Insurance coverage
Cigna + Express Scripts
Cigna covers Spravato under its behavioral health benefits. Prior authorization required, with a two-trial step-therapy requirement. Cigna historically had one of the more generous ketamine infusion policies but narrowed it in 2024; today only specific plan designs cover IV ketamine for TRD.
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
- Documented TRD.
- Administered at REMS site with Cigna Behavioral network participation.
Practical tips
- Cigna's medical necessity criteria for ketamine are in Coverage Policy 0502.
- Express Scripts handles the pharmacy benefit side.
Providers accepting Cigna
Always confirm in-network status with both the clinic and your plan before your first session.
No verified providers currently list Cigna. This can mean the plan is typically self-pay, or that we have not yet surfaced plan acceptance - check back as we expand clinic onboarding.