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Mutual of Omaha Rx Premier Plan 2022 Formulary

This drug list was updated in March 2022| Premier Plan | Mutual of Omaha Rx (PDP) 2022 Formulary (List of Covered Drugs) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN Formulary ID Number: 22021, Version 10 This Formulary was updated on 3/1/2022. For more recent information or other questions, please contact Mutual of Omaha RxSM (PDP) Customer Service at or, for TTY users, , 24 hours a day, 7 days a week, or visit Note to existing members: This Formulary has changed since last year. Please review this document to make sure that it still contains the drugs you take. When this drug list ( Formulary ) refers to we, us, or our, it means Omaha Health Insurance Company ( Omaha Lif e and Health Insurance Company in California).

Apr 01, 2022 · drugs from our formulary, or add prior authorization, quantity limits and/or step therapy restrictions on a drug or move a drug to a higher cost -sharing tier, we must notify affected members of the change at least 30 days before the change becomes effective, or at the time the member requests a

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  Step, Authorization, Therapy, Prior, Prior authorization, Or step therapy

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