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Product Details for
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Mutual of Omaha
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Premium |
per month for |
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Deductible |
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Initial Coverage Limit |
per year |
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Gap Coverage(also known as the "donut hole") |
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Cost Sharing Tier 1: Preferred Generic |
Preferred Pharmacy (30-day)
Standard Pharmacy (30-day)
Mail Order (90-day)
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Cost Sharing Tier 2: Generic |
Preferred Pharmacy (30-day)
Standard Pharmacy (30-day)
Mail Order (90-day)
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Cost Sharing Tier 3: Preferred Brand |
Preferred Pharmacy (30-day)
Standard Pharmacy (30-day)
Mail Order (90-day)
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Cost Sharing Tier 4: Non-preferred Brand |
Preferred Pharmacy (30-day)
Standard Pharmacy (30-day)
Mail Order (30-day)
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Cost Sharing Tier 5: Specialty |
Preferred Pharmacy (30-day)
Standard Pharmacy (30-day)
Mail Order (30-day)
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Important Plan Documents |
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ActionsPharmacy Lookup
Our preferred pharmacy network includes CVS, CVS-Target, Walmart, and local and regional pharmacies.
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