Anthem and Spravato™ (Esketamine) - Is it Covered?
Does Anthem cover Spravato™ (Esketamine)?
Anthem may cover Spravato, but approval depends on your specific health plan, medical history, and diagnosis. At Libertas Mind, we work closely with Anthem to help patients secure successful prior authorizations, ensuring they receive the treatment they need with minimal delays. Anthem follows a detailed set of clinical criteria that must be met before Spravato is approved.
This typically includes confirming the diagnosis, documenting past treatment attempts, and ensuring the medication will be administered in a certified healthcare setting. Our care team guides you through each step so the process is smooth and clearly understood.
Anthem Spravato™ (Esketamine) Coverage Requirements
- You must be:
- 18 years of age or older
- You must have one of the following:
- Treatment-resistant depression (TRD)
- Major depressive disorder (MDD) with acute suicidal ideation or behavior
- You must meet all of the following:
- Depression is diagnosed with an approved tool, such as the PHQ
- Spravato is used along with an oral antidepressant
- Treatment administered under healthcare supervision
- Blood pressure is checked before and after each session
- Provider monitors for sedation and dissociation for at least two hours
- Facility, pharmacy, and patient registered with the REMS program
- Provider monitors for clinical worsening or suicidal thoughts
How to Check Anthem Spravato™ (Esketamine) Coverage
Libertas Mind is in-network with most major insurance plans, including Anthem. Our care coordinators can:
- Verify your Anthem Spravato benefits
- Check prior authorization requirements
- Help gather needed documentation
- Estimate out-of-pocket costs
- Guide you through scheduling treatment
We make the process simple so you can focus on your care.
Why Spravato™ (Esketamine) Matters for Depression Treatment
- Spravato is an effective treatment for:
- Treatment-resistant depression
- Major depressive disorder with suicidal ideation
Clinical studies show 40–60% effectiveness depending on treatment duration.
Spravato is derived from ketamine and delivered as a nasal spray.
It must be administered in a certified medical setting and is not available at regular pharmacies.
Libertas Mind Accepts Anthem Insurance
At Libertas Mind, we believe quality mental health care should be accessible. We accept Anthem and many other major insurance plans.
Our team can guide you through understanding your Spravato coverage and starting treatment.
FAQs About Anthem and Spravato™ (Esketamine) Coverage
Yes, many Anthem plans cover Spravato™, but approval depends on your diagnosis, treatment history, and specific plan benefits. Prior authorization is almost always required.
Anthem typically requires that you are 18 or older, have treatment-resistant depression or MDD with suicidal ideation, have tried at least two antidepressants without success, and receive treatment in a certified REMS facility.
Yes. Anthem requires medical documentation, prior treatment history, PHQ-9 scoring, and provider information before approving Spravato™ treatment.
This depends on your specific plan. Costs may include copays, deductibles, or coinsurance. Our care coordinators can help you verify your exact coverage and estimate costs.
No. Spravato™ can only be administered in a certified healthcare setting under supervision. It is not dispensed at retail pharmacies.
Yes. Libertas Mind is in-network with most Anthem plans. Our team can verify your benefits, handle your prior authorization, and guide you through starting treatment.
Does Anthem 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. Anthem and Spravato nasal spray has specific criteria before offering this medication. While Anthem coverage varies by state and insurance provider, typically Anthem 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 Anthem 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 Anthem 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 Anthem.
Our experienced team can provide detailed information about Spravato treatment.
