Is Spravato Covered By Insurance?

If you or a loved one is struggling with treatment-resistant depression, you may have heard about a new medication called Spravato. But with its high cost, you may be wondering if it’s covered by insurance. The good news is that,…

If you or a loved one is struggling with treatment-resistant depression, you may have heard about a new medication called Spravato. But with its high cost, you may be wondering if it’s covered by insurance. The good news is that, in some cases, insurance may cover Spravato. Let’s dive into the details and explore how you can potentially access this innovative treatment option.

Spravato is a relatively new medication that was approved by the FDA in 2019 for the treatment of treatment-resistant depression. As a nasal spray, it’s designed to be used in conjunction with an oral antidepressant and is typically administered in a healthcare provider’s office. But with a price tag of up to $6,785 per month, cost can be a significant barrier for many patients. So, is Spravato covered by insurance? Let’s find out.

Is Spravato Covered by Insurance?

Is Spravato Covered by Insurance?

When it comes to treating mental health issues, there are many different medications available. One of the newer options is Spravato, which is a nasal spray that is used to treat depression. While this medication has shown promising results, many patients wonder if it is covered by their insurance. In this article, we will explore the topic of whether or not Spravato is covered by insurance.

What is Spravato?

Spravato is a medication that was approved by the FDA in 2019 for the treatment of depression. It is a nasal spray that contains esketamine, which is a derivative of ketamine. This medication is intended for use in conjunction with an oral antidepressant and is administered in a medical setting under the supervision of a healthcare professional.

While Spravato has shown promise in treating depression, it is not a first-line treatment and is typically only used when other medications have not been effective. Because of its unique nature, Spravato is a more expensive medication than many other antidepressants on the market.

Is Spravato Covered by Insurance?

The short answer is that it depends on your insurance plan. Some insurance plans will cover the cost of Spravato, while others may not. It is important to check with your insurance provider to see if they cover this medication and what your out-of-pocket costs may be.

One factor that can impact whether or not your insurance will cover Spravato is the diagnosis code that is used. In order for insurance to cover this medication, it must be used to treat treatment-resistant depression. If your healthcare provider uses a different diagnosis code, your insurance may not cover the cost of the medication.

How Much Does Spravato Cost?

As mentioned earlier, Spravato is a more expensive medication than many other antidepressants on the market. The cost of Spravato can vary depending on a number of factors, including your insurance coverage and the dosage that is prescribed.

On average, the cost of a single Spravato treatment session can range from $590 to $885. This does not include the cost of the oral antidepressant that is also required as part of the treatment plan.

What are the Benefits of Spravato?

Spravato has shown promise in treating treatment-resistant depression, which is a type of depression that has not responded to other medications. This medication can provide relief from symptoms of depression in as little as a few hours, which is faster than many other antidepressants on the market.

In addition, Spravato is administered under the supervision of a healthcare professional, which can provide additional support and monitoring for patients who are struggling with depression.

What are the Risks of Spravato?

Like any medication, Spravato does come with some risks. The most common side effects include dizziness, nausea, and headaches. In addition, Spravato can cause sedation and dissociation, which can be concerning for some patients.

There is also a risk of abuse and dependence with Spravato, as it is a derivative of ketamine. For this reason, Spravato is only administered in a medical setting under the supervision of a healthcare professional.

Spravato vs. Other Antidepressants

When it comes to treating depression, there are many different medications available. Spravato is a newer medication that has shown promise in treating treatment-resistant depression. However, it is not a first-line treatment and is typically only used when other medications have not been effective.

Other antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), are more commonly used to treat depression. These medications are often less expensive and have fewer potential side effects than Spravato.

Conclusion

While Spravato is a newer medication that has shown promise in treating treatment-resistant depression, it is not covered by all insurance plans. If you are considering Spravato as a treatment option, it is important to check with your insurance provider to see if it is covered and what your out-of-pocket costs may be.

It is also important to weigh the potential benefits and risks of Spravato against other treatment options. Your healthcare provider can help you make an informed decision about the best course of treatment for your individual needs.

Frequently Asked Questions

What is Spravato?

Spravato is a nasal spray medication that is used to treat depression in patients who have not responded well to other treatments. It contains the active ingredient esketamine, which is a derivative of ketamine.

It is important to note that Spravato is not a first-line treatment for depression and should only be used under the guidance of a healthcare professional.

How effective is Spravato in treating depression?

Clinical trials have shown that Spravato is effective in treating depression in patients who have not responded well to other treatments. In these studies, patients who received Spravato saw a significant improvement in their symptoms compared to those who received a placebo.

However, it is important to note that Spravato may not work for everyone and individual responses to the medication may vary. It is also important to continue with other treatments for depression, such as therapy and medication, as recommended by a healthcare professional.

Is Spravato covered by insurance?

Many insurance plans do cover Spravato, but coverage may vary depending on the specific plan and individual circumstances. Patients should check with their insurance provider to determine their coverage options.

For patients who do not have insurance coverage for Spravato, the manufacturer offers a patient assistance program to help with the cost of the medication.

What are the potential side effects of Spravato?

Like any medication, Spravato can cause side effects. The most common side effects of Spravato include disassociation, dizziness, nausea, and sedation.

More serious side effects, such as increased blood pressure and heart rate, may also occur. Patients should discuss potential side effects with their healthcare professional before starting treatment with Spravato.

How is Spravato administered?

Spravato is administered as a nasal spray under the supervision of a healthcare professional. Patients are required to remain under observation for at least 2 hours after each dose to monitor for potential side effects.

The dosage and frequency of Spravato may vary depending on the individual patient’s response and healthcare professional’s recommendation.

Does Insurance Cover Esketamine Nasal Spray?


In conclusion, Spravato is a promising treatment option for individuals struggling with depression. While it has been approved by the FDA and is available on the market, the cost of this medication may be a concern for some patients. However, it is important to note that many insurance plans do provide coverage for Spravato.

If you or a loved one is considering Spravato as a treatment option, it is important to speak with your insurance provider to determine what coverage may be available. Additionally, it may be helpful to explore financial assistance programs that can help offset the cost of this medication.

Overall, while the cost of Spravato may be a barrier for some patients, it is important to remember that there are resources available to help make this treatment option more accessible. With proper support and access to care, individuals struggling with depression can find hope and healing through innovative treatments like Spravato.

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