Does your insurance cover Spravato? Almost certainly. Here’s how we make sure.
Nearly every plan in New Jersey covers Spravato for depression that hasn’t responded to antidepressants. What stands between you and treatment is paperwork, and the paperwork is ours to do.
The plans most of our patients have.
- Horizon Blue Cross Blue Shield of NJ, New Jersey’s largest insurer.
- Aetna, Cigna, UnitedHealthcare, Oxford, AmeriHealth, Meritain Health and many others, including most employer and marketplace plans.
- Medicare, with your plan’s own rules on cost sharing.
- NJ Medicaid (NJ FamilyCare): Horizon NJ Health, Aetna Better Health of New Jersey, UnitedHealthcare Community Plan and Wellcare. Patients pay $0, and we help set up insurance-covered rides to treatment.
Don’t see your plan? Call anyway. We check every plan individually, and this list is the most common, not the complete one.
$0 to $40 a treatment
- NJ Medicaid: $0. Initial denials are common, and we’re incredibly persistent about appealing.
- Commercial insurance: up to $40 after Janssen’s SpravatoWithMe program, for patients who are eligible. Your own plan sets the details.
- We check before you commit. Insurance verification starts the moment you reach out.
Why approval takes paperwork, and why it usually goes through.
Spravato is approved for adults whose depression hasn’t responded to at least two antidepressants. Insurers want to see that history written down before they pay for it.
- A diagnosis of major depression, confirmed at your evaluation.
- The antidepressants you’ve tried. You don’t need perfect records. We work from what you remember and from your past prescribers.
- A clinician’s note on why Spravato is the right next step for you.
That’s the prior authorization. We write it, submit it and follow it up. In our most recent internal review, 95% were approved on the first try.
Tell us your plan. We’ll tell you where you stand.
Coverage checks start the moment you reach out, and you’ll know your cost before your first treatment.
Name, date of birth and insurer. We check your plan and call you back. No commitment.
Check my coverageRegister once, and our team starts your insurance check and reaches out to schedule your evaluation.
Request an evaluationThe details, plan by plan.
- Cost & insurance: what you’ll pay with each type of coverage, and with none.
- Prior authorization & appeals: how we get Spravato approved, and what we do when it’s denied.
- NJ Medicaid: why first answers are often no, and how we keep going.
- Horizon BCBSNJ: New Jersey’s largest insurer and Spravato.
What people ask before they call.
Does insurance cover Spravato?
For most people in New Jersey, yes. Commercial plans, Medicare and NJ Medicaid all cover Spravato for treatment-resistant depression, usually with a prior authorization first.
Do I have to call my insurance company first?
No. Send us your insurance details and we do the checking and the paperwork. You aren’t asked to chase your insurer.
What if my plan isn’t on your list?
Call anyway. The list shows the plans most of our patients have, not every plan we can work with. We check each one individually.
What if my insurance denies it?
We appeal, through every level the plan allows. In our most recent internal review, 34 of 36 denials were overturned. If a plan still won’t cover Spravato, we help you get it through the manufacturer, and our fee stays $40 a session.