Question 1

What is the cost of ketamine treatment with Tufts Health Plan?

Accepted Answer

Your cost depends on which Tufts Health Plan you carry. Lumin Health is in-network with some Tufts programs and out-of-network with others, so plan-level details matter. On a free consultation we verify your specific Tufts plan, confirm whether you're in-network at Lumin for Spravato (esketamine), and walk through what your coverage means in dollars. For Tufts plans where we're out-of-network, we'll explain self-pay rates and can provide a superbill for potential out-of-network reimbursement.

Question 2

Does Tufts Health Plan cover ketamine for depression, PTSD, and chronic pain?

Accepted Answer

Tufts Health Plan typically covers Spravato (esketamine) for treatment-resistant depression (TRD) when specific medical criteria are met. Tufts generally considers IV ketamine infusions and intramuscular ketamine to be investigational and does not cover them. Whether you can use your Tufts benefits at Lumin Health depends on your specific Tufts program — we're in-network with some Tufts plans and out-of-network with others. We confirm your in-network status on a free consultation before any treatment begins.

Question 3

How do I get pre-authorization for Spravato (esketamine) with Tufts?

Accepted Answer

Prior-authorization handling depends on which Tufts plan you carry. For Tufts programs where Lumin Health is in-network, our intake team submits the prior-auth request to Tufts on your behalf as part of your onboarding. For Tufts plans where we're out-of-network, prior authorization through Tufts isn't possible and treatment is self-pay. The fastest way to find out which path applies to you is a free consultation — we'll verify your Tufts plan and walk you through next steps.

Question 4

How do I know if I'm a good candidate for ketamine therapy, and how can I start treatment?

Accepted Answer

Ketamine therapy is generally recommended for individuals with serious depression or related conditions that haven't responded well to standard treatments. At Lumin Health, our medical team conducts a thorough assessment of your medical history and current symptoms to determine if ketamine or Spravato is appropriate for you. If you're a good candidate and decide to proceed, you can book a free consultation (online or by phone at 617-863-8810). Lumin Health is in-network with some Tufts Health Plan programs and out-of-network with others, so our intake team will verify your specific plan and explain either your in-network benefits or self-pay options before you begin treatment.

Question 5

Does Tufts Health Plan cover ketamine therapy or ketamine treatment?

Accepted Answer

Tufts Health Plan generally covers the FDA-approved nasal spray Spravato (esketamine) for depression. Tufts typically does not cover other forms of ketamine therapy — such as IV infusions or intramuscular injections — for psychiatric conditions. Whether Tufts coverage applies at Lumin Health depends on your specific Tufts program: we're in-network with some Tufts plans for Spravato and out-of-network with others. Our intake team verifies your plan on a free consultation.

Question 6

Does Tufts Health Plan cover Spravato (esketamine)?

Accepted Answer

Yes — Tufts Health Plan policies usually include coverage for Spravato (esketamine) for members with Treatment-Resistant Depression (TRD) when medical criteria are met. At Lumin Health, whether your Tufts Spravato benefit applies directly depends on your specific Tufts program. We're in-network with some Tufts plans and out-of-network with others. On a free consultation our intake team verifies your plan and confirms whether we can bill Tufts directly or whether treatment will be self-pay.

Question 7

Does Tufts Health Plan cover ketamine infusions or ketamine injections?

Accepted Answer

As of 2025, Tufts Health Plan considers ketamine infusions and intramuscular injections for psychiatric conditions to be investigational and not medically necessary, and does not cover them. Tufts coverage at Lumin Health applies only to Spravato (esketamine) and only for Tufts plans where Lumin is in-network. We're in-network with some Tufts programs and out-of-network with others; IM ketamine treatments at Lumin Health are self-pay regardless of Tufts plan because Tufts does not cover that form of treatment.

Question 8

Ketamine Infusions vs. Spravato (Esketamine): What's the Difference for Tufts Patients?

Accepted Answer

For Tufts members, Spravato (esketamine) is an FDA-approved medication and is often covered by Tufts when treatment-resistant depression (TRD) criteria are met. Ketamine infusions and intramuscular injections are typically not covered by Tufts because Tufts considers them investigational. At Lumin Health, Spravato may be covered through Tufts if your specific Tufts plan is one we're in-network with — we're in-network with some Tufts programs and out-of-network with others. IM ketamine treatments at Lumin Health are self-pay across all Tufts plans because Tufts does not cover that category of treatment.

Question 9

Does Lumin Health accept Tufts Health Plan for Spravato treatment?

Accepted Answer

It depends on your specific Tufts plan. Lumin Health is in-network with some Tufts Health Plan programs and out-of-network with others. For Tufts plans where we're in-network, we can use your Tufts benefits for Spravato (esketamine) treatment — including the initial consultation, the Spravato course of care, and ongoing follow-up. For Tufts plans where we're out-of-network, Spravato is available on a self-pay basis. Free consultations are offered to all prospective patients regardless of insurance, and our intake team verifies your specific Tufts plan before treatment begins.

Question 10

How can I get Spravato (esketamine) covered by Tufts Health Plan?

Accepted Answer

To get Spravato (esketamine) covered by Tufts Health Plan, you typically need to (1) see an in-network provider, and (2) meet Tufts' medical criteria — most commonly a diagnosis of treatment-resistant depression and a documented history of inadequate response to prior antidepressants. Lumin Health is in-network with some Tufts plans and out-of-network with others. On a free consultation, our intake team verifies whether your specific Tufts plan is one we can bill, confirms whether you meet Tufts' clinical criteria, and handles the prior-authorization submission for in-network plans.

Does Tufts Health Plan cover ketamine therapy or ketamine treatment?

Does Lumin Health accept Tufts Health Plan for Spravato treatment?

Are there other resources Lumin Health can recommend if my Tufts Health Plan is not covered?

Frequently asked questions