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 Tufts Health Plan cover ketamine therapy or treatment?
Latest medical review on: July 9th, 2025. Medically reviewed by Chief Medical Officer Dr. Ben Yudkoff.
Tufts Health Plan covers the FDA-approved version of ketamine called Spravato (esketamine), a highly effective solution for treating depression. However, Tufts Health Plan does not cover intravenous (IV) or intramuscular (IM) ketamine treatment for conditions associated with depression, anxiety, or other mood disorders.
Key Takeaways: Does Tufts Health Plan cover ketamine for mental health?
• Tufts Health Plan 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.
• Please note that Lumin Health only works with some plans in the Tufts umbrella, and Lumin Health unfortunately cannot work with Health Together/Health Direct/OneCare/ConnectorCare Tufts Health Plans.
• 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.
• Please note that Lumin Health only works with some plans in the Tufts umbrella, and Lumin Health unfortunately cannot work with Health Together/Health Direct/OneCare/ConnectorCare Tufts Health Plans.
Does Tufts Health Plan cover Spravato treatment?
Yes. Tufts Health Plan covers Spravato (esketamine) 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 Tufts Health Plan cover ketamine infusions or intramuscular injections of ketamine?
Tufts Health Plan does not cover ketamine infusions or any form of treatment for mental health issues. However, Tufts Health Plan 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.
Does Lumin Health accept Tufts Health Plan for Spravato treatment?
Yes, Lumin Health accepts Tufts Health Plan insurance for initial psychiatric consults, Spravato (esketamine) therapy, and ongoing care. Esketamine therapy is a great option for those looking for ketamine therapy, and provides very similar benefits for those dealing with mood and mental health issues.
How can I get Spravato (esketamine) covered by Tufts Health Plan?
The criteria for getting ketamine therapy with Spravato covered by Tufts Health Plan 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
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 Tufts Health Plan?
Is ketamine FDA-approved?
Does Tufts Health Plan 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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