When depression
treatment hasn't
worked,
ketamine
therapy might

Esketamine (Spravato) is one of the two mirror-image molecules in ketamine, made as a nasal spray. It is FDA-approved for adults with treatment-resistant depression and for major depressive disorder with acute suicidal ideation, so most insurance plans cover it for people who meet their criteria. You take the spray yourself at our office, and our clinical team monitors you for at least two hours afterward, as the FDA requires. Ketamine contains both molecules. It is not FDA-approved for depression, so its use is off-label and usually self-pay – but is still safe, effective, and is used as “standard of care” for treatment despite being off-label. At Lumin Health, ketamine is given as an intramuscular (IM) injection; we do not offer IV ketamine. Both work on the brain’s glutamate system, and our team will help you decide which fits your condition, history and insurance.

For most people, ketamine and esketamine (Spravato) are well tolerated when given by trained clinicians in a monitored medical setting. At Lumin Health, treatment is overseen by board-certified, academically-affiliated psychiatrists. Ketamine has been used in medicine for more than 50 years, and the doses used for depression are a fraction of those used for anesthesia, so you stay awake throughout.

We screen everyone before treatment, including for conditions that can make it unsafe, such as uncontrolled high blood pressure, certain heart and blood-vessel conditions, a history of psychosis, and pregnancy. You are monitored throughout every session, and we check your blood pressure before and after. Common short-term effects include feeling detached or “floaty”, drowsiness, dizziness, changes in perception, blurred vision, a faster heart rate, nausea, headache and a temporary rise in blood pressure. They usually fade within a couple of hours, and most people feel like themselves later that day. You’ll need a ride home, and you can’t drive until the next day after a night’s sleep.

At Lumin Health, ketamine and esketamine are only given under supervision at our office and are never taken at home. Like other antidepressants, esketamine (Spravato) carries an FDA warning about suicidal thoughts in young adults, so tell us right away about any new or worsening thoughts. If you are in crisis, call or text 988. If anything comes up during a session, our team is there to help right away.

Insurance Coverage: Coverage depends on the type of treatment. Esketamine (Spravato) – the FDA-approved nasal spray for depression – is covered by Medicare and most major private insurance plans for patients who meet the criteria (generally, those with treatment-resistant depression who have tried other antidepressants). If you qualify for Spravato, your insurer will typically pay for the medication and treatment sessions, leaving you with only a co-pay or deductible similar to a regular specialist visit. Lumin Health works with a wide range of insurers (including Aetna, Blue Cross Blue Shield, Cigna, United Healthcare, Medicare, and others), and about 95% of our patients have Spravato treatment covered by their insurance, making it very accessible and affordable. We handle the insurance authorization process for Spravato and will let you know upfront if you’re covered.

Out-of-Pocket Costs: Ketamine infusion or injection therapy (the off-label treatment) is typically not covered by insurance for depression or anxiety. This means patients opting for IV or IM ketamine will usually pay out-of-pocket. At Lumin Health, we strive to keep ketamine therapy affordable and transparent. We charge about $500 per session for intramuscular ketamine treatments, and a typical full treatment package (6–10 sessions over several weeks) ranges from roughly $3,000 to $5,000 in total. This per-session cost is often significantly lower than many hospital-based IV ketamine infusions (which can run $600–$1,000 or more each). We also offer flexible payment plans and will work with you to minimize financial barriers – our team can discuss financing options during your consultation. In summary, insurance will pay for Spravato in most cases (making that option low-cost for you), whereas ketamine IV/IM therapy is self-pay but priced with affordability in mind. We’re committed to helping you get the treatment you need, and we’ll guide you through the costs and insurance details so there are no surprises.

Ketamine therapy is generally recommended for individuals with serious depression or related conditions that haven’t responded well to standard treatments. If you have tried traditional antidepressants and talk therapy without sufficient improvement, you may be a good candidate to consider ketamine or esketamine. The best way to know for sure is to have a professional evaluation. At Lumin Health, our experienced medical team will conduct a thorough assessment of your medical history, current symptoms, and past treatment trials to determine if ketamine or Spravato is appropriate and safe for you. We take into account factors like your diagnosis, how many treatments you’ve tried, and any health issues that might affect ketamine’s use. If you’re deemed a good candidate and you decide to proceed, starting treatment is straightforward – you can book a free consultation with us (online or by phone at 617-863-8810) to discuss your case and ask any questions. From the initial consultation to your first session, the process is usually quick. In fact, most patients can begin treatment within a few weeks after the evaluation (and we do our best to accommodate urgent cases faster). Our staff will guide you through every step – verifying your insurance coverage for Spravato (esketamine) if applicable or discussing payment options for ketamine, scheduling your appointments, and coordinating care with your existing providers if needed. This personalized intake process ensures that you feel informed and supported from day one so you can start your ketamine therapy journey with confidence and hope for relief.