Will My Insurance Cover Ketamine Infusion Treatments?

Posted on January 30, 2020


Illustration of the inner workings of health insurance coverage showing cogs and gears working together.

A common question that we hear is “will my insurance cover Ketamine infusions?” Ever since the FDA approved some forms of Ketamine (esketamine), many people are wondering whether there is Ketamine insurance coverage available to them. In this article, we will answer questions related to “can you bill insurance for Ketamine infusions?” As we dive deeper into the Ketamine insurance particulars, we will also look at some cost-saving options for Ketamine infusion therapy that is not covered by insurance companies.

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Does Insurance Cover Ketamine Treatments?

At this time, Ketamine insurance is only possible if the patient has a valid medical pain diagnosis. Supporting documentation is required, but is not always enough to guarantee coverage. Whether or not Ketamine treatments are covered by insurance depends on what specific insurance you have and what your diagnosis is. The individual must have commercial or private insurance; federally or state-funded insurance such as CHAMPVA, TriCare, Medicaid or Medicare do not qualify for Ketamine insurance coverage. It’s best to talk with your insurance company or local Ketamine infusion professionals to determine if there is coverage available to you.

Will Insurance Cover Ketamine Infusions in Colorado?

Fortunately, some insurance companies are covering FDA approved Ketamine treatments in Colorado. As mentioned above, even on the state level, this coverage depends on what your specific medical diagnosis is and what your insurance company is willing to cover. The truth is, even with insurance, it can be difficult to get coverage for these types of Ketamine treatments. However, we expect that to change in the future. As more studies prove the effectiveness of Ketamine therapy when used to alleviate the symptoms of depression and anxiety, more forms of Ketamine will get approved by the FDA, which will open the door for wider insurance coverage.

Guide to Getting Insurance to Cover Ketamine Treatments

Insurance companies can be a pain to deal with for something as simple as a routine hospital visit let alone more serious situations. You first need to find out what the statutes and limitations are for getting Ketamine insurance coverage from your particular insurance company. If you meet the criteria and bill accordingly, you can get insurance coverage for FDA-approved forms of Ketamine. You must have the appropriate diagnosis and the Ketamine treatment must be used for pain-related or treatment-resistant depression issues. To reduce the cost of Ketamine with insurance, you want to provide clear documentation of your medical diagnosis to your insurance company showing that you meet their criteria for coverage. If you do your homework and get the paperwork in place, you have a better chance of receiving coverage.

How to Save Money on Ketamine Infusions without Insurance Coverage

Fortunately, you can save on Ketamine infusion therapy in Colorado Springs without insurance coverage. Here at the Military Matters Ketamine Clinic, we provide the following cost savings for patients seeking treatment:

  • Military service members (Active Duty, Reserve, and/or Retired), as well as Public Safety members (Fire, EMS, Law Enforcement), get $300 off the total price of 6 infusions. This discount is applied on a per infusion basis equaling a $50 discount per infusion. We break the discount down in case patients fail to complete the entire series of infusions.
  • We offer a payment plan for all patients (military or non-military) with 0% interest. Billing plans are designed on a case by case basis. However, when on our payment plan, we do require some payment from the patient at each visit.

As you evaluate how to save money on Ketamine infusions (aside from saving money directly on treatment), you must factor in the end result. Likely, you are currently taking various medications to treat your ailment. Part of the many benefits that Ketamine has to offer includes a reduction in prescription medication usage, which translates into fewer doctor appointments; indirectly, this is a cost-saving benefit that most don’t take into account. At this time, Ketamine infusion therapy isn’t covered by insurance but the Military Matters Ketamine Clinic offers discounted rates to military veterans and active-duty military service members. Don’t prolong the boost to your well-being simply because of cost, instead, speak with our professional team to see what can be done for you and your unique financial situation.

Ketamine Infusion Therapy in Colorado Springs

Can Ketamine treatment be covered with out of network insurance? Can I get my insurance company to cover Ketamine? Our team can help you answer these questions and navigate your insurance coverage to determine what you are eligible for. The Military Matters Ketamine Clinic is located in the Mt. Carmel Veterans Service Center in Colorado Springs. We serve the broader Colorado Springs region with Ketamine infusion therapy focusing on military veterans that are suffering from depression, anxiety, and pain. Ketamine has been proven as an effective treatment that can help give you back your life. If you are struggling with depression, anxiety or chronic pain, there is hope for you. Call us at 719-671-3147 or contact us by filling out the form below.

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