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- Mutual of Omaha Medicare prescription plan pros and cons
- Available Medicare Part D prescription drug plans
- Mutual of Omaha Medicare Part D service area
- Mutual of Omaha Medicare Part D star ratings
- Third-party ratings
- About Mutual of Omaha
- Compare alternatives
- Find the right Medicare Part D prescription drug plan
Mutual of Omaha sells insurance and offers financial services. About 106,000 Medicare beneficiaries have Mutual of Omaha Part D prescription drug plans as of April 2022.
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 scores well on certain medication- and health condition-specific quality measures from the Centers for Medicare & Medicaid Services, or CMS. It doesn’t perform as well on measures of overall quality and member satisfaction.
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.
Available 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.
While many major insurance companies offer three Medicare Part D plans, Mutual of Omaha has two options for stand-alone Medicare prescription plans for 2022:
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.
Both Mutual of Omaha plan options are available in every market the company serves.
Mutual of Omaha Medicare Part D premiums and deductibles
Here are the 2022 premiums and deductibles for Mutual of Omaha’s stand-alone Medicare prescription drug plans:
Mutual of Omaha Rx Premier
Annual deductible: $480.
Mutual of Omaha Rx Plus
Annual deductible: $480.
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:
Tier 1: Preferred generic drugs
Commonly prescribed, low-cost generic drugs.
Tier 2: 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
Very high-cost brand-name and generic drugs.
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 have the lowest copays for prescriptions you get from preferred (in-network) pharmacies or by mail.
Mutual of Omaha’s cost-sharing requirements are the same for either preferred in-person or mail-order pharmacies. However, you’ll generally need to get your mail-order medications 90 days at a time — 30-day supplies aren’t available by mail order for drugs on Tiers 1-3.
The Mutual of Omaha Rx Premier plan has a $0 deductible for drugs in Tiers 1-2 and for certain insulins in Tier 3. The deductible for other Tier 3 drugs and Tiers 4-5 is $480.
The Mutual of Omaha Rx Plus plan has a $480 deductible for all covered drugs.
Mutual of Omaha’s Premier plan has a $0 copay for Tier 1 drugs from preferred retail or mail-order pharmacies. The Plus plan doesn’t have any $0 copays — Tier 1 drugs from preferred retail pharmacies have a $1 copay for a 30-day supply.
Both plans have copay or coinsurance requirements for Tier 2 and above, which 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.
Both Mutual of Omaha plans start requiring coinsurance rather than copays at Tier 3, but the Premier plan makes exceptions for certain insulins, which have a copay instead.
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: 3.5
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 overall rating of 3.5 stars. The 2022 average for all stand-alone Medicare Part D plans from all providers, weighted by enrollment, was 3.7 stars.
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.
Here’s how stand-alone Mutual of Omaha prescription drug plans compared with national averages for each of the 12 Part D measures:
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 AM Best believes Mutual of Omaha has a superior ability to meet its ongoing insurance obligations.
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. In 2020, Mutual of Omaha had $11 billion in revenue.
Compare Medicare Part D prescription drug plan companies
Average Medicare Part D star rating (2022)
Find the right Medicare Part D prescription drug plan
The interactive tool on Medicare.gov can help 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 this 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).