Ketamine Insurance Coverage

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 and Patient Experience team at Principium Psychiatry are here to help you navigate the complexities of health care coverage.

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 has been diagnosed with severe depression and have not found relief with other treatments, SPRAVATO™ (esketamine) may be a treatment option. Our clinicians evaluate each patient individually to determine whether SPRAVATO is appropriate as part of a comprehensive care plan. Ketamine and SPRAVATO® treatments are administered in person at Principium Psychiatry offices located in New York, Connecticut, and California.

Does Insurance Cover SPRAVATO™ (esketamine) Treatment?

Ketamine infusions for depression are considered an off-label treatment and are typically not covered by insurance. SPRAVATO™ (esketamine) is an FDA-approved medication for certain adults with treatment-resistant depression. Principium Psychiatry accepts most major insurance plans, and the SPRAVATO medication may be covered by many insurers. Coverage for the medication and associated treatment visits can vary depending on your individual plan, and our team can help verify your benefits before treatment.

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 feel free to call the office nearest to you:

Midtown Manhattan, Lower Manhattan, Greenwich, CT: (212) 335-0236

The Hamptons and Garden City, Long Island: (631) 247-3002

Santa Monica, CA: (310) 564-0110 ext. 1 .

Just let us know that you’d like assistance figuring out whether your plan covers SPRAVATO™, and we’ll handle the rest.

After gathering your treatment history and insurance information, we can contact your insurance provider. 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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