Does MedMutual Medicare Advantage cover Qsymia?
Excluded by the plan
MedMutual Medicare Advantage excludes Qsymia from coverage— an exception may be available with clinical justification.
This plan explicitly excludes this medication from coverage. An exception may be available.
Verbatim status from policy: Excluded
Last verified 2026-04-30.
Requirements
- Prior authorization
- Required
- Step therapy
- Not required
Sources
- Glucose-Dependent Insulinotropic Polypeptide (GIP) and Glucagon-Like Peptide-1 (GLP-1) Agonists
Medical Mutual of Ohio · Effective 2025-07-17 · vLast Revised 07/17/2025
- Weight Loss Glucagon-Like Peptide-1 (GLP1) Agonists
Medical Mutual of Ohio · Effective 2026-01-15 · vRevised 01/15/2026; Annual Review 07/17/2025.
- Panniculectomy, Abdominoplasty and Suction-Assisted Lipectomy
Medical Mutual of Ohio · Effective 2019-10-03 · v96001
- Weight Loss Glucagon-Like Peptide-1 (GLP1) Agonists
Medical Mutual of Ohio · Effective 2026-01-15 · vAnnual Review Date: 07/17/2025; Last Revised Date: 01/15/2026
- Weight Loss Appetite Suppression and Orlistat
Medical Mutual of Ohio · Effective 2025-08-21 · vSD (rev 08/2025)
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.
Keep exploring
Other medications on this plan