Key takeaway
Coverage varies by plan. Here is how to approach prior authorization, clinic fees, and manufacturer support without surprises.
Coverage varies Many commercial plans, Medicare, and Medicaid programs have coverage policies for SPRAVATO®, but criteria differ and usually require prior authorization. We do not publish prices because costs depend on your plan, the clinic, and the treatment phase.
Questions for your insurer 1. Is SPRAVATO® covered under my medical or pharmacy benefit? 2. Is prior authorization required, and what documentation is needed (for example, prior antidepressant trials)? 3. Are the observation visit and monitoring billed separately? 4. What will my copay or coinsurance be per visit?
Questions for the treatment center 1. Are you a certified SPRAVATO® treatment setting? 2. Do you handle the prior authorization? 3. Which plans do you accept? 4. Are there facility fees in addition to the medication?
Manufacturer support The manufacturer offers a patient support program that may help eligible commercially insured patients with out-of-pocket costs. Eligibility rules apply; government-insured patients generally are not eligible for manufacturer copay programs. Check the official program for current terms.
General information only — verify details with your plan and clinic.
This page is informational and is not medical advice.