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Will Insurance Cover My Ketamine Treatments?

Article Summary: If you are wondering if your insurance will cover ketamine treatments at our clinic or other clinics that offer this treatment this article will go into the details of that question.  Answer = Yes, but it requires taking certain steps, and even with the correct steps, not all insurance companies will cover the cost. 

Insurance Coverage for Ketamine Infusions 

Factors that play a role

Ketamine new Perspective Visuals

If you can answer yes to most of these factors then it's worth spending your time completing the process to get reimbursed from your insurance. If you answered no to most of these factors then I recommend you make it so you can say yes to most of these questions before taking the steps to get reimbursed by your insurance. If you have a health savings account we do accept credit cards tied to those accounts and can email you a receipt.  

Steps patients will need to take to get reimbursed by your insurance

Insurance ill for ketamine infusion

Superbill Example

This is an example of what a superbill looks like.  A superbill is an itemized receipt that is submitted to health insurance companies for reimbursement for medical expenses.  The process works the smoothest if you remember to ask for and receive an electronic copy of your superbill at the end of your appointment.  This process does require you to be organized and submit things in an organized timely way to increase the likelihood of getting reimbursed.

Background on FDA approval for Ketamine

In recent years ketamine infusions have been changing the lives of people who struggle with medically resistant depression, anxiety as well as certain types of chronic pain. Ketamine was first used as an anesthetic. It was approved by the FDA in 1970 as an anesthetic and analgesic in operating and emergency rooms under the brand name Ketalar. 

Research on the efficacy of ketamine for the treatment of depression and other mood disorders is ongoing.   As more clinical data is published it's clear that ketamine is a potent medication with many uses.  The list of diagnoses that ketamine improves continues to grow.  We look forward to additional research that meets the standards insurance companies utilize to cover the medical cost of ketamine infusions. 

Ketamine Infusion IV Drip in Right Arm