In short
- Standalone Part D plans are set by region, so Omaha has the same 9 plans for 2027 as the rest of Nebraska, down from 11.
- Inside Medicare Advantage, Douglas County drops from 24 drug-covering plans in 2026 to 20 for 2027, out of 24 standard plans (CMS).
- Medica members in Douglas and Sarpy counties need new drug coverage for January 1, 2027.
- Negotiated Medicare prices for 15 more drugs, including Ozempic, Wegovy and Trelegy Ellipta, start January 1, 2027.
- A Medicare Savings Program also qualifies you for Extra Help. In Omaha, you can apply through iServe Nebraska or the DHHS Omaha line.
Omaha has a lot of moving parts on the drug side for 2027. Standalone plans leave the state, Medicare Advantage drug coverage shrinks in Douglas County, and a new round of negotiated drug prices kicks in on January 1. This page covers what that means for an Omaha address. For how Part D works in general (tiers, formularies, phases), see the statewide Part D guide.
What drug coverage choices do Omaha residents have for 2027?
You can pair Original Medicare with one of 9 standalone Part D plans, or get drug coverage built into a Medicare Advantage plan. The standalone list is the same across Nebraska, because CMS offers those plans by region. The Advantage list is set county by county, and that is where Omaha's choices thinned out.
| Option for an Omaha address | 2026 | 2027 |
|---|---|---|
| Standalone Part D plans (statewide) | 11 from 6 companies | 9 from 5 companies |
| Douglas County Advantage plans with drug coverage | 24 of 29 | 20 of 24 |
Two standalone plans, CVS's SilverScript Choice and HCSC's HealthSpring Extra Rx, drop out of Nebraska for 2027. On the Advantage side, UnitedHealthcare's AARP plans with drug coverage survive in only five Nebraska counties, and Douglas and Sarpy are two of them. Expect premiums, pharmacy networks, formularies and even which plans exist to differ by county and change every year.
What happens to drug coverage for Omaha's Medica members?
It ends with the plan on December 31, 2026. Medica's Medicare Advantage plans, including their drug coverage, are not in the CMS 2027 data for Douglas or Sarpy County. If you do nothing, Medicare moves you to Original Medicare with no drug plan.
To keep coverage continuous, either join another Advantage plan with drug coverage, or go back to Original Medicare and join a standalone Part D plan, by December 7. The Omaha Medicare Advantage page covers the later window that runs through February.
Which 2027 changes could change your Omaha pharmacy bill?
Three, mainly. The federal standard benefit moves up, a new set of negotiated prices begins, and plans can reshuffle how they tier common drugs.
| Part D standard benefit | 2026 | 2027 |
|---|---|---|
| Maximum deductible | $615 | $700 |
| Out-of-pocket cap | $2,100 | $2,400 |
On January 1, 2027, Medicare's negotiated prices for 15 more drugs take effect. They include Ozempic, Rybelsus and Wegovy; Trelegy Ellipta and Breo Ellipta; Linzess; Tradjenta; Janumet; Xifaxan; and cancer drugs such as Ibrance and Xtandi. CMS estimates enrollees will save about $685 million out of pocket in 2027. Your own savings depend on your plan's deductible and tier for the drug. The drug price negotiation update has the full list.
Check your pharmacy too. Many plans split their network into preferred and standard pharmacies, with different copays for the same prescription. Look up the exact Omaha pharmacy you use, and price mail order for maintenance medications.
Is your Omaha employer, union or military drug coverage creditable?
Find out, and keep the answer on file. Omaha retirees often come from big employers: Union Pacific, Mutual of Omaha, First National Bank of Omaha, Omaha Public Schools and the health systems. Every year, the plan has to tell you in writing whether its drug coverage is creditable, which means it is expected to pay, on average, as much as standard Medicare drug coverage.
- Creditable: stay on it, hold off on Part D, and file the notice somewhere safe. No penalty applies.
- Not creditable, or you are dropping it: join Part D within the allowed window to avoid a penalty.
- Offutt and military retirees: Medicare lists TRICARE as coverage that can be creditable. TRICARE generally also requires you to sign up for Part A and Part B when first eligible.
How can Omaha residents get help paying for prescriptions?
Start with the two federal and state programs that lower drug costs:
- Extra Help, which Social Security runs. A single person qualified in 2026 with income up to $23,940 and resources up to $18,090. For 2027, its maximum copays are $5.80 per generic and $14.40 per brand-name prescription. The Extra Help guide explains how to apply.
- Medicare Savings Programs, run by Nebraska DHHS. In 2026, QMB covers people with income up to $1,330 a month ($1,804 for a couple), SLMB up to $1,596 ($2,164) and QI up to $1,796 ($2,435), with a resource limit of $9,950 ($14,910 for a couple). Enrolling in any of them qualifies you for Extra Help automatically.
You apply for Medicare Savings Programs through iServe Nebraska, or by calling DHHS in Omaha at (402) 595-1178 or toll-free at (855) 632-7633. Bill does not enroll anyone in Medicaid programs, but he can explain how they work with your Medicare plan. The Medicare Savings Programs guide has the details.
How does a Part D review work by phone from Omaha?
Most Omaha reviews happen by phone or video, and they work fine. Before the call, gather every medication with its dose and how often you take it, plus the pharmacy you use. Bill enters the list for your Douglas or Sarpy County address, compares standalone plans and Advantage plans side by side, and walks you through the yearly total, not just the premium.
For unbiased help without an agent, call Volunteers Assisting Seniors, Omaha's Nebraska SHIP (formerly SHIIP) office, at 402-444-6617 (SHIP's statewide line is 1-800-234-7119), or Medicare's own line, 1-800-MEDICARE (1-800-633-4227), which runs 24 hours a day, 7 days a week (TTY 1-877-486-2048). When your list is ready, talk to Bill.
Frequently asked questions
CMS lists nine standalone Part D plans from five companies for 2027, two fewer plans and one fewer company than in 2026. They are the same nine plans offered everywhere in Nebraska. Omaha residents in Douglas County can also get drug coverage through 20 standard Medicare Advantage plans that include it. Plans, premiums and pharmacy networks vary by county and change every year.
The standalone plans are identical, because CMS offers them by region and all of Nebraska shares one region. The Medicare Advantage plans with drug coverage differ by county. For 2027, Douglas County has 20 of them and Lancaster County has 22, from a slightly different set of companies. Pharmacy networks also differ by plan, so check your own Omaha pharmacy.
Yes. Medicare lists TRICARE, along with VA coverage and many employer and union plans, as coverage that can be creditable, meaning you can skip Part D without a late penalty while you have it. Military retirees should also know that TRICARE generally requires Part A and Part B once you are first eligible. Keep records of your coverage in case a Part D plan asks later.
Apply through Nebraska DHHS, online at iServe Nebraska or by phone. DHHS lists an Omaha line, (402) 595-1178, and a toll-free line, (855) 632-7633. In 2026, the QMB program's income limit is $1,330 a month for one person, with a resource limit of $9,950. If you qualify for any Medicare Savings Program, you get Extra Help with Part D automatically.
Medicare's negotiated price for Ozempic, Rybelsus and Wegovy, $274 for a 30-day supply, takes effect January 1, 2027. That is the price your plan pays. What you pay depends on your plan's deductible, how it tiers the drug and whether it covers the drug for your use. Compare your plan's 2027 formulary before December 7, 2026.
Sources
- CMS: 2027 Medicare Advantage and Part D state fact sheets (opens in a new tab)
- CMS: CY 2027 Medicare Advantage and Part D landscape files (opens in a new tab)
- CMS: Negotiated prices for 2027 (opens in a new tab)
- CMS: CY 2027 Rate Announcement (Part D parameters) (opens in a new tab)
- Nebraska DHHS: Income levels and resources (477-000-012) (opens in a new tab)
- Nebraska DHHS: iServe and ACCESSNebraska (opens in a new tab)
- Medicare & You 2027 handbook (opens in a new tab)
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. 1-800-MEDICARE (1-800-633-4227) is available 24 hours a day, 7 days a week. TTY users can call 1-877-486-2048.
