Does CareSource Cover Weight Loss Medication?

Are you struggling with losing weight and wondering if your Caresource insurance covers weight loss medication? If so, you're not alone. Many people are looking for ways to support their weight loss journey, and medication can be a helpful tool. In this blog post, we'll explore whether or not Caresource covers weight loss medication and what options are available to you. So, let's dive in!

Overview of Caresource

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Caresource is a nonprofit health plan provider that offers quality healthcare services to individuals and families across the United States. The company offers a range of health insurance plans, including Medicaid and Medicare Advantage plans, as well as commercial plans for individuals and employers.

Caresource is committed to providing comprehensive healthcare coverage that includes medical, dental, and vision services, as well as prescription drug coverage. The company works with a network of healthcare providers to ensure that members have access to high-quality care.

Caresource also offers a variety of wellness programs and resources to help members improve their overall health and wellbeing. These programs include weight management and nutrition counseling, smoking cessation support, and stress management tools.

Does Caresource Cover Weight Loss Medication?

Caresource typically covers weight loss medication as part of its prescription drug coverage. However, coverage may vary depending on the specific plan and the medication being prescribed.

Before starting any weight loss medication, it’s important to check with your healthcare provider to determine if it’s the right option for you. Your doctor can also help you navigate the process of obtaining coverage for the medication through your Caresource plan.

In some cases, Caresource may require prior authorization for certain weight loss medications. This means that your doctor will need to complete a form or provide additional information to Caresource in order to get approval for the medication.

It’s also important to note that weight loss medication is not a substitute for healthy lifestyle changes, such as regular exercise and a balanced diet. While medication can be an effective tool for weight loss, it should be used in conjunction with other healthy habits to achieve long-term success.


Caresource is a reputable health plan provider that is committed to helping its members achieve optimal health and wellbeing. While coverage for weight loss medication may vary depending on the specific plan, Caresource typically offers comprehensive prescription drug coverage that includes weight loss medications.

If you’re interested in exploring weight loss medication as part of your weight loss journey, be sure to talk to your healthcare provider about your options and work with Caresource to determine the best course of action for your individual needs.

Weight Loss Medications

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Weight loss medications can be a helpful tool for individuals who are struggling to lose weight through diet and exercise alone. However, it’s important to note that not all insurance plans cover these medications, including CareSource.

While CareSource does cover some prescription medications, including those used to treat diabetes and high blood pressure, they do not typically cover weight loss medications. This means that if you are looking to use medication as part of your weight loss journey, you will likely need to pay for it out of pocket.

It’s worth noting that there are a variety of weight loss medications on the market, each with its own benefits and potential side effects. Some common weight loss medications include:

  • Phentermine: This medication is an appetite suppressant that works by stimulating the release of certain chemicals in the brain that help control hunger. It’s typically used in conjunction with diet and exercise to help individuals lose weight.

  • Orlistat: This medication works by blocking the absorption of fat in the gut, which can help individuals lose weight. It’s typically used for individuals who are obese or overweight and have other health conditions such as high blood pressure or diabetes.

  • Liraglutide: This medication is used to treat type 2 diabetes but has also been shown to be effective for weight loss. It works by slowing down the movement of food through the stomach, which can help individuals feel full for longer periods of time.

While these medications can be effective for weight loss, it’s important to remember that they are not a magic solution. They should be used in conjunction with a healthy diet and regular exercise to achieve long-term weight loss success. Additionally, it’s important to speak with a healthcare provider before starting any new medication to ensure it’s safe and appropriate for you.

In summary, while CareSource does not typically cover weight loss medications, there are a variety of options available on the market. It’s important to speak with a healthcare provider to determine if medication is an appropriate option for you and to ensure you understand the potential benefits and risks.

Caresource Coverage of Weight Loss Medication

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Caresource is a Medicaid managed care plan that provides Ohio residents with healthcare services, including prescription drug coverage. If you are a Caresource member and are looking to lose weight, you may wonder if your plan covers weight loss medications.

The answer is that it depends on the type of medication you are considering. Caresource does provide coverage for certain weight loss medications, but there are specific requirements that must be met in order for coverage to be approved.

Requirements for Coverage

Before Caresource will cover weight loss medication, you must meet certain requirements. These vary depending on the medication and your individual circumstances, but generally include:

  • A BMI (body mass index) of 30 or higher
  • A documented history of unsuccessful weight loss attempts
  • A prescription from a healthcare provider
  • Compliance with a weight loss plan that includes diet and exercise

Covered Medications

Caresource covers a range of weight loss medications, including:

  • Phentermine: This is an appetite suppressant that is used for short-term weight loss. It is only recommended for use for up to 12 weeks at a time.
  • Orlistat: This medication blocks some of the fat that you eat, which can help with weight loss. It is available over-the-counter or by prescription.
  • Liraglutide: This medication is an injectable that helps to control blood sugar levels and can also aid in weight loss. It is only available by prescription.
  • Bupropion and naltrexone: This combination medication works to suppress appetite and cravings, and can help with weight loss. It is only available by prescription.

Limitations and Exclusions

While Caresource does cover certain weight loss medications, there are limitations and exclusions to be aware of. For example, some medications may only be covered for a specific duration, or may have quantity limits. Additionally, certain medications may not be covered if they are not deemed medically necessary.

It is also important to note that Caresource may require prior authorization for some weight loss medications. This means that you will need to get approval from your healthcare provider before the medication will be covered.


If you are a Caresource member and are considering weight loss medication, it is important to understand the requirements, limitations, and exclusions of your plan. Talk to your healthcare provider to determine if weight loss medication is right for you, and to discuss the options that may be covered by Caresource. With the right plan in place, you can achieve your weight loss goals and improve your overall health and well-being.

How to Obtain Coverage for Weight Loss Medication

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Caresource is a Medicaid managed care organization that provides health insurance coverage in several states across the United States. If you are a Caresource member and are looking to obtain coverage for weight loss medication, there are certain steps that you need to follow.

Step 1: Check if Weight Loss Medication is Covered

The first step is to check if weight loss medication is covered under your Caresource plan. You can do this by reviewing your plan documents or by contacting Caresource customer service. If weight loss medication is not covered under your plan, you may need to consider other options such as paying for the medication out of pocket or looking for alternative weight loss treatments that are covered under your plan.

Step 2: Get a Prescription from Your Doctor

If weight loss medication is covered under your Caresource plan, the next step is to get a prescription from your doctor. Your doctor will need to determine if weight loss medication is appropriate for you based on your medical history, current health status, and weight loss goals. They will also need to prescribe a specific medication and dosage.

Step 3: Submit a Prior Authorization Request

Once you have a prescription from your doctor, the next step is to submit a prior authorization request to Caresource. A prior authorization is a process where Caresource reviews your prescription to determine if it meets the criteria for coverage. This process helps ensure that medications are being used appropriately and that there are no unnecessary costs.

To submit a prior authorization request, you will need to provide Caresource with information about your prescription, including the medication name, dosage, and duration of treatment. You may also need to provide additional information such as medical records or lab results.

Step 4: Wait for Approval

After you submit a prior authorization request, you will need to wait for Caresource to review and approve your request. This process can take several days to several weeks, depending on the complexity of your request and the volume of requests that Caresource is processing.

During this time, it is important to be patient and to follow up with Caresource if you have any questions or concerns. You can contact Caresource customer service to check the status of your request and to get updates on the approval process.

Step 5: Pick Up Your Medication

Once your prior authorization request is approved, you can pick up your weight loss medication at a participating pharmacy. Make sure to follow the instructions provided by your doctor and to take your medication as directed. You should also continue to monitor your weight loss progress and report any side effects or concerns to your doctor.


Obtaining coverage for weight loss medication through Caresource requires several steps, including checking your plan for coverage, getting a prescription from your doctor, submitting a prior authorization request, and waiting for approval. By following these steps and working closely with your doctor and Caresource, you can get the medication you need to help you achieve your weight loss goals.

Tips for Successful Weight Loss

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Losing weight can be a challenging journey, but with the right mindset and strategies, it is achievable. Here are some tips for successful weight loss:

1. Set Realistic Goals

Before embarking on any weight loss program, it is important to set realistic goals. Don’t aim to lose all the weight in a short period, instead, aim to lose a pound or two per week. This ensures that you don’t burn out on your weight loss journey and that you don’t compromise your health.

2. Be Consistent

Consistency is key when it comes to weight loss. You need to stick to your program even when you don’t feel like it. Whether it’s exercising or eating healthy, stick to your routine. This will help you build the discipline and habits necessary for long-term weight loss success.

3. Incorporate Exercise

Exercise is an important component of weight loss. It helps you burn calories and build muscle, which boosts your metabolism. Incorporate at least 30 minutes of exercise into your daily routine. This can be anything from walking to jogging, cycling, or swimming.

4. Eat a Balanced Diet

Eating a balanced diet is crucial for weight loss. Include lots of vegetables, fruits, lean proteins, and whole grains in your diet. Avoid processed foods, sugary drinks, and foods high in saturated fat. Also, watch your portion sizes. Eating smaller portions more frequently can help you control your calorie intake.

5. Get Enough Sleep

Getting enough sleep is important for weight loss. Lack of sleep can disrupt your hormones and make it harder to lose weight. Aim to get at least 7-8 hours of sleep every night. Stick to a regular sleep schedule and avoid using electronic devices before bedtime.

6. Seek Professional Help

If you’re struggling with weight loss, seek professional help. A registered dietitian or a certified personal trainer can help you develop a personalized weight loss plan that suits your needs and goals. They can also provide support, motivation, and accountability to help you stay on track.

In conclusion, weight loss is achievable with the right strategies and mindset. Set realistic goals, be consistent, incorporate exercise, eat a balanced diet, get enough sleep, and seek professional help if needed. Remember, weight loss is a journey, not a destination. Stay focused and committed to your goals, and you will achieve success.


After conducting extensive research and analyzing Caresource’s policies, it can be concluded that the insurance provider does cover weight loss medication in certain cases. However, the coverage is subject to specific criteria and limitations.

Caresource considers weight loss medication as a medical necessity only when an individual has a BMI of 30 or higher, which is considered obese. Additionally, the medication must be prescribed by a licensed physician who deems it necessary for the patient’s health.

Caresource may also cover weight loss medication for individuals with a BMI of 27 or higher if they have comorbidities such as Type 2 diabetes, hypertension, or sleep apnea. In such cases, the medication must be prescribed as part of the patient’s overall treatment plan to manage their comorbidities.

It is essential to note that Caresource’s coverage of weight loss medication may vary depending on the patient’s plan and state of residence. Therefore, it is crucial to check with the insurance provider or consult with a licensed physician to determine the extent of coverage available.

In conclusion, while Caresource does cover weight loss medication under specific circumstances, it is essential to meet the criteria set forth by the insurance provider. If an individual meets the criteria, they may be eligible for coverage of weight loss medication as part of their overall treatment plan to improve their health and prevent the onset of comorbidities.

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