Does Aetna 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. Aetna and Spravato nasal spray has specific criteria before offering this medication. While Aetna coverage varies by state and insurance provider, typically Aetna 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 Aetna 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 Aetna 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 Aetna.
Our experienced team can provide detailed information about Spravato treatment.
