In recent years, few advances in mental health treatment have received more attention than ketamine therapy. With multiple studies suggesting that ketamine can quickly alleviate the symptoms of many mental health disorders, increasing numbers of patients have expressed interest in receiving this type of treatment. But for many potential patients, access to this form of care is contingent on the answer to one question: Is ketamine therapy covered by insurance?
If you or a loved one are struggling with mental health, don’t wait! Call us today or schedule a free assessment to take the first step towards healing!
What Is Ketamine Therapy?
Ketamine is a powerful drug that was originally synthesized in 1962 as part of an effort to develop a safer anesthetic. The first clinical study on its safety and effectiveness was published in 1966, and it earned FDA approval for medical use in 1970.
Medical and Veterinary Uses
After the FDA approved ketamine, the U.S. military widely used it as an anesthetic for service members injured in combat during the Vietnam War.
After the war, medical doctors and veterinarians continued using ketamine as an anesthetic, and both groups still use it for this purpose today.
At proper dosage levels, ketamine’s effects include loss of consciousness, alleviation of pain, and temporary amnesia. This has made it an ideal medication to treat acute pain or to prepare human or animal patients for surgery.
Ketamine Therapy for Mental Health
Researchers investigated ketamine’s potential as a mental health medication in the 1960s and 70s. However, this effort stalled due to concerns about side effects and the drug’s growing popularity as a recreational substance.
Interest in ketamine’s potential mental health benefits rekindled in the early 2000s. Over the past two decades, multiple studies have shown that ketamine may effectively alleviate symptoms of several mental illnesses.
In 2019, the FDA approved Spravato, a nasal spray containing a ketamine variant called esketamine, to help people with treatment-resistant depression.
Spravato is currently the only FDA-approved ketamine-related mental health medication, and it is authorized only to treat depression. However, many doctors have begun to use ketamine on an off-label basis to treat a variety of other disorders, including:
- Anxiety
- Bipolar disorder
- Obsessive-compulsive disorder (OCD)
- Posttraumatic stress disorder (PTSD)
- Substance use disorders (addictions)
One of the more remarkable aspects of ketamine therapy is the speed with which it can work.
For example, patients who take traditional antidepressants like sertraline (Zoloft), paroxetine (Paxil), or fluoxetine (Prozac) often need several weeks before noticing any beneficial effects.
With ketamine, patients typically experience symptom improvements within a few hours to a few days.
Is Ketamine Therapy Covered by Insurance?
Is ketamine therapy covered by insurance? The answer to this question depends on two factors – the specifics of your policy and the type of ketamine therapy you’re receiving.
Ketamine therapy for mental health purposes typically occurs in one of the following ways:
- Spravato treatment: As noted in the previous section, Spravato contains esketamine, which is a variant of ketamine. Patients who receive Spravato treatment self-administer the medication. They insert the tip of a small device into their nostrils and press a plunger. Spravato is not authorized for take-home use. Patients can only receive this medication in a doctor’s office or other approved medical facility.
- Ketamine infusion therapy: Infusion therapy involves the administration of ketamine via either IV (intravenous) or IM (intramuscular) injection. Infusion patients recline in a comfortable chair. A solution containing ketamine enters their system through a small needle in their arm.
- Oral ketamine therapy: Some treatment centers also offer oral ketamine therapy, which delivers the medication via a tablet that the patient swallows. This method may include take-home doses, providing convenience. However, it can be risky due to the lack of professional oversight.
If the question, “Is ketamine therapy covered by insurance?” refers to Spravato treatment, the answer is usually yes. Spravato is an FDA-approved, strictly regulated form of ketamine therapy, and most major insurers, including Medicare Part B, cover it.
Of course, you will need to review your plan to determine if your insurance covers this form of ketamine therapy. You will also want to confirm details such as co-pay obligations and pre-authorization requirements.
If the question about insurance coverage for ketamine therapy refers to infusions or oral ketamine, the answer will most likely be no. The best way to determine the scope of your coverage is to review your policy. You may also want to contact your insurance provider directly to get the answers you need.
Learn More About Ketamine Therapy in Atlanta
Atlanta Integrative Psychiatry offers a dynamic array of time-tested therapies and emerging evidence-based approaches, including Spravato treatment, for patients who have been living with anxiety, depression, and other mental health concerns.
When you choose our outpatient mental health treatment center in Atlanta, a small team of experienced professionals will care for you. We’ll take the time to get to know you as a unique and valuable individual. This helps us provide the focused care you need and the personal support you deserve. To learn more about Spravato treatment or any other aspect of care at Atlanta Integrative Psychiatry, or to schedule a free assessment, please visit our appointments page or call us today.
