Cigna and Spravato™ (Esketamine) - Is it covered?
Does Cigna cover Spravato™ (Esketamine)?
Cigna may cover Spravato, but approval depends on your specific health plan, diagnosis, and documented treatment history. At Libertas Mind, we help patients navigate the prior authorization process and are often successful in securing coverage so treatment can begin without delays. Cigna follows a clear set of medical-necessity requirements that must be met before Spravato is approved.
This typically includes confirming the diagnosis, reviewing past treatment attempts, and ensuring Spravato will be administered safely in a certified REMS facility. Our care team guides you through each step so the process is smooth and easy to understand.
Cigna may cover Spravato (esketamine) depending on your specific health plan, diagnosis, and documented treatment history. Coverage varies from plan to plan, but at Libertas Mind, we regularly help patients obtain the necessary authorization so their Spravato treatment is covered.
Because Spravato is administered only in a REMS-certified facility, Cigna follows specific medical-necessity requirements before approving treatment. Below is an overview of the eligibility criteria that Cigna typically uses.
Cigna’s Clinical Requirements for Spravato™ (Esketamine) Coverage
Age Requirement:
- You must be 18 years or older to receive Spravato under Cigna coverage.
Diagnosis Requirement — at least one of the following:
Treatment-Resistant Depression (TRD) –
- Cigna generally requires documentation that the patient has not responded adequately to two or more antidepressants, each from different classes.
Major Depressive Disorder (MDD) –
- With acute suicidal ideation or behavior, evaluated by a qualified mental health professional.
- Age Requirement:
- You must be 18 years or older to receive Spravato under Cigna coverage.
- Diagnosis Requirement — at least one of the following:
- Treatment-Resistant Depression (TRD) –
Cigna generally requires documentation that the patient has not responded adequately to two or more antidepressants, each from different classes. - Major Depressive Disorder (MDD) –
With acute suicidal ideation or behavior, evaluated by a qualified mental health professional.
Additional Requirements — all of the following must be met:
Depression must be documented using a validated assessment tool such as the PHQ-9
Spravato must be used together with an oral antidepressant
Medication must be administered in a certified healthcare setting with medical supervision
Blood pressure monitoring is required before and after each dose
A minimum two-hour observation period must be performed to monitor for sedation and dissociation
Patient, prescriber, and facility must be enrolled in the REMS (Risk Evaluation and Mitigation Strategy) program
The prescriber must monitor for clinical worsening, behavioral changes, and suicidal thoughts or behaviors
- Additional Requirements — all of the following must be met:
Depression must be documented using a validated assessment tool such as the PHQ-9
Spravato must be used together with an oral antidepressant
Medication must be administered in a certified healthcare setting with medical supervision
Blood pressure monitoring is required before and after each dose
A minimum two-hour observation period must be performed to monitor for sedation and dissociation
Patient, prescriber, and facility must be enrolled in the REMS (Risk Evaluation and Mitigation Strategy) program
The prescriber must monitor for clinical worsening, behavioral changes, and suicidal thoughts or behaviors
These requirements help ensure safe administration and appropriate use of Spravato.
How to Check Cigna Spravato™ (Esketamine) Coverage
Libertas Mind is in-network with many major insurers, including Cigna.
Our care coordinators can:
- Verify your specific Cigna benefits
- Determine whether prior authorization is required
- Help gather documentation for eligibility
- Estimate your out-of-pocket costs
- Guide you through each step of the approval process
We make the insurance process straightforward so you can focus on your treatment.
Why Spravato™ (Esketamine) Is Important for Depression Treatment
Spravato offers a valuable treatment option for adults with severe depression who haven’t found relief with traditional medications. Studies show that Spravato can produce significant improvement in depressive symptoms, especially in TRD, with 40–60% efficacy rates depending on treatment duration.
Spravato is a nasal-spray medication derived from ketamine, a compound that has been used for many years to help treat mood disorders. Unlike oral antidepressants, Spravato provides a more rapid therapeutic effect, making it an important option for individuals with severe or persistent depression.
Spravato must be administered in-office only, under medical supervision, due to safety requirements and REMS program regulations.
REMS Certification and Safety Requirements
Spravato treatment is regulated by the FDA under the REMS program to ensure safe use.
This requires:
A certified healthcare facility
Trained and authorized prescribers
Patient observation for at least two hours
Documented monitoring of vital signs and side effects
Libertas Mind is a REMS-certified facility and provides a safe, structured environment for Spravato administration.
Libertas Mind Accepts Cigna Insurance
At Libertas Mind, we believe that effective mental health care should be accessible and affordable. We proudly accept Cigna insurance and assist patients in navigating their coverage, treatment authorization, and Spravato eligibility.
Our team will walk you through each step from verification to treatment scheduling to ensure a seamless experience.
Libertas Mind Accepts Cigna Insurance
At Libertas Mind, we believe quality mental health care should be accessible. We accept Cigna and many other major insurance plans, and we help patients understand how their coverage applies to Spravato treatment.
Our team can guide you through verifying your Cigna benefits, understanding your Spravato coverage, and starting treatment with confidence.
Learn More About Spravato Treatment
Become A Patient
Frequently Asked Questions
In most cases, yes. Cigna typically requires prior authorization to confirm that the patient meets diagnostic and clinical criteria for Spravato treatment. Our care team can assist in obtaining the necessary documentation and submitting the authorization request.
Cigna usually requires:
A confirmed diagnosis of TRD or MDD with acute suicidal ideation or behavior
Medical records showing inadequate response to at least two antidepressants
Recent depression assessment scores (e.g., PHQ-9)
Confirmation that treatment will occur in a REMS-certified facility.
We help gather and submit all required documents.
Out-of-pocket expenses depend on your specific Cigna plan. Some patients may have copays, deductibles, or coinsurance. After verifying your benefits, we can give you a clear estimate of your expected costs before treatment begins.
No. Spravato cannot be self-administered at home. Cigna requires that all Spravato doses be administered in a REMS-certified healthcare setting with mandatory post-dose monitoring. This ensures patient safety and treatment compliance.
Does Cigna cover Spravato (Esketamine)? This depend’s on your specific health plan and diagnosis status. In general, Libertas Mind is successful in helping patients get successful prior authorizations so their Spravato treatment is covered. Cigna and Spravato nasal spray has specific criteria before offering this medication. While Cigna coverage varies by state and insurance provider, typically Cigna requires:
- 18 years of age or older
- Have at least one of the following:
- Treatment-resistant depression which includes an inadequate treatment response to at least two different types of antidepressants.
- Major depressive disorder (MDD) with acute suicidal ideation or behavior
- And have all of the following:
- Depression that was diagnosed with an approved scoring tool like the PHQ-9
- Is used in conjunction with an oral antidepressant
- Is administered under the supervision of a healthcare provider
- Blood pressure is to be assessed prior and after each administration
- Prescriber agrees to monitor for sedation and dissociation for at least two hours after administration
- Healthcare setting, pharmacy, and patient are registered with the The Risk Evaluation and Mitigation Strategy (REMS) program
- Prescriber agrees to monitor for clinical worsening and emergence of suicidal thoughts and behaviors
How to check Cigna Spravato Coverage
Libertas Mind is in-network with most major insurance plans. One of our care coordinators can help you navigate your insurance coverage and help you get the care you need.
Why is Spravato or esketamine important for Depression treatment?
Spravato is a new and very effective treatment for resistant depression (TRD) and adults with major depressive disorder (MDD). Randomized trials have shown that Spravato can relieve TRD quickly. Depending on the length of Spravato treatment, studies suggest 40-60% efficacy. Click here to learn more.
Spravato or esketamine was derived from ketamine, which has a long history of helping mood disorders. Spravato was made into a nasal spray that you self administer. It can only be given in a doctor’s office.
Spravato can only be administered in a licensed healthcare setting with medical professionals trained to prescribe and distribute it. The Risk Evaluation and Mitigation Strategy (REMS) program for Spravato mandates that healthcare facilities that administer the medicine be certified. Spravato is not available at your local pharmacy.
Learn more about the science underlying Spravato treatment here
Libertas Mind Accepts Cigna Insurance
At Libertas Mind, we belive that quality mental health services should not be a financial burden. We accept a wide range of insurance plans, including Cigna.
Our experienced team can provide detailed information about Spravato treatment.
