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Mutual of Omaha Rx Essential (PDP)

Mutual of Omaha Rx Essential (PDP) S7126-114 Plan Details
2 out of 5 stars

Mutual of Omaha Rx Essential (PDP) is a plan offered by Mutual of Omaha.
Plan ID: S7126-114.

$19.70
Monthly Premium

Mutual of Omaha Rx Essential (PDP) is a plan offered by Mutual of Omaha.
Plan ID: S7126-114.

Mutual of Omaha Rx Essential (PDP) S7126-114 Plan Details
2 out of 5 stars

Mutual of Omaha Rx Essential (PDP) is a plan offered by Mutual of Omaha.
Plan ID: S7126-114.

$19.70
Monthly Premium

Alabama Counties Served

Autauga Baldwin Barbour Bibb Chambers Cherokee Colbert Fayette Blount Bullock Butler Calhoun Chilton Choctaw Clarke Clay Cleburne Coffee Conecuh Coosa Covington Crenshaw Cullman Dade Dale Dallas De Kalb Elmore Escambia Etowah Franklin Geneva Greene Hale Henry Houston Jackson Jefferson Lamar Lauderdale Lawrence Lee Lowndes Macon Madison Marengo Marion Marshall Mobile Monroe Montgomery Noxubee Perry Pickens Pike Randolph Russell Saint Clair Shelby Sumter Talladega Tallapoosa Tuscaloosa Walker Washington Wilcox Winston

Tennessee Counties Served

Anderson Bedford Benton Bledsoe Cannon Blount Bradley Campbell Carroll Carter Cheatham Chester Claiborne Clay Cocke Coffee Crockett Cumberland Davidson Decatur Dekalb Dickson Dyer Fayette Fentress Franklin Gibson Giles Grainger Greene Grundy Hamblen Hamilton Hancock Hardeman Hardin Hawkins Haywood Henderson Henry Hickman Houston Humphreys Jackson Jefferson Johnson Knox Lake Lauderdale Lawrence Lewis Lincoln Loudon Macon Madison Marion Marshall Maury Mcminn Mcnairy Meigs Monroe Montgomery Moore Morgan Obion Overton Perry Pickett Polk Putnam Rhea Roane Robertson Rutherford Scott Sequatchie Sevier Shelby Smith Stewart Sullivan Sumner Tipton Trousdale Unicoi Union Van Buren Warren Washington Wayne Weakley White Williamson Wilson

Basic Costs and Coverage

Coverage Cost
Monthly Deductible $505
Out of Pocket Max In-Network: $-1
Out-of-Network: N/A
Initial Coverage Limit $4660
Catastrophic Coverage Limit $7,400

Prescription Drug Costs and Coverage

The Mutual of Omaha Rx Essential (PDP) plan offers the following prescription drug coverage, with an annual drug deductible of $505 (excludes Tier 1) per year.

Coverage
Cost
Coverage & Cost
Annual Drug Deductible $505 (excludes Tier 1)
Preferred Generic
  • Preferred cost-share retail $0.00
  • Standard retail $15.00
  • Preferred cost-share mail order N/A
  • Standard mail order N/A
Annual Drug Deductible $505 (excludes Tier 1)
Preferred Generic
  • Preferred cost-share retail N/A
  • Standard retail N/A
  • Preferred cost-share mail order N/A
  • Standard mail order N/A
Annual Drug Deductible $505 (excludes Tier 1)
Preferred Generic
  • Preferred cost-share retail $0.00
  • Standard retail $45.00
  • Preferred cost-share mail order $0.00
  • Standard mail order $0.00
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