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Is Ketamine Covered by Insurance for Depression Treatment?

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Published on:
Published in: Ketamine

Understanding What’s Covered, What’s Not, and How to Get Help

Ketamine is one of the most promising treatments for treatment-resistant depression. It works fast—often in just hours—and helps when other antidepressants don’t. But while ketamine therapy is life-changing for many people, it can also be expensive.

So one of the first questions people ask is:
Is ketamine covered by insurance?

The answer is: sometimes yes, sometimes no. It depends on the type of ketamine, your insurance plan, and how your treatment is administered.

Let’s break it down so you can make informed decisions and avoid surprise bills.

What Types of Ketamine Treatments Are Available?

There are five main types of ketamine used for depression:

  1. IV Ketamine Infusion Therapy – Administered through a vein in a clinic
  2. IM Ketamine Injections – Injected into the muscle, fast and efficient
  3. Spravato® (Esketamine) – FDA-approved nasal spray taken in a clinic
  4. Oral Ketamine (Lozenges or Capsules) – Used at home or in therapy
  5. Ketamine-Assisted Psychotherapy (KAP) – Combines ketamine with talk therapy

The most important factor when it comes to insurance is this:
🔹 Only one of these options is FDA-approved for depression—Spravato®.

Spravato®: The Ketamine Treatment Insurance Covers

Spravato® (esketamine) is the nasal spray version of ketamine. It was approved by the FDA in 2019 for:

  • Treatment-resistant depression (for people who didn’t respond to at least two antidepressants)
  • Major depression with suicidal thoughts

Because it is FDA-approved for these uses, most major insurance providers (including Medicare and Medicaid in many states) will cover Spravato®.

✅ Bella Vida TMS is a REMS-certified provider of Spravato® in Phoenix, Gilbert, and Glendale, which means we meet all federal safety requirements.

We also verify your benefits for free and help patients understand exactly what their insurance will and won’t cover.

What About IV, IM, and Oral Ketamine?

Unfortunately, IV infusions, IM injections, and oral ketamine are considered “off-label” for depression. That means:

  • They are not FDA-approved for mental health treatment
  • Insurance companies typically do not cover these forms
  • You will likely have to pay out of pocket

💡 However, that doesn’t mean they aren’t effective. Many people who don’t respond to other treatments find relief with these forms—especially when done under medical supervision.

Costs can range from $300–$600 per session, depending on the clinic and treatment type.

Some clinics offer packages or payment plans to make these options more accessible.

Ketamine-Assisted Psychotherapy (KAP) and Insurance

KAP combines ketamine (usually oral or IM) with therapy. It’s a powerful option for people working through:

  • Trauma
  • PTSD
  • Deep emotional blocks
  • Treatment-resistant depression

Because the ketamine is off-label, KAP is generally not covered by insurance—though the therapy portion might be if done with a licensed provider in-network.

Does Bella Vida TMS Accept Insurance for Ketamine?

Yes—but with a few important details:

✅ We accept most major insurance plans
✅ We are in-network for Spravato® treatment
✅ We provide free insurance verification and prior authorization assistance
✅ We offer alternative treatments like TMS, which is covered by most plans
❌ We do not offer IV or IM ketamine directly, but can help guide you to trusted providers if needed

If you’re unsure what your insurance covers, we can help walk you through it with no pressure.

Here’s How the Process Works

  1. Call or fill out our online form
  2. We verify your insurance and check your plan for Spravato® and TMS coverage
  3. You meet with our clinical team to confirm eligibility and build a care plan
  4. We submit pre-authorization forms if needed
  5. You begin treatment—with confidence and clarity

What If You’re Not Covered?

If your insurance doesn’t cover ketamine, don’t panic. You still have options:

  • Ask about TMS therapy, which is non-medication-based and covered by most plans
  • Consider using HSA or FSA funds for ketamine-related care
  • See if a financing plan or payment package is available
  • Ask your provider if there are clinical trials or sliding-scale programs nearby

Ketamine treatment is changing the future of depression care—but it’s not always easy to navigate the costs. Knowing which forms of ketamine are covered and which are not can help you make the right decision for your health and finances.

At Bella Vida TMS, we believe everyone deserves access to life-saving care. That’s why we’re proud to offer Spravato®, TMS therapy, and compassionate support every step of the way.

References

  1. U.S. Food & Drug Administration (FDA) – FDA Approves New Nasal Spray Medication for Treatment-Resistant Depression
    https://www.fda.gov/news-events/press-announcements/fda-approves-new-nasal-spray-medication-treatment-resistant-depression
  2. Spravato® (Esketamine) Official Website – Indications, Insurance Support, and Safety Information
    https://www.spravato.com
  3. National Institute of Mental Health (NIMH) – Treatment-Resistant Depression
    https://www.nimh.nih.gov/health/topics/treatment-resistant-depression
  4. Harvard Health Publishing – Ketamine for major depression: New tool, new questions
    https://www.health.harvard.edu/blog/ketamine-for-major-depression-new-tool-new-questions-2019052216673
  5. Yale School of Medicine – Ketamine Offers Hope for People with Severe Depression
    https://medicine.yale.edu/news-article/ketamine-offers-hope-for-people-with-severe-depression/
  6. Mayo Clinic – Ketamine infusion therapy for depression
    https://www.mayoclinic.org/tests-procedures/ketamine-infusion/about/pac-20417354
  7. Centers for Medicare & Medicaid Services (CMS) – Medicare Coverage Database for Esketamine (Spravato®)
    https://www.cms.gov

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