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Ketamine Insurance Coverage

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Insurance Coverage for SPRAVATO™ (esketamine) Treatment

Have you or a loved one sought several treatments for depression, including antidepressant medication, therapy and more? If you feel that previous treatment methods haven’t delivered the lasting results you’re after, SPRAVATO™ (esketamine) may be an option to consider. However, before making the transition to a new treatment, many patients and their families have questions about whether their health care insurance plans will provide coverage.

The treatment providers at Principium Psychiatry are here to help you navigate the complexities of health care coverage and equip you with all the information you need.

What Is SPRAVATO™ (esketamine) Treatment?

SPRAVATO™ is an adults-only prescription medication used to treat depression that isn’t improving with the help of antidepressants. SPRAVATO™ contains the drug esketamine, which comes in the form of a nasal spray. You must take this treatment under the supervision of a health care provider, and you should combine it with one or more antidepressant medications taken orally.

SPRAVATO™ treatment has been studied and shown to improve symptoms of depression among patients. If you or a loved one struggles with severe diagnosed depression, our SPRAVATO™ (esketamine) treatment could make the difference you need.

Does Insurance Cover SPRAVATO™ (esketamine) Treatment?

Because Ketamine is an off-label treatment, insurance companies do not cover Ketamine infusions for depression treatment. This means that medical appointments for SPRAVATO™ are not covered in-network. However, the nasal spray medication used in SPRAVATO™ is covered by every major insurance provider in-network through Principium.

How to Check Whether Your Insurance Plan Will Cover Treatment

If you’re unsure whether your current health care insurance coverage will include SPRAVATO™ (esketamine), you can turn to two sources to learn more.

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1. Call Your Insurance Company

Your first option is to contact your insurance provider directly and ask them:

  • Whether SPRAVATO™ nasal spray is covered under your plan.
  • For more information about the percentage of medication covered by our insurance.
  • Whether you need preapproval before beginning treatment.

2. Call Principium Psychiatry

If you are unable to contact your insurance company or would prefer to speak with us directly, feel free to call Principium Psychiatry at 917-993-5018. Just let us know that you’d like assistance figuring out whether your plan covers SPRAVATO™, and we’ll handle the rest.

After finding out some basic information from you regarding your treatment history and insurance information, we can contact your provider on a case-by-case basis. Although we’re an out-of-network provider, we can discuss coverage for your treatment. We’ll relay any information directly to you and keep you informed with your coverage details.

Take the Next Steps With Principium Psychiatry

After learning the details of your SPRAVATO™ insurance coverage, you can begin pursuing treatment by scheduling an appointment with Dr. Cohen and the team at Principium. Our clinics, located in NYC, Greenwich CT and Santa Monica CA combine experienced leadership and cutting-edge therapy to provide advanced options for our patients. We are here to help you or a loved one find help for depression.

Do you have any more questions regarding SPRAVATO™ (esketamine) treatment or insurance? Feel free to contact us to learn more.

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