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Product Details for

 

Mutual of Omaha

Premium

per month for  
Deductible


Initial Coverage Limit

per year

Gap Coverage

(also known as the "donut hole")

Cost Sharing

Tier 1: Preferred Generic

Preferred:

Standard:

90-day Mail:

Cost Sharing

Tier 2: Generic

Preferred:

Standard:

90-day Mail:

Cost Sharing

Tier 3: Preferred Brand

Preferred:

Standard:

90-day Mail:

Cost Sharing

Tier 4: Non-preferred Brand

Preferred:

Standard:

30-day Mail:

Cost Sharing

Tier 5: Specialty

Preferred:

Standard:

30-day Mail:

Important Plan Documents

Pharmacy Lookup

CVS is our preferred network, including: CVS, CVS-Target, Walmart as well as local and regional pharmacies.

Pharmacy Finder

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