Mutual of Omaha Medicare Part D 2023 Review

Mutual of Omaha’s Rx Essential plan is a new low-cost option, but the company’s quality ratings from CMS are significantly below average.
Alex Rosenberg
By Alex Rosenberg 
Edited by Dawnielle Robinson-Walker

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Mutual of Omaha sells insurance and offers financial services. About 107,000 Medicare beneficiaries have Mutual of Omaha Part D prescription drug plans as of October 2022

Centers for Medicare & Medicaid Services. PDP Plan Directory. Accessed Oct 27, 2022.
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Unlike many Medicare Part D insurance companies, Mutual of Omaha doesn’t sell Medicare Advantage plans. The company specializes in insurance that complements your main health insurance, such as Medicare Part D plans, Medicare Supplement Insurance, life insurance and long-term care insurance.

Mutual of Omaha has a new low-cost plan for 2023, Mutual of Omaha Rx Essential, but its other two plans are more expensive than similar plans from major competitors. The company gets low 2023 Medicare Part D star ratings from the Centers for Medicare & Medicaid Services, or CMS.

Here’s what you should know about Mutual of Omaha Medicare Part D prescription drug plans.

Mutual of Omaha Medicare prescription plan pros and cons

Medicare prescription drug plans from Mutual of Omaha have advantages and disadvantages.

Pros

Cons

  • Medication management. Mutual of Omaha performs better than the national average on quality measures related to helping beneficiaries with conditions like diabetes, hypertension and high cholesterol get and take their medications.

  • Lower cost of entry in 2023. The new Essential plan makes Mutual of Omaha more price-competitive with other companies’ low-premium options.

  • Low quality ratings. Mutual of Omaha’s Part D quality ratings from CMS are significantly lower than most competitors.

  • Cost sharing. Mutual of Omaha has few $0-deductible and $0-copay options and requires coinsurance rather than copays for many drugs.

Mutual of Omaha Medicare Part D prescription drug plans

Medicare beneficiaries with Original Medicare (Part A and/or Part B) can purchase a Medicare Part D plan for prescription drug coverage. Part D plans are sold by private insurance companies. The costs and coverage can vary significantly, so it’s important to compare options.

Mutual of Omaha has added a third Medicare Part D plan for 2023, up from the two it offered in 2022. Here are Mutual of Omaha’s 2023 Medicare prescription drug plans

Mutual of Omaha. Our Prescription Drug Plans. Accessed Oct 27, 2022.
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  • Mutual of Omaha Rx Essential: According to Mutual of Omaha, this plan is “ideal for newly eligible Medicare clients, clients with low drug utilization, or clients on low-cost maintenance medications.”

  • Mutual of Omaha Rx Premier: According to Mutual of Omaha, this plan “delivers affordable coverage and a $0 deductible for Tier 1-2 drugs.”

  • Mutual of Omaha Rx Plus: According to Mutual of Omaha, this plan “covers a broad choice of prescriptions while offering low-cost generic drug choices.”

Mutual of Omaha Medicare Part D service area

Mutual of Omaha offers stand-alone Medicare prescription drug plans in Washington, D.C., and every state except New York

Centers for Medicare & Medicaid Services. 2023 PDP Landscape Source File (v 10 14 2022): State; Organization Name; Plan Name. Accessed Oct 27, 2022.
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All three Mutual of Omaha plan options are available in every market the company serves.

Mutual of Omaha Medicare Part D cost

Mutual of Omaha Medicare Part D premiums and deductibles

Average premiums have more than doubled for the Mutual of Omaha Rx Premier plan, growing by more than $36 per month. That plan was the less expensive of two options last year, but for 2023, it’s the middle of Mutual of Omaha’s three options. However, at more than $70 per month, on average, it costs as much as some companies’ high-end offerings.

The Mutual of Omaha Rx Plus plan, the company’s high-end option, costs about the same as it did last year. The Mutual of Omaha Rx Essential plan is the company’s low-cost option, and it’s new for 2023.

Here are the 2023 premiums and deductibles for Mutual of Omaha’s stand-alone Medicare prescription drug plans

Centers for Medicare & Medicaid Services. 2023 PDP Landscape Source File (v 10 14 2022): Monthly Drug Premium. Accessed Oct 27, 2022.
:

Plan

Pricing

Mutual of Omaha Rx Essential

Monthly premiums:

  • Lowest: $18.10.

  • Average: $19.58.

  • Highest: $22.50.

Annual deductible: $505.

Mutual of Omaha Rx Premier

Monthly premiums:

  • Lowest: $52.10.

  • Average: $70.75.

  • Highest: $95.90.

Annual deductible: $505.

Mutual of Omaha Rx Plus

Monthly premiums:

  • Lowest: $75.30.

  • Average: $89.55.

  • Highest: $107.90.

Annual deductible: $505.

» If you have concerns about affording Medicare Part D, look into Medicare Extra Help.

Mutual of Omaha Medicare Part D drug formulary tiers

A formulary is a list of the prescription drugs covered by an insurance plan. The plans often organize different kinds of drugs into tiers according to the cost of the drugs.

Mutual of Omaha’s Medicare prescription drug plans use a five-tier formulary

Mutual of Omaha. Mutual of Omaha Rx (PDP) 2023 Formulary. Accessed Oct 27, 2022.
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Drug tier

Description

Tier 1: Preferred generic drugs

Commonly prescribed, low-cost generic drugs.

Tier 2: Generic drugs

Generic drugs.

Tier 3: Preferred brand drugs

Most insulins, preferred brand-name drugs and some generic drugs.

Tier 4: Non-preferred drugs

Non-preferred brand-name and generic drugs that may have lower-cost alternatives.

Tier 5: Specialty tier drugs

High-cost drugs that meet Medicare’s definition of a specialty drug.

Each tier has copay or coinsurance requirements. You’ll generally pay more for drugs listed in higher tiers up to Tier 4, but Tier 5 specialty drugs have a lower coinsurance requirement than Tier 4 drugs.

The drugs included in tiers and what you’ll pay for each tier depends on your choice of prescription drug plan and what kind of pharmacy you use. For example, Mutual of Omaha plans often have the lowest copays for prescriptions you get as a 90-day mail-order supply, but prescriptions from preferred (in-network) retail pharmacies have only slightly higher copays. Prescriptions from non-preferred pharmacies can cost significantly more.

$0-deductible options

The Mutual of Omaha Rx Essential and Rx Premier plans have $0 deductibles for Tier 1-2 drugs. The Premier plan also has no deductible for certain Tier 3 insulins. For all other covered drugs, both plans have a deductible of $505.

The Mutual of Omaha Rx Plus plan has a $505 deductible for all covered drugs.

$0-copay options

Mutual of Omaha’s Essential plan has a $0 copay for Tier 1 drugs from preferred retail or mail-order pharmacies. The Premier and Plus plans don't have any $0 copays — Tier 1 drugs from preferred retail pharmacies have $1 copay for a 30-day supply.

Drugs on higher tiers can quickly get more expensive. As a result, it’s important to check where your medications and pharmacies fall on each plan’s formulary.

Coinsurance vs. copay requirements

You’ll want to check whether you’ll pay a copay or coinsurance for your medications. Copays are set dollar amounts, so it’s easy to see what you’ll pay. Coinsurance is a percentage of the price for your medications, so coinsurance requirements can be more unpredictable and more expensive.

Mutual of Omaha plans start requiring coinsurance rather than copays at different tiers depending on your plan:

  • Mutual of Omaha Rx Essential: Copays for Tiers 1-2; coinsurance for Tiers 3-5.

  • Mutual of Omaha Rx Premier: Copays for Tiers 1-3; coinsurance for Tiers 4-5.

  • Mutual of Omaha Rx Plus: Copays for Tiers 1-2; coinsurance for Tiers 3-5.

You can enter your medications and pharmacy information on Mutual of Omaha’s website to see which drugs are covered and review your estimated costs with different plan options.

Mutual of Omaha Medicare Part D star ratings

Average Part D star rating, weighted by enrollment: 2 stars

The Centers for Medicare & Medicaid Services rates Medicare Part D plans on 12 quality measures. (You can find definitions for each of these factors in the CMS Star Ratings Technical Notes.)

These ratings use a 5-point scale, where 5 is the best and 1 is the worst. The agency bases its ratings on drug plans’ quality of service and customer experiences, and ratings are updated annually.

Based on the most recent year of data, stand-alone Mutual of Omaha prescription drug plans get an average rating of 2 stars, weighted by enrollment. The 2023 average for all stand-alone Medicare Part D plans from all providers, weighted by enrollment, was 3.25 stars

Centers for Medicare & Medicaid Services. 2023 Medicare Star Ratings Fact Sheet. Accessed Oct 27, 2022.
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Compare Mutual of Omaha’s Part D star ratings

Mutual of Omaha’s stand-alone Medicare Part D plans outperformed the national average on five Part D measures and fell behind the national average on seven measures

Centers for Medicare & Medicaid Services. 2023 Star Ratings Data Table - Measure Stars (Oct 04 2022). Accessed Oct 27, 2022.
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Here’s how stand-alone Mutual of Omaha prescription drug plans compared with national averages for each of the 12 Part D measures

:

Measure

Mutual of Omaha's rating

National average

Medicare plan finder price accuracy

5 stars.

3.5 stars.

Medication adherence for diabetes medications

3 stars.

2.9 stars.

Medication adherence for hypertension

3 stars.

2.7 stars.

Medication adherence for cholesterol

4 stars.

3.1 stars.

Statin use in persons with diabetes

3 stars.

2.9 stars.

Measure

Mutual of Omaha's rating

National average

Call center – foreign language interpreter and TTY availability

4 stars.

4.1 stars.

Complaints about the drug plan (a higher star rating means fewer complaints)

2 stars.

4.4 stars.

Members choosing to leave the plan (a higher star rating means fewer members choose to leave)

1 star.

4 stars.

Drug plan quality improvement

1 star.

2.2 stars.

Rating of drug plan

1 star.

3.3 stars.

Getting needed prescription drugs

2 stars.

3.5 stars.

Medication Therapy Management program completion rate for comprehensive medication review

3 stars.

3.1 stars.

Third-party ratings

AM Best Financial Strength Rating: A+

AM Best is a credit rating agency that specializes in the insurance industry. In February 2022, AM Best affirmed its Financial Strength Rating, or FSR, of A+ (Superior) for Mutual of Omaha Insurance Corp. and its subsidiaries: United of Omaha Life Insurance Company, Companion Life Insurance Company and United World Life Insurance Company, collectively referred to as Mutual of Omaha

.

An A+ rating in this category indicates that Mutual of Omaha has a superior ability to meet its ongoing insurance obligations, according to AM Best.

About Mutual of Omaha

Mutual of Omaha, headquartered in Omaha, Nebraska, was founded in 1909 as the Mutual Benefit Health & Accident Association. The company changed its name to Mutual of Omaha in 1950. Mutual of Omaha sells Medicare Supplement Insurance and Medicare Part D plans, dental insurance, life insurance and other insurance products such as long-term care and disability insurance. It also offers other financial services such as annuities, mortgages and investment services.

Compare alternatives

Compare Medicare Part D prescription drug plan companies

Company

Average stand-alone Medicare Part D star rating, weighted by enrollment (2023)

3.21 stars.

3.5 stars.

3.52 stars.

3.02 stars.

2 stars.

3 stars.

Find the right Medicare Part D prescription drug plan

The interactive tool on Medicare.gov can help you find a Medicare Part D plan that covers your prescriptions. It also helps you compare costs among Medicare Part D and Medicare Advantage plans available to you.

Here are some things to keep in mind when comparing plans:

  • Check the formulary: You’ll want to make sure the medicines you currently take and, importantly, any you think you might need in the future, are covered under each of the plans you’re considering. Talk to your health care providers about what brand-name and generic medicines to look for and any alternatives that may also work in case you can’t find your current medicines on the plans available in your area.

  • Look for plan changes: Formularies change frequently. Your insurer should send you a Notice of Plan Change when the formulary changes. Read that document carefully.

  • Check the pharmacy network: Most Medicare Part D plans negotiate with a network of pharmacies for the lowest cost. Check to see if your pharmacy or an equally convenient one is in the plan’s network. Also, compare prices for using mail order.

If your plan does change, and the change affects the prescription drugs you need, you can switch plans during Medicare's open enrollment period, Oct. 15 to Dec. 7. Changes go into effect on the following Jan. 1.

If you have additional questions about Medicare, visit Medicare.gov or call 800-MEDICARE (800-633-4227, TTY 877-486-2048).
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