You've been through this before

Maybe it was therapy sessions capped at a number that ran out by March. Maybe a treatment your doctor recommended that came back denied. Maybe a claim you fought for months and lost.

At some point you concluded that mental health coverage is theoretical, and you stopped asking.

That's a reasonable conclusion from the evidence. It's also, for this particular treatment, not necessarily true.

The distinction is FDA approval. SPRAVATO® is approved for treatment-resistant depression, which means insurers have an established process for covering it — rather than the ambiguity around treatments used off-label.

Medicare Part B covers it. Most commercial plans cover it. Both require prior authorization.

Your plan wants documentation that you meet criteria for treatment-resistant depression. Typically:

• Records showing at least two antidepressant trials, usually from different classes, without adequate response
• Sometimes a current depression severity score
• Sometimes therapy history

It generally takes somewhere between a few days and two weeks.

We do this part. Our team gathers records, submits the request, and files the appeal if it comes back denied. Most denials come from incomplete documentation rather than genuine ineligibility, and appeals with fuller records often succeed.

You've probably fought an insurer alone before. You wouldn't be doing that here.

There are two separate charges — the medication and the required observation visit. Programs that reduce one don't necessarily touch the other, which is how people end up with unexpected bills.

There's a manufacturer savings program for eligible commercially insured patients that can substantially reduce the medication cost, plus a separate program that can offset observation costs. Neither applies to Medicare or Medicaid. There's also an assistance foundation for uninsured patients.

We'll enroll you in whatever you qualify for and give you a real number in writing before your first session.