Does Centene Ambetter Marketplace Ohio cover Qsymia?
Centene Ambetter Marketplace Ohio does not cover Qsymia.
This plan does not currently cover this medication.
Verbatim status from policy: Qsymia/phentermine-topiramate not listed
Last verified 2026-04-30.
Requirements
- Prior authorization
- Not required
- Step therapy
- Not required
Sources
- Clinical Payment Policies | Ambetter from Buckeye Health Plan (including Centene Pharmacy Policies CP.PMN.295, CP.PCH.12, CP.PCH.13)
Ambetter from Buckeye Health Plan / Centene Corporation · Effective 2024-06-01 (Wegovy), 2025-01-01 (Plan EOC) · vCP.PMN.295 (rev 02-2026); CP.PCH.12 (rev 2017); CP.PCH.13 (rev 2017); CP.MP.37; CP.MP.40
- WellCare of Kentucky Medicaid Provider Manual; Kentucky Medicaid Prior Authorization Criteria (Wegovy/Zepbound)
WellCare of Kentucky (Centene) · Effective 2025-10-10 (Manual); 2026-01-03 (Wegovy PA); 2025-07-01 (Zepbound PA) · vEffective Oct 10, 2025 (Manual); Effective Jan 3, 2026 (Wegovy); Effective July 1, 2025 (Zepbound)
- 2025 FORMULARY (Ambetter from Buckeye Health Plan)
Ambetter from Buckeye Health Plan (Centene) · Effective 2025-01-01
- Bariatric Surgery; Medicare Coverage of Anti-Obesity Medications
Wellcare (Centene Corporation) · Effective 2025-05-01 (Policy WA.CP.MP.37); Last Revised 2024-03-24 (General CP.MP.37) · vCP.MP.37; WA.CP.MP.37; MI.CP.MP.37
- Clinical Policy: Bariatric Surgery
Centene Corporation (Buckeye Health Plan) · Effective 2026-02-26 · vCP.MP.37; rev 02/26
What to do next
Even when a plan says no, an exception or appeal is often possible — especially when there's a strong clinical case. Your prescriber can request a coverage determination.