Does my insurance cover SPRAVATO® treatment?
- Insurance coverage varies based on the individual health plan. We encourage you to check your insurance benefits for SPRAVATO® coverage, including co-pays and deductibles, along with whether SPRAVATO® falls under your medical or pharmacy benefits. The RCBM SPRAVATO® Program does not participate with TriCare, Carelon Behavioral Health, UMR, Beaumont UMR, Blue Care Network, Humana, and Medicaid. If you have one of these health plans, please visit SPRAVATO®.com to find a SPRAVATO® center that takes your insurance.
- All insurances require pre-authorization and continued authorization for SPRAVATO® treatment, while each insurance company has different criteria for authorization of SPRAVATO®. This includes a history of inadequate response to several different classes of anti-depressant medications with a trial of a minimum of 8 - 12 weeks each, along with augmentation strategies.
- Your healthcare provider must refer you for SPRAVATO® treatment and document the medical necessity of SPRAVATO® based on the required criteria.
- If you have a commercial health plan, SPRAVATO with me is available to help you navigate access and affordability.
