$0-$50

 

30%

X-Ray Services

$75

 

30%

Prescription Drug Copays (Pref) T1/T2/T3/T4/T5/T6
 

$0/$0/25%/50%/28%/$0

 
RX Deductible
 

$420

 
RX Deductible Tiers
 

Tiers 3-5

 

*Agent/Broker use only. Confidential and proprietary. Not to be distributed or shared with Medicare beneficiaries. Distribution to any person or company is prohibited and may be grounds for contract termination. Final 2025 plan and benefit information may be discussed with beneficiaries on or after October 1.


Houston

Available in Austin, Brazoria, Chambers, Colorado, Fort Bend, Galveston, Grimes, Hardin, Harris, Jefferson, Liberty, Matagorda, Montgomery, Orange, Polk, San Jacinto, Trinity, Walker, Waller and Wharton counties.

Wellcare Mutual of Omaha Simple Secure Open (PPO)

Contract Number
 

H7323012000

 
INN/OON/Tier

INN

 

OON

Total Premium (Part C Part D)
 

$0.00

 
Inpatient Acute

$320 copay per day
for days 1-5
$0 copay per day
for days 6-90
No additional hospital days

 

$525 copay per day
for days 1-5
$0 copay per day
for days 6-90
No additional hospital days

Plan Deductible
 

No

 
Maximum Out of Pocket (MOOP) INN

$5,900

 

N/A

Maximum Out of Pocket (MOOP) Combined
 

$9,000

 
PCP Office Visits

$0

 

$25

Specialist Office Visits

$0

 

$50

Wellcare Spendables™
 

OTC Allowance of $30 per quarter for covered items

 
Fitness
 

$0

 
Dental Benefits

Preventive dental care and services ($0 copay)

 

Preventive dental care and services (50% cost share)

Vision Benefits

$0 copay for a routine exam, plus get up to $100 for unlimited contacts, glasses, lenses, and/or frames per year

 

40% coinsurance for a routine exam, 40% coinsurance for eyewear/services and get up to $100 towards unlimited contacts, glasses, lenses, and/or frames per year

Hearing Allowance
 

$350 - hearing aids per ear every year ($0 copay INN/40% cost share OON)

 
Lab Services

$0-$50

 

40%

X-Ray Services

$75

 

40%

Prescription Drug Copays (Pref) T1/T2/T3/T4/T5/T6
 

$0/$0/25%/50%/28%/$0

 
RX Deductible
 

$420

 
RX Deductible Tiers
 

Tiers 3-5

 

*Agent/Broker use only. Confidential and proprietary. Not to be distributed or shared with Medicare beneficiaries. Distribution to any person or company is prohibited and may be grounds for contract termination. The plan information contained in this document is pending government approval and subject to change. Final 2025 plan and benefit information may be discussed with beneficiaries on or after October 1.

Available in Appling, Atkinson, Bacon, Baker, Baldwin, Banks, Barrow, Bartow, Ben Hill, Berrien, Bibb, Bleckley, Brantley, Brooks, Bryan, Burke, Butts, Camden, Candler, Carroll, Catoosa, Charlton, Chatham, Chattahoochee, Chattooga, Cherokee, Clarke, Clayton, Clinch, Cobb, Coffee, Colquitt, Columbia, Cook, Coweta, Crawford, Crisp, Dade, Dawson, Decatur, DeKalb, Dodge, Dooly, Douglas, Echols, Effingham, Elbert, Emanuel, Evans, Fannin, Fayette, Floyd, Forsyth, Franklin, Fulton, Gilmer, Glascock, Gordon, Grady, Greene, Gwinnett, Habersham, Hall, Hancock, Haralson, Harris, Hart, Heard, Henry, Houston, Irwin, Jackson, Jasper, Jeff Davis, Jefferson, Jenkins, Johnson, Jones, Lamar, Lanier, Laurens, Liberty, Lincoln, Long, Lowndes, Lumpkin, Macon, Madison, Marion, McDuffie, McIntosh, Meriwether, Miller, Mitchell, Monroe, Montgomery, Morgan, Murray, Muscogee, Newton, Oconee, Oglethorpe, Paulding, Peach, Pickens, Pierce, Pike, Polk, Pulaski, Putnam, Quitman, Rabun, Randolph, Richmond, Rockdale, Schley, Screven, Seminole, Spalding, Stephens, Stewart, Talbot, Taliaferro, Tattnall, Taylor, Telfair, Thomas, Tift, Toombs, Towns, Treutlen, Troup, Turner, Twiggs, Union, Upson, Walker, Walton, Ware, Warren, Washington, Wayne, Webster, Wheeler, White, Whitfield, Wilcox, Wilkes, Wilkinson, and Worth counties.

Wellcare Mutual of Omaha Simple Open (PPO)

Contract Number
 

H0111001000

 
INN/OON/Tier

INN

 

OON

Total Premium (Part C Part D)
 

$0.00

 
Inpatient Acute

$375 copay per day
for days 1-7
$0 copay per day
for days 8-90
No additional hospital days

 

50% of the total cost
for days 1-90

Plan Deductible
 

No

 
Maximum Out of Pocket (MOOP) INN

$5,900

 

N/A

Maximum Out of Pocket (MOOP) Combined
 

$10,000

 
PCP Office Visits

$0

 

$30

Specialist Office Visits

$40

 

$55

Wellcare Spendables™
 

OTC Allowance of $75 per quarter for covered items

 
Fitness
 

$0

 
Dental Benefits

No annual prev max plus $2,000 in comp dental services, Incl. exams, fillings & minor restorative services ($0 copay)

 

No annual prev max plus $2,000 in comp dental services, Incl. exams, fillings & minor restorative services (50% cost share)

Vision Benefits

$0 copay for a routine exam, plus get up to $100 for unlimited contacts, glasses, lenses, and/or frames per year

 

40% coinsurance for a routine exam, 40% coinsurance for eyewear/services and get up to $100 towards unlimited contacts, glasses, lenses, and/or frames per year

Hearing Allowance
 

$500 - hearing aids per ear every year ($0 copay INN/40% cost share OON)

 
Lab Services

$0-$50

 

50%

X-Ray Services

$75

 

50%

Prescription Drug Copays (Pref) T1/T2/T3/T4/T5/T6
 

$0/$0/25%/46%/28%/$0

 
RX Deductible
 

$420

 
RX Deductible Tiers
 

Tiers 3-5

 

*Agent/Broker use only. Confidential and proprietary. Not to be distributed or shared with Medicare beneficiaries. Distribution to any person or company is prohibited and may be grounds for contract termination. Final 2025 plan and benefit information may be discussed with beneficiaries on or after October 1.

Available in Abbeville, Aiken, Allendale, Anderson, Bamberg, Barnwell, Beaufort, Berkeley, Calhoun, Charleston, Cherokee, Chester, Chesterfield, Clarendon, Colleton, Darlington, Dillon, Dorchester, Edgefield, Fairfield, Florence, Georgetown, Greenville, Greenwood, Hampton, Horry, Jasper, Kershaw, Lancaster, Laurens, Lee, Lexington, Marion, Marlboro, McCormick, Newberry, Oconee, Orangeburg, Pickens, Richland, Saluda, Spartanburg, Sumter, Union, Williamsburg, and York counties.

Wellcare Mutual of Omaha Simple Open (PPO)

Contract Number
 

H7326001000

 
INN/OON/Tier

INN

 

OON

Total Premium (Part C Part D)
 

$0.00

 
Inpatient Acute

$350 copay per day
for days 1-5
$0 copay per day
for days 6-90
$0 copay
for 10 additional hospital days

 

40% of the total cost
for days 1-90
0% of the total cost
for days 91-100

Plan Deductible
 

No

 
Maximum Out of Pocket (MOOP) INN

$4,150

 

N/A

Maximum Out of Pocket (MOOP) Combined
 

$6,200

 
PCP Office Visits

$0

 

$35

Specialist Office Visits

$20

 

$50

Wellcare Spendables™
 

OTC Allowance of $90 per quarter for covered items

 
Fitness
 

$0

 
Dental Benefits

No annual prev max plus $3,000 in comp dental services, Incl. exams, fillings, minor restorative services & dentures ($0-20% coinsurance)

 

No annual prev max plus $3,000 in comp dental services, Incl. exams, fillings, minor restorative services & dentures (50% cost share)

Vision Benefits

$0 copay for a routine exam, plus get up to $200 for unlimited contacts, glasses, lenses, and/or frames per year

 

40% coinsurance for a routine exam, 40% coinsurance for eyewear/services and get up to $200 towards unlimited contacts, glasses, lenses, and/or frames per year

Hearing Allowance
 

$750 - hearing aids per ear every year ($0 copay INN/40% cost share OON)

 
Lab Services

$0-$50

 

50%

X-Ray Services

$40

 

50%

Prescription Drug Copays (Pref) T1/T2/T3/T4/T5/T6
 

$0/$0/25%/43%/28%/$0

 
RX Deductible
 

$420

 
RX Deductible Tiers
 

Tiers 3-5

 

*Agent/Broker use only. Confidential and proprietary. Not to be distributed or shared with Medicare beneficiaries. Distribution to any person or company is prohibited and may be grounds for contract termination. Final 2025 plan and benefit information may be discussed with beneficiaries on or after October 1.

Available in Adams, Asotin, Benton, Chelan, Clallam, Clark, Columbia, Cowlitz, Douglas, Ferry, Franklin, Garfield, Grant, Grays Harbor, Island, Jefferson, King, Kitsap, Kittitas, Klickitat, Lewis, Lincoln, Mason, Okanogan, Pacific, Pend Oreille, Pierce, San Juan, Skagit, Skamania, Snohomish, Spokane, Stevens, Thurston, Wahkiakum, Walla Walla, Whatcom, Whitman, and Yakima counties.

Wellcare Mutual of Omaha Simple Open (PPO)

Contract Number
 

H596500200

 
INN/OON/Tier

INN

 

OON

Total Premium (Part C Part D)
 

$0.00

 
Inpatient Acute

$400 copay per day
for days 1-5
$0 copay per day
for days 6-90
No additional hospital days

 

30% of the total cost
for days 1-90

Plan Deductible
 

No

 
Maximum Out of Pocket (MOOP) INN

$5,900

 

N/A

Maximum Out of Pocket (MOOP) Combined
 

$10,000

 
PCP Office Visits

$0

 

$25

Specialist Office Visits

$25

 

$50

Wellcare Spendables™

OTC Allowance of $91 per quarter for covered items

 

OTC Allowance of $91 per quarter for covered items

Fitness
 

$0

 
Dental Benefits

No annual prev max plus $1,500 in comp dental services, Incl. exams, fillings, minor restorative services & dentures ($0 copay)

 

No annual prev max plus $1,500 in comp dental services, Incl. exams, fillings, minor restorative services & dentures (50% cost share)

Vision Benefits

$0 copay for a routine exam, plus get up to $200 for unlimited contacts, glasses, lenses, and/or frames per year

 

40% coinsurance for a routine exam, 40% coinsurance for eyewear/services and get up to $200 towards unlimited contacts, glasses, lenses, and/or frames per year

Hearing Allowance
 

$500 - hearing aids per ear every year ($0 copay INN/40% cost share OON)

 
Lab Services

$0-$50

 

40%

X-Ray Services

$75

 

40%

Prescription Drug Copays (Pref) T1/T2/T3/T4/T5/T6
 

$0/$0/25%/50%/28%/$0

 
RX Deductible
 

$420

 
RX Deductible Tiers
 

Tiers 3-5

 

*Agent/Broker use only. Confidential and proprietary. Not to be distributed or shared with Medicare beneficiaries. Distribution to any person or company is prohibited and may be grounds for contract termination. Final 2025 plan and benefit information may be discussed with beneficiaries on or after October 1.

Wellcare Mutual of Omaha Premium Enhanced Open (PPO)

Contract Number
 

H5965007000

 
INN/OON/Tier

INN

 

OON

Total Premium (Part C Part D)
 

$96.00

 
Inpatient Acute

$200 copay
up to 90 days per admission

 

30% of the total cost
for days 1-90

Plan Deductible
 

No

 
Maximum Out of Pocket (MOOP) INN

$2,000

 

N/A

Maximum Out of Pocket (MOOP) Combined
 

$3,000

 
PCP Office Visits

$0

 

$0

Specialist Office Visits

$0

 

$0

Wellcare Spendables™

OTC Allowance of $45 per quarter for covered items

 

OTC Allowance of $45 per quarter for covered items

Fitness
 

$0

 
Dental Benefits

No annual prev max plus $1,500 in comp dental services, Incl. exams, fillings & minor restorative services ($0 copay)

 

No annual prev max plus $1,500 in comp dental services, Incl. exams, fillings & minor restorative services (50% cost share)

Vision Benefits

$0 copay for a routine exam, plus get up to $100 for unlimited contacts, glasses, lenses, and/or frames per year

 

40% coinsurance for a routine exam, 40% coinsurance for eyewear/services and get up to $100 towards unlimited contacts, glasses, lenses, and/or frames per year

Hearing Allowance
 

$350 - hearing aids per ear every year ($0 copay INN/40% cost share OON)

 
Lab Services

$0-$50

 

40%

X-Ray Services

$0

 

40%

Prescription Drug Copays (Pref) T1/T2/T3/T4/T5/T6
 

$0/$0/25%/50%/28%/$0

 
RX Deductible
 

$420

 
RX Deductible Tiers
 

Tiers 3-5

 

*Agent/Broker use only. Confidential and proprietary. Not to be distributed or shared with Medicare beneficiaries. Distribution to any person or company is prohibited and may be grounds for contract termination. Final 2025 plan and benefit information may be discussed with beneficiaries on or after October 1.

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