Mutual of Omaha Rx Plus is a 0.0 Star Medicare Part D Plan for Medicare Beneficiaries in Arizona
CMS gave this prescription drug plan a quality rating of 0.0 out of 5.0 stars (New Plan, Not Yet Rated).
These are the areas of the plan that are important to compare and review:
- Premium & Deductible: The premium is the amount you will pay monthly. Plus, many plans have an annual deductible that must be met before cost sharing begins.
- Coverage Phases: Part D plans have an initial coverage limit, followed by a coverage gap, and then catastropic coverage. Some plans offer some coverage in the gap.
- Co-pays & Co-insurance: If you have regular prescriptions, it's critical to verify that your drugs are covered and to know what you will pay at the pharmacy.
- CMS Ratings: Important measurements across 4 different areas that will help you understand how well this plan will care for you.
Mutual of Omaha Rx Plus does not pay all costs; it's a cost-sharing plan. If you join, you share in the overall costs with Mutual of Omaha Rx by paying a monthly premium, an annual deductible (if applicable), and copayments and/or coinsurance at your pharmacy.
This plan is not available to people receiving full Low Income Subsidy (LIS) benefits.
This plan has a $435.00 deductible (annual).
For 2020, the maximum Part D deductible is $435. A plan with the maximum deductible does not necessarily mean that it is more expensive than a plan with a lower deductible or no deductible at all. You need to consider all costs.
You Pay the Premium + Deductible + Copayments
You are required to pay your premium each month, even if you don't fill a prescription. Plus, you'll pay all of your prescription costs until the annual deductible amount has been paid (if any). You'll also pay the required copayment at your pharmacy when you have your prescriptions filled. These are your costs and the plan pays the rest.
What You Pay Could Be Different
Most people pay the standard premium. However, if you qualify for Extra Help with your Medicare Part D plan due to your income, your premium may be lower or cost you nothing at all. But, if you did not enroll in a Part D plan as soon as you were first eligible, Medicare can impose a penalty and your premium will be higher. To get an exact rate for your situation, contact a Arizona Medicare Insurance Agent.
Mutual of Omaha Rx Plus is a Basic PDP. At a minimum, Mutual of Omaha Rx must offer a "standard benefit" package mandated by law. The standard benefit includes an annual deductible and a gap in coverage, aka, donut hole. Carriers may also offer plans that:
- are actuarially equivalent to the standard benefit; or
- are enhanced, offering benefits in addition to the standard benefit.
Typically, enhanced plans offer additional coverage during the coverage gap. If you fell into the donut hole last year, shop enhanced plans.
Initial Coverage Limit
The ICL is the same for all Arizona plans, but it changes from year-to-year. If you enroll in Mutual of Omaha Rx Plus you share the cost of all covered medications with Mutual of Omaha Rx. You each pay your share until $4020.00 (retail spending) has been spent at the pharmacy. If you reach that level of spending on your prescriptions then you fall into the dreaded coverage gap and you are responsible for all costs. Fortunately, automatic discounts kick in to help you until you qualify for Medicare's catastrophic coverage in Arizona.
Coverage Gap (aka, Donut Hole)
When you reach the coverage gap, commonly called the donut hole, you pay for your medications yourself. Most seniors never go into the coverage gap, but it is possible to hit it quickly if you have expensive long-term prescriptions.
If you reach the ICL (most people don't), then you are responsible for 100% of your prescription costs until your out-of-pocket costs hit $6,350 (excluding your monthly premiums and the amount paid by the plan). This is called the coverage gap or donut hole. The good news is that you get a 75% discount on your brand-name prescription drugs and your generic medications while you're in the gap. You get to the other side of the donut hole when you've spent $6,350, at which point you automatically qualify to receive catastrophic coverage from Medicare.
Additional Gap Coverage
Mutual of Omaha Rx Plus does not offer additional assistance in the coverage gap. If you reached the coverage gap last year and were not able to afford your medications, be sure to check with your local Arizona Medicaid office. You may qualify for additional assistance. The Social Security Administration's Extra Help program is another opportunity for seniors on Medicare who are not able to afford their prescriptions.
Copayment & Coinsurance Details
In addition to the monthly premium and annual deductible, the Mutual of Omaha Rx Plus prescription drug plan has copayments (fixed dollar amount) and/or coinsurances (percentage) that you must pay when you pickup your medications. Here's the schedule for this plan:
IMPORTANT: In order to determine if this is the best PDP for you, it's critical that you look up your prescriptions in the plan's formulary.
Medicare Part D Star Ratings
In this section we show you the quality rating for this plan. Each year the Centers for Medicare and Medicaid Services (CMS) rates prescription drug plans in four broad categories. We do not recommend joining a plan with an overall rating less than 3.0. The following marks will give you an idea of the level of care you will receive if you join this Mutual of Omaha Rx plan.
Contact Mutual of Omaha Rx
Here's the new member contact information for Mutual of Omaha Rx:
For assistance 24 hours a day, call 800-633-4227. TTY users should call 877-486-2048. If you qualify for Medicare but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Part D program on www.medicare.gov. For information about the SSA's Extra Help program, download the Understanding Extra Help guide.
This stand-alone Medicare Part D plan is compatible with Medicare Part A (hospital insurance) and Medicare Part B (medical insurance), and all Arizona Medigap plans. It's also compatible with Medicare Part C plans in Arizona, so long as the plan does not include prescription drug coverage.
If you are entitled to Medicare Part A (enrolled or not) or currently enrolled in Medicare Part B you may join the Mutual of Omaha Rx Plus prescription drug plan. Unless you also receive benefits from Medicaid, enrollment in a Part D plan is voluntary. This plan is available in Scottsdale, Phoenix, Peoria, Surprise, Mesa, Tucson, Tempe, Yuma, Avondale, Buckeye, Chandler, Goodyear, Gilbert, Lake Havasu City, Flagstaff, Bullhead City, and all other towns and cities in Arizona.