Q1GROUP LLC | Q1Medicare.com - a non-government resource for the Medicare community

2024 Medicare Prescription Drug Plan Cost-Sharing Details

Send this chart to my email
Receive our free Part D Newsletter
2024 Medicare Prescription Drug
Formulary (Drug List) Cost-Sharing Details
Mutual of Omaha Rx Essential (PDP) (S7126-127-0)
Benefit Details        
all covered insulin pay $35 or less
This plan is available in CMS PDP Region 25
which includes: IA MN MT NE ND SD WY

Click on a letter below to view the
Mutual of Omaha Rx Essential (PDP) Formulary
A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z  0-9 
This Plan Uses Lower Cost-Sharing for Preferred Pharmacies
  30-Day Supply
Cost-Sharing
90-Day Supply
Cost-Sharing
Preferred Pharmacy Standard Pharmacy Mail- Order* Preferred Pharmacy Standard Pharmacy Mail- Order*
Initial Deductible Phase Cost Sharing
Tier 1: Preferred Generic: $0.00(E) $15.00(E) n/a(E) $0.00(E) $45.00(E) $0.00(E)
Tier 2: Generic: 100% 100% 100% 100% 100% 100%
Tier 3: Preferred Brand: 100% 100% 100% 100% 100% 100%
Tier 4: Non-Preferred Drug: 100% 100% 100% 100% 100% 100%
Tier 5: Specialty Tier: 100% 100% 100% 100% 100% 100%
Initial Coverage Phase Cost-Sharing
Tier 1: Preferred Generic: $0.00 $15.00 n/a $0.00 $45.00 $0.00
Tier 2: Generic: $15.00 $20.00 n/a $45.00 $60.00 $37.50
Tier 3: Preferred Brand: 20% 22% n/a 20% 22% 20%
Tier 4: Non-Preferred Drug: 48% 50% 48% n/a n/a n/a
Tier 5: Specialty Tier: 25% 25% 25% n/a n/a n/a
Coverage Gap (Donut Hole) Phase Cost Sharing
Plan offers no Gap Coverage -- 75% Generic and 75% Brand Donut Hole Discount applies
All Formulary Generic Drugs: 25% 25% 25% 25% 25% 25%
All Formulary Brand-Name Drugs: 25% 25% 25% 25% 25% 25%
Catastrophic Coverage Phase Cost Sharing
All Formulary Drugs:


$0 cost-sharing.
The Inflation Reduction Act (IRA) of 2022 eliminates beneficiary cost-sharing once your TrOOP reaches the established maximum cap on out-of-pocket spending for Part D formulary drugs (RxMOOP).
Notes:
*The mail-order cost-sharing is the plan’s "preferred" mail-order cost-sharing.
(E) Drugs on this tier are excluded from the Initial Deductible and do not count toward meeting the deductible.
Go to the Mutual of Omaha Rx Essential (PDP) 2024 Formulary Browser by choosing a letter below:
A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z  0-9 
Send this chart to my email
Receive our free Part D Newsletter