How do I Know if my IV Ketamine Treatment Will be Covered by Insurance?

IV ketamine treatment is a newer and revolutionary approach to treating a number of mental health issues like treatment-resistant depression, treatment-resistant bipolar disorder, PTSD, and OCD. However, people who are struggling with the impacts of these conditions may wonder whether or not this type of treatment is right for them. One of the most influential aspects of whether or not a patient chooses to utilize a specific treatment is cost. And, one of the most influential aspects of the cost of medical treatments is insurance coverage. Knowing whether or not IV ketamine treatment sessions will be covered under the cost of your treatment plan can make or break your consideration for a treatment that may be life-changing for you. So, determining whether or not this treatment may be covered by your insurance is a crucial factor.

There are a few things that your insurance provider may look for before determining if you are covered for ketamine treatments including:

Your Mental Health Diagnosis

Insurance providers may not cover the cost of IV ketamine treatment if you don’t have a diagnosis that supports the use of this treatment. For example, if you are diagnosed with a mental health issue that the FDA has not approved for the use of ketamine-assisted therapy, your insurance provider may not cover the cost of these treatments. In general, you must have a diagnosis of treatment-resistant depression, treatment-resistant bipolar disorder, OCD, or PTSD to have your insurance provider determine that ketamine therapy will be helpful to you and is essential for your treatment plan.

Your Medical Need for Ketamine Therapy

Insurance providers don’t like to cover the cost of treatments if they can determine that you may not need them. So, they will look into whether or not a treatment is crucial to you before covering its cost. This means that you (or your doctor) will have to provide your insurance company with proof that ketamine therapy is essential for your treatment. This may include having to show previously used treatments (like antidepressants) that haven’t helped with symptoms in the past before they approve to cover the cost of your treatments.

Alternative Treatments

Some insurance companies may ask that you utilize other forms of treatments before you move forward with ketamine treatments. So, before you move forward with ketamine as a means to treat a mental health condition, you may have to first use other treatments to see if these work.

Mental Health Professional Approval

Before your insurance company will approve to cover the cost of treatment, they may ask for approval from your doctor. This approval can be sent through your doctor’s office (or by your mental health treatment provider). This will give your insurance company more information about why your doctor thinks you are a good candidate for this treatment and why you may require this treatment for treating the mental health issues you’re facing.

Other Considerations When Thinking About Insurance Coverage for Ketamine

While your insurance may have many requirements before approving to cover the cost of ketamine therapies, it’s also important to consider the type of insurance plan you have and what insurance company you have. Some insurance plans and companies don’t cover the cost of ANY ketamine treatments, and some insurance plans don’t cover the cost of mental health treatments at all. So, before considering ketamine therapy for yourself, first, make sure that you talk to your insurance provider about your coverage options.

Ketamine Therapy Covered by Insurance at Delray Brain Science

Delray Brain Science accepts a number of different types of insurance plans from a number of different insurance providers. Find out if we take your insurance and more about ketamine infusion therapy by reaching out to us today.