Insurance coverage
Anthem Blue Cross Blue Shield
Anthem (an Elevance Health subsidiary) operates BCBS plans in 14 states. Spravato is covered with prior auth. IV ketamine for TRD is covered under Anthem Medical Policy BEH.00014 in most Anthem states - one of the more generous commercial ketamine policies in the country.
Coverage at a glance
| Modality | Status |
|---|---|
| Spravato (esketamine) | Covered |
| Ketamine IV infusion | Sometimes covered |
| Ketamine IM injection | Sometimes covered |
| Ketamine oral/lozenge | Not covered |
| Psilocybin (Oregon licensed) | Not covered |
| Psilocybin (Colorado licensed) | Not covered |
What the plan requires
- BEH.00014 criteria: TRD, failed 2+ antidepressants, no active substance use disorder.
- REMS site for Spravato.
Practical tips
- Anthem Blue Cross of California covers IV ketamine for TRD at more clinics than most BCBS affiliates.
Providers accepting Anthem
Always confirm in-network status with both the clinic and your plan before your first session.