Does UnitedHealthcare cover Spravato? Usually, and we do the paperwork.
UnitedHealthcare commercial plans, including those administered through Optum, cover Spravato for treatment-resistant depression with a prior authorization, which we prepare and submit for you. Most of our commercial patients pay up to $40 a treatment. One exception to know up front: we don't accept UnitedHealthcare Medicare Advantage plans.
Does UnitedHealthcare cover Spravato in New Jersey?
- Commercial plans: yes, with a prior authorization. UnitedHealthcare wants to see the diagnosis and the antidepressants you've tried. We gather it at your evaluation.
- Up to $40 a treatment for most commercial patients, after the SpravatoWithMe savings program, for those who are eligible. We confirm your cost before you start.
- UnitedHealthcare Medicare Advantage: not accepted. Call us and we'll talk through your options. Medicare and Spravato.
$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.
What if UnitedHealthcare denies Spravato?
If UnitedHealthcare denies Spravato, we keep going. Our thorough evaluations mean 95% of our requests are approved the first time. When one isn't, we always request a peer-to-peer review, always file a second-level appeal if that fails, and always go to independent external review if the appeal fails. In our most recent internal review, 34 of 36 denials were overturned.
Employer, individual and Optum-run plans differ.
That's why we check your exact plan before quoting a cost, usually before your evaluation.
A visit or two a week, not a pill every day.
Spravato's side effects stay inside the two hours you rest with us, at our offices in Bridgewater, Morristown, Nutley and Hoboken.
30 doses
Every day.
Side effectsEvery single day: sedation, dry mouth, sexual side effects, weight gain.
8 visits
Twice a week.
4 visits
Down to once a week.
2–4 visits a month
Down to once a week or every other week. Dashed: weeks you may or may not need.
Side effectsMostly gone by the end of each visit.
What does UnitedHealthcare's Spravato policy require?
UnitedHealthcare's commercial medical drug policy for Spravato (effective May 2026) asks for these for treatment-resistant depression:
- Two antidepressants or treatment regimens that didn't work, at least 8 weeks each, with the name, dates and length of each trial. Add-on treatments, such as lithium or an antipsychotic, count as a regimen.
- A starting score on a standard depression questionnaire, such as the PHQ-9, recorded before your first dose. We do this at your evaluation.
- A diagnosis by a mental health professional, with a psychiatrist prescribing or consulting.
- A certified Spravato office and dosing that follows the label. Both are how we work.
Approvals run for up to 12 months. To renew, UnitedHealthcare wants a recent questionnaire score showing you've responded, which is why we check in with you at your visits.
The stepsFrom your UnitedHealthcare card to your first treatment.
- You reach outSend the short form or call with your card handy.
- We check your planCoverage, prior authorization and your share of the cost.
- Your evaluationUsually within one business day.
- We get the approvalWe submit and follow it through, appealing if needed.
Have UnitedHealthcare? Find out your cost today.
Send us your plan details and we'll check your Spravato coverage, usually before your evaluation.
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 evaluationWhat UnitedHealthcare members ask us.
Does UnitedHealthcare cover Spravato?
UnitedHealthcare commercial plans cover Spravato with a prior authorization, which we handle for you.
Do you accept UnitedHealthcare Medicare Advantage for Spravato?
No. We accept every other Medicare Advantage plan, and Original Medicare. Call us and we'll talk through your options.
What does UnitedHealthcare require for Spravato?
Two antidepressants or regimens that didn't work, at least 8 weeks each; a starting score on a depression questionnaire; a mental health diagnosis; and a psychiatrist involved. We gather it at your evaluation.
Does Optum cover Spravato?
Optum is part of UnitedHealthcare, and some plans run their mental health or pharmacy benefits through it. We check how your exact plan handles Spravato before you start.
How much does Spravato cost with UnitedHealthcare?
Most of our commercial patients pay up to $40 a treatment after the SpravatoWithMe savings program, for those who are eligible.