Insurance & Payment Options
We explain ketamine therapy insurance San Diego patients often ask about, including coverage options and eligibility.
Spravato is covered by most major insurance plans. IV and IM ketamine are self-pay with transparent pricing and flexible options.
Understanding Your Coverage
Insurance coverage for ketamine-based treatments can be confusing. Here is the straightforward breakdown:
Some treatments are FDA-approved and commonly covered by insurance. Others are considered off-label and are typically self-pay across the country — not just at our clinic.
Our goal is clarity. Before you start treatment, you will know exactly what is covered, what is not, and what your financial responsibility will be.
Insurance Accepted
INSURED OPTION
Spravato® (Esketamine)
Spravato (esketamine) is FDA-approved for treatment-resistant depression and is covered by most major insurance plans.
Your out-of-pocket cost depends on your specific plan, deductible status, and copay structure. We handle prior authorization and insurance verification for you — at no cost.
What’s Included:
- Prior authorization handled by our team
- Free insurance benefits verification
- In-network with most major carriers
- Medical monitoring during every session
- Ongoing medication management included
Self-Pay
SELF-PAY OPTION
IV & IM Ketamine Therapy
IV and IM ketamine are administered off-label for depression, anxiety, PTSD, chronic pain, and related conditions. Because they are off-label, insurance companies typically do not cover them.
This is consistent across virtually all ketamine clinics in the country.
We offer transparent pricing with no hidden fees. Contact us for current session rates and package options.
What’s Included:
- Medically supervised monitoring
- Personalized dosing protocol
- Private treatment suite with ocean views
- Pre- and post-session clinical check-in
- Integration guidance after each session
Insurance Plans We Accept for Spravato
The following insurance carriers are commonly accepted for Spravato (esketamine) treatment at our Cardiff-by-the-Sea clinic:
Aetna
Anthem
Cigna
UnitedHealthcare
Medicare
Medicaid
Health Net
Ambetter
MultiPlan
PHCS
Sharp Health Plan
Blue Shield of California
TriWest Healthcare Alliance
Don’t see your plan listed? We work with additional carriers and can check your specific benefits during your free consultation.
THE REAL COST OF WAITING
What Is It Actually Costing You to Wait?
We understand that cost matters. But consider what untreated depression, anxiety, or chronic pain may already be costing you:
Lost Productivity
Depression alone costs the average worker dozens of lost workdays per year. Anxiety and chronic pain add more. That is salary, promotions, and career momentum slipping away.
Damaged Relationships
When you are suffering, the people closest to you suffer too. Isolation, irritability, and emotional withdrawal strain marriages, friendships, and family bonds.
Medications That Aren’t Working
Many patients with treatment-resistant depression have tried multiple medications — each with copays, side effects, and months of waiting to see if they help.
Ketamine therapy is an investment in recovery — and for many patients, it works faster than traditional medications.
How Insurance Verification Works
We make this simple. You do not need to call your insurance company or navigate confusing benefit documents.
Book a Free Call
Schedule a free 15-minute consultation. We will ask about your insurance plan, diagnosis, and prior treatments. No cost, no commitment.
We Verify Your Benefits
Our team contacts your insurance carrier directly and verifies your specific benefits for Spravato. We confirm deductible status, copay amounts, and prior authorization requirements.
Know Before You Start
Before your first session, you will know exactly what your plan covers and what your out-of-pocket costs will be. No surprises. Complete clarity.
SELF-PAY OPTIONS & FINANCIAL FLEXIBILITY
Self-Pay? You Still Have Options.
Even when insurance does not cover treatment directly, there are ways to reduce your out-of-pocket expense.
Superbill for Out-of-Network Reimbursement
After each session, we provide a detailed medical receipt (superbill) with diagnostic codes. You may submit this to your insurance company for possible out-of-network reimbursement.
HSA & FSA Accounts
Ketamine therapy is generally considered a qualified medical expense under most Health Savings Account (HSA) and Flexible Spending Account (FSA) plans.
Payment Plans & Financing
We want cost to be solvable, not a barrier to treatment. Ask about flexible payment options during your consultation.
Tax Deductibility
Medical expenses exceeding 7.5% of your adjusted gross income may be tax-deductible. Speak with your tax professional for guidance.
COVERAGE AT A GLANCE
Spravato® (Esketamine)
Insurance: Often Covered
Self-Pay: Available
HSA/FSA: Eligible
IV Ketamine Infusions
Insurance: Not Covered
Self-Pay: Yes
HSA/FSA: Eligible
IM Ketamine Sessions
Many patients with treatment-resistant depression have tried multiple medications — each with copays, side effects, and months of waiting to see if they help.
Medication Management
Insurance: Often Covered
Self-Pay: Available
HSA/FSA: Eligible
Comprehensive Medical Evaluation
Insurance: Often Covered
Self-Pay: Available
HSA/FSA: Eligible
FAQ
INSURANCE & PAYMENT FAQs
Does insurance cover ketamine therapy?
It depends on the type of treatment. Spravato (esketamine) is FDA-approved and covered by most major insurance plans. IV and IM ketamine are typically self-pay.
How do I know if my insurance covers Spravato?
Book a free 15-minute consultation. We will verify your benefits directly with your carrier.
Does Medicare cover Spravato?
Yes. Medicare covers Spravato for eligible patients with treatment-resistant depression.
Can I use my HSA or FSA?
Yes. IV ketamine, IM ketamine, Spravato copays, and related medical services are generally eligible expenses.
Why isn’t IV ketamine covered?
IV ketamine for depression and anxiety is considered off-label use. Because of that classification, most insurance companies do not reimburse for it.
Do you offer payment plans?
Yes. Ask about flexible payment options during your consultation.
Don’t Let Cost Be the Reason You Keep Suffering
We will verify your insurance, explain your options, and help you find a path forward. Your consultation is free. There is no obligation.