Is Spravato Covered by Insurance?

Common questions about Spravato include which disorders does it treat, how does it work, and is Spravato covered by insurance? If you or someone close to you has been considering Spravato, and you’re curious about cost, Time Wellness Georgia can help. We offer comprehensive and personalized medication-assisted treatment options for those struggling with treatment-resistant depression and other mental health concerns. 

Call us at 470-291-2011 to learn more about affordable esketamine treatment in Georgia. 

What Is Spravato?

Spravato is the brand name of a prescription nasal spray that contains esketamine, which is a variant of ketamine. 

In 2019 U.S. Food and Drug Administration (FDA) approved Spravato for adults ages 18 and over who have what clinicians refer to as treatment-resistant depression (TRD): 

• TRD is defined as major depressive disorder (MDD) with symptoms that have not improved, even after the individual has taken at least two different antidepressants.
• The FDA’s initial approved uses also included treating patients with major depressive disorder who were experiencing acute suicidal ideation.

When the FDA approved Spravato in 2019, it stipulated that Spravato should be used in conjunction with an oral antidepressant. In 2025 the FDA expanded its approval to authorize Spravato for use as a standalone antidepressant. 

Is Spravato Covered by Insurance?

Spravato has proved to be quite effective at helping people whose depression symptoms hadn’t responded to other forms of treatment. But since it’s a somewhat new medication, it’s understandable to wonder, is Spravato covered by insurance?

The good news is that, yes, Spravato is covered by most major insurance companies, including Medicare. Of course, the extent of that coverage can vary from company to company and provider to provider.

The best way to determine if Spravato is covered by your insurance is to check with your insurer, either by visiting their online member portal or calling their member support line.

Points to address when reviewing your policy or speaking to a representative of your insurer include:

• Is Spravato covered by your insurance?
• Will you be responsible for a co-pay or a deductible?
• Is a preauthorization required before your insurer will cover Spravato treatment?
• What information does your insurer need from your healthcare provider?
• Is your healthcare provider in-network with your insurance company?

When you choose Time Wellness Georgia, we can help you with this and another insurance-related matters. With your permission, we can coordinate directly with your insurance company to confirm your coverage, verify your benefits, and find the answers to any other questions you have.

How Does Spravato Work?

Two common questions about how Spravato works involve how the medication is administered and how the drug produces its effects once it’s in your system.

Administration

Patients self-administer Spravato, but they can only use the medication in an approved setting under the supervision of a qualified healthcare professional.

Each package of Spravato contains two applicators. You simply tilt your head back, place the tip of one of the applicators into one of your nostrils, inhale, and press the button to administer the medication. You then repeat the same steps with the other applicator in your other nostril.

After you administer the Spravato, you will need to remain in the office for a two-hour observation period to ensure you don’t experience any serious side effects. During this period, your healthcare professional will monitor your blood pressure and other vital signs. You will be awake and alert, and may choose to read, listen to music, watch a video, or simply relax. 

Once the observation period is over, you can return to any activities that don’t require full alertness, but you won’t be able to drive or operate heavy machinery until you’ve had a full night’s sleep.

Mechanism of Action

Spravato works by increasing the amount of glutamate, which is the body’s primary excitatory neurotransmitter. This means that it stimulates increased functioning throughout the central nervous system. 

Glutamate is also involved in processes such as mood, learning, and neuroplasticity (the brain’s ability to make structural and functional changes in response to injuries or experiences). The involvement with neuroplasticity appears to be central to Spravato’s antidepressant affects: 

• As described in an October 2024 article in the journal Biomedicines, esketamine (the primary active ingredient in Spravato) blocks receptors in the brain that are associated with glutamate. 
• This blockage has the effect of triggering an increased release of glutamate.
• This increase in glutamate promotes the formation of new synapses in the prefrontal cortex (PFC).
• Located behind the forehead, the PFC is the area of the brain that controls cognition, attention, and emotion regulation.
• Glutamate’s impact on the PFC can cause a rapid easing of depression symptoms, with some patients experiencing improvements within a few hours or a few days of completing their first Spravato session.

During the induction phase, patients typically receive Spravato twice a week for four to six weeks. This phase is usually following by four weekly Spravato sessions, with additional sessions scheduled depending on the individual’s progress and continued needs.

Is Spravato Safe?

The FDA’s approval of Spravato is based on tests that show the medication is both safe and effective when used as directed under the supervision of a qualified medical professional. However, as is the case with virtually every FDA-approved prescription medication,  “safe” does not mean completely risk-free.

Adverse effects that have been most frequently associated with Spravato use include:

• Drowsiness or sleepiness
• Dizziness or lightheadedness
• Dissociation, or the sense of becoming detached from your body and mind
• Nausea
• Constipation

Less common but potentially much more serious side effects can include:

• Hallucinations
• Slow or difficult breathing
• Suicidal thoughts
• Increased blood pressure

Side effects, if they do occur, are likely to set in within the two-hour observation window. So if you experience any distress, you should have immediate access to appropriate care. If you develop any health concerns after you’ve left the doctor’s office, you should contact them immediately. If you have particularly severe effects, you may need to call 911 or visit an emergency department.

Learn More About Spravato in Georgia

Time Wellness Georgia provides customized outpatient care for adults whose lives have been disrupted by anxiety, depression, other mental health concerns, and co-occurring addictions. 

Treatment at our center in Atlanta, GA, includes a dynamic array of evidence-based therapies and support services. We are also able to incorporate Spravato and other prescription medications into treatment when appropriate.

To learn more about how we can help you or a loved one, or to schedule a free assessment, please visit our Contact page or call us today.