Is Ketamine Treatment Covered by Insurance? How Expensive Is Ketamine Therapy?

Is ketamine infusion covered by insurance, or is any other form of ketamine covered? How much does ketamine cost?

One day, you discover the possibility that ketamine treatment could be the answer to relieving pain, depression, anxiety, and more. You begin to read testimonials and articles about the power of ketamine for depression, ketamine for PTSD, or ketamine for OCD.

As your confidence in this proven medical therapy grows, a question arises in your mind. What about insurance coverage? How much does ketamine treatment cost?

Of course, these questions are perfectly understandable. Medical treatment tends to be expensive. IF you have coverage, you are going to want to make the call and ask: “Is ketamine therapy covered by insurance?”

If you are looking for ketamine for addiction, you may already suspect that health insurance coverage for ketamine is not the same as coverage for rehab. Rehab websites almost always have a button to check health plan coverage, while ketamine clinic websites do not.

Why would a rehab be covered and not a proven medical treatment like ketamine? Rehabs are pricey containers for the Alcoholics Anonymous 12-step program, but insurance companies shell out tens of thousands of dollars for a 30-day stay.

Is esketamine covered by insurance? How much are ketamine treatments?

Esketamine is a nasal spray, also known by the brand name, Spravato. Spravato is administered in a psychiatrist’s office, or hospital psych facility, on a weekly basis.

Is esketamine a form of ketamine? How does it differ from traditional ketamine used in IV infusions?

When we look at the ketamine molecule, there are actually right-handed and left-handed versions of the molecule. We call these mirror images isomers. Ketamine has both an s-isomer, the left-hand, and an r-isomer, the right hand.

Ketamine infusions use the complete blend of both isomers, where esketamine, as you may have guessed, is the s-isomer of the molecule. This isolated ketamine isomer is patented, and it is FDA approved for the treatment of treatment-resistant depression.

Health insurance companies use FDA-approval status of medical therapies as a reason to cover or not cover a treatment. If a medical treatment has not achieved FDA approval, the insurance companies will call it experimental, even if it has been proven to be safe and effective for decades.

Esketamine is not safer or more effective than ketamine. In fact, it may be inferior in some ways, because the r-isomer of the molecule is missing.

Yet, because a pharmaceutical company was able to patent esketamine and get FDA approval, insurance companies have been obligated to cover it. Ketamine, on the other hand, has been a generic drug for many years, so there is no big pharma money behind the push to get FDA approval for the many conditions that can be treated with ketamine IV infusions.

Is ketamine covered by insurance in any situation?

As you can imagine, most ketamine clinics do not accept insurance for IV infusion therapy. However, in some cases, insurance companies will cover the treatment.

Simply ask your ketamine provider if they will provide a superbill, which is a receipt with procedure codes and diagnosis codes. This document may be submitted to your health insurance company to see if they will offer you direct reimbursement for part or all of the cost.

Another consideration is the fact that the talk therapy component of your treatment will almost certainly be covered by nearly all insurances. Health insurance companies are required to cover the cost of mental health care.

For patients seeking ketamine treatment for depression, esketamine is typically a covered benefit. Ask if your ketamine clinic offers Spravato treatment for depression.

How much does ketamine therapy cost?

How much is ketamine treatment? How much do ketamine infusions cost? The cost may vary from one type of treatment to another.

For example, the cost of ketamine for chronic pain can be a different cost compared to ketamine for PTSD. There may also be differing costs based on packages, if you choose to pay for a series of infusions together.

To get a clear picture of how much ketamine IV infusion therapy is going to cost, the best thing to do is to call the clinic and simply ask. Your ketamine clinic staff will provide a comprehensive breakdown of costs for various treatments.

You may be surprised at how affordable IV infusions can be. Ketamine is not an expensive drug, so most of the cost relates to the safe IV administration of therapy.

Regardless of the route you choose to take, it is important prioritizing your health. Our physical and mental health are our most important possessions.

Ketamine infusion is highly effective and affordable. Consider ketamine for depression, suicidality, PTSD, OCD, anxiety, chronic pain and neuropathic pain, addiction, migraines, and bipolar disorder.

If you are looking for the best ketamine infusion center in the Washington Metropolitan Area and in the state of Maryland, please contact our Annapolis location for more information. Learn more about the best ketamine treatment Maryland has to offer.