If you’d like to explore how ketamine therapy or Spravato (esketamine) treatment could help depression and anxiety, we invite you to book a complimentary consultation below. We look forward to speaking with you.
Does Harvard Pilgrim Health Care cover ketamine therapy or treatment?
Latest medical review on: July 9th, 2025. Medically reviewed by Chief Medical Officer Dr. Ben Yudkoff.
Harvard Pilgrim covers the FDA-approved version of ketamine called Spravato (esketamine), a highly effective solution for treating depression. However, Harvard Pilgrim does not cover intravenous (IV) or intramuscular (IM) ketamine treatment for conditions associated with depression, anxiety, or other mood disorders.
Key Takeaways: Does Harvard Pilgrim Health Care cover ketamine for mental health?
• Harvard Pilgrim covers Spravato (esketamine) for depression, which is a nasal spray formulation of ketamine boasting similar efficacy
• This is because Spravato (esketamine) has full FDA approval for the treatment of treatment-resistant depression through Johnson & Johnson
• Your coverage may vary based on your specific plan. Get in touch with Lumin Health to explore your options. We handle all prior authorization on your behalf to make this process as seamless as possible.
• This is because Spravato (esketamine) has full FDA approval for the treatment of treatment-resistant depression through Johnson & Johnson
• Your coverage may vary based on your specific plan. Get in touch with Lumin Health to explore your options. We handle all prior authorization on your behalf to make this process as seamless as possible.
Does Harvard Pilgrim cover Spravato treatment and esketamine?
Yes. Harvard Pilgrim Health Care covers Spravato treatment for people suffering from Treatment Resistant Depression (TRD). Costs are typically a co-pay, and allow for ongoing treatment. Schedule a consultation with us to see if you qualify.
Does Harvard Pilgrim cover ketamine infusions and ketamine infusions?
Harvard Pilgrim does not cover ketamine infusions or any form of treatment for mental health issues. However, Harvard Pilgrim does cover Spravato (esketamine) treatment. Esketamine is a derivative of ketamine, is FDA approved for the treatment of depression, and has proven to be highly effective.
Ketamine Infusions vs. Spravato (Esketamine): What's the Difference for Harvard Pilgrim Health Care Patients?
Spravato is the "s-enantiomer" of ketamine and has a different pathway for coverage and prior authorization than traditional ketamine therapy through intravenous or intramuscular administration. Knowing this key difference can be crucial to finding the correct coverage information.
Does Lumin Health accept Harvard Pilgrim Health Care for Spravato?
Yes, Lumin Health accepts Harvard Pilgrim Health Care insurance for initial psychiatric consults, Spravato (esketamine) therapy, and ongoing care. Esketamine therapy provides a great alternative to ketamine therapy, and provides very similar benefits for those dealing with mood and mental health issues.
How can I get Spravato (esketamine) covered by Harvard Pilgrim?
The criteria for getting ketamine therapy with Spravato covered by Harvard Pilgrim Health Care can vary based on each case, but some commonalities are below.
Individual is 18 years of age or older
Meets Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) criteria
Has had an inadequate response to four antidepressants from at least 2 different antidepressant classes
Individual does not have any FDA labelled contraindications to esketamine nasal spray
Learn more about the specific insurance coverage for esketamine therapy and Spravato with Harvard Pilgrim Health Care. For more information about how Lumin Health works with insurance, visit our insurance cost & information page.
Frequently asked questions
What is the cost of ketamine treatment with Harvard Pilgrim?
Is ketamine FDA-approved?
Does Harvard Pilgrim Health Care cover ketamine for depression, PTSD, and chronic pain?
How do I get pre-authorization for Spravato (esketamine)?
How do I know if I’m a good candidate for ketamine therapy, and how can I start treatment?
Article Reviewed by Dr. Benjamin Yudkoff, MD, MA
Dr. Yudkoff is a board-certified psychiatrist who provides the most up-to-date psychiatric care to people managing illnesses that have not satisfactorily resolved with treatment as usual, and in a way which honors principles of autonomy, self-direction, and holistic approaches. He has lectured on spirituality and ketamine therapy, is an Instructor in Psychiatry at Harvard Medical School, and has taught a humanism course to residents of the Harvard Brigham and Women’s Hospital Residency Training Program. Dr. Yudkoff has served as the Medical Director of the Brigham and Women’s Faulkner Hospital and the Medical Director of the Interventional Psychiatric Service (electroconvulsive therapy, ketamine, and esketamine). Dr. Yudkoff has published scientific articles on ketamine and psychopharmacology, and has won several teaching awards from Harvard Medical School students and Brigham and Women’s Psychiatric Residents.
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