Key Takeaways:
- Spravato (esketamine) is an FDA-approved nasal spray for treatment-resistant depression and is often covered by insurance, though requirements and coverage vary by provider.
- Insurance approval typically requires documentation of past treatment failures, a formal diagnosis, and pre-authorization, which PMC Heal helps patients manage.
- PMC Heal offers comprehensive support—including insurance verification and billing assistance—to make Spravato costs more accessible and reduce financial stress.
- Even if insurance doesn’t fully cover costs, options like HSAs, FSAs, payment plans, and manufacturer savings programs can help make treatment more affordable.
If you’re struggling with depression that hasn’t responded to traditional treatments, you may have already heard about Spravato. This FDA-approved therapy—delivered as a nasal spray in a clinical setting—is helping many people find rapid, life-changing relief. But the most common question we hear from patients isn’t just about how Spravato works. It’s about affordability: Is Spravato covered by insurance?
At PMC Heal, we know that navigating mental health care can feel overwhelming, especially when cost is involved. That’s why we’re here to break down how esketamine insurance coverage works, what to expect from Spravato costs, and how our team helps make this innovative treatment more accessible.
What Is Ketamine Therapy?
Ketamine is best known as an anesthetic, but in recent years, it has gained significant attention for its rapid antidepressant effects—especially in patients with treatment-resistant depression. In mental health care, ketamine works by targeting the brain’s glutamate system, promoting synaptic repair and neuroplasticity. Unlike traditional antidepressants, which usually take weeks to work, ketamine often provides relief within hours or days.
It’s most commonly used to treat:
- Major depressive disorder
- PTSD
- Anxiety disorders
- Suicidal ideation
PMC Heal offers several forms of ketamine-based treatment, including the FDA-approved nasal spray Spravato (esketamine) for depression. This version is specifically approved for use in treatment-resistant depression and must be administered under medical supervision.
When comparing ketamine vs. TMS, one major factor is speed—ketamine tends to act more quickly, which can be vital in acute or crisis situations. It’s one of the most effective options available in the space of alternative depression treatment, and PMC Heal is proud to be a leading provider.
In fact, one 2023 study on the efficacy of ketamine for treating anxiety and depression found that 49% of patients responded positively to treatment for depression, and around 26% achieved remission. For anxiety, 47.5% of patients responded positively to treatment, and 25.6% achieved remission. Furthermore, these improvements were sustained for up to a year after treatment.
What Is TMS (Transcranial Magnetic Stimulation)?
Transcranial magnetic stimulation (TMS) is a non-invasive treatment that uses targeted magnetic pulses to stimulate nerve cells in areas of the brain that are associated with mood regulation. It doesn’t involve medication, anesthesia, or systemic side effects, which makes it a preferred option for people sensitive to drug-based treatments.
TMS is most often used for:
- Major depressive disorder (especially treatment-resistant depression)
- Anxiety disorders (in some cases)
The procedure typically involves daily sessions, five days a week, over the course of four to six weeks. Each session lasts about 20–40 minutes. Patients remain awake and alert, and there’s no downtime afterward.
In the conversation about TMS vs. ketamine, one of the main distinctions is the mechanism of action—TMS influences electrical activity in the brain, while ketamine acts on brain chemistry. Both approaches are evidence-based and can be effective, depending on the individual. Harvard Health Publishing reports that around 50% to 60% of individuals with depression who haven’t responded to medication see significant improvement with TMS therapy.
Comparing Ketamine and TMS Side-by-Side
Choosing between ketamine vs. TMS isn’t about which is better overall—it’s about which is better for you. Each treatment has unique strengths, and understanding them can help you and your provider determine the best fit.
Here’s a side-by-side look at how they compare:
| Factor | Ketamine Therapy | Transcranial Magnetic Stimulation (TMS) |
| Speed of Relief | Often within hours to a few days | Typically after 2–4 weeks of treatment |
| Treatment Setting | Medical supervision required (in-clinic) | Outpatient setting; no anesthesia required |
| Session Frequency | Varies; may be 1–2 times per week or more | 5 times per week for 4–6 weeks |
| Side Effects | Dissociation, dizziness, increased blood pressure | Scalp discomfort, headache, rare seizure risk |
| Medication Use | Involves drug administration (IV or nasal) | No medications involved |
| Insurance Coverage | Often covered for Spravato; variable for IV | Usually covered by insurance |
| Best For | Rapid relief, suicidal thoughts, severe cases | Gradual improvement, drug-sensitive patients |
Both treatments are widely respected and increasingly used in mental health care. Your medical history, symptoms, treatment goals, and even lifestyle factors (like schedule or sensitivity to medications) can influence which approach is best.
Which Treatment Is Right for You? It Depends on Your Journey
There’s no one-size-fits-all answer when choosing between TMS and ketamine. What matters most is your unique story—your symptoms, your treatment history, and your goals for recovery.
At PMC Heal, we start with a thorough assessment to understand where you’re coming from and what you’ve already tried. From there, we develop a treatment plan that may include TMS, ketamine therapy, or even a combination over time. Some patients begin with one treatment and switch to or add the other based on how they respond. Your plan evolves with you.
We’re not here to sell a one-track solution—we’re here to help you find the right tools for your healing.
You Don’t Have to Choose Alone
Exploring alternative depression treatment options like ketamine and TMS can feel daunting, especially when you’re already exhausted from trying what hasn’t worked. But you don’t have to make these decisions on your own.
PMC Heal specializes in innovative, evidence-based mental health care that prioritizes the individual. Whether you’re curious about starting treatment or just want to learn more, we’re here to help you navigate the possibilities.
