Will My Insurance Cover My Ketamine Treatment?

Many patients struggling with mental health conditions like treatment-resistant depression and PTSD are hearing about ketamine as a breakthrough treatment option and are wondering whether their health insurance might cover ketamine treatments. 

Ketamine is considered a game-changer for many seeking alternative treatment options for chronic pain and mental health conditions. However, most insurance companies in the United States don’t cover these treatments (yet).

Why Your Ketamine Treatment Isn’t Covered by Insurance

There are several factors that account for the lack of insurance coverage for ketamine treatments. Keep reading to learn more about why your ketamine treatment likely isn’t covered by your insurance. 

Not FDA Approved

While ketamine is FDA approved for use as an anesthetic, and esketamine is approved as a nasal spray, neither form of the drug is approved for the treatment of depression, anxiety, PTSD, OCD, or other mood disorders. Ketamine in low doses for mental health and chronic pain is considered “off-label use” thus leading to its lack of insurance coverage. Even Spravato, the nasal spray form of esketamine, isn’t covered by many insurance companies. 

A Research-Based Treatment Option

Studies and research into the efficacy of ketamine for treating depression and mood disorders are still being done. And although some researchers and medical professionals have shed some light on ketamine’s effective, fast-acting results, insurance companies don’t consider the little that’s been done enough for coverage. However, research is in the process of advancing several psychedelic medications to FDA approval. If and when low doses of ketamine become FDA approved for treating depression, more insurance companies will probably get on board with covering it. 

Unaware That Ketamine is a Potential Treatment Option

Many people are unaware of ketamine being a treatment option for depression. Those who have heard of ketamine usually associate it with veterinary practices or recreational drug use. Its use as a treatment alternative for depression is so new that most insurance agents likely haven’t even heard of it yet. This should change in time, as more people hear of the incredible results that are being obtained. A highly-accredited clinic will always be willing to discuss all aspects of ketamine treatment as well as payment options with you.