Does United Health Care Insurance Cover TMS and Spravato Ketamine Therapy?

United Healthcare covers Deep TMS and Spravato ketamine therapy for adults 18 and over. Deep TMS is also covered for teens 15-18 years old with 2 or more med trials. Read more to learn how your United Healthcare insurance plan can unlock powerful, life-changing treatments that go beyond traditional medication.
At Axis Integrated Mental Health, we help patients across Colorado use their insurance benefits to access Deep TMS and Spravato (esketamine) therapy. The best part? You can start your journey to feeling better without worrying about huge out-of-pocket costs.

Your United Healthcare Benefits Make It Possible

Navigating insurance can be confusing, but we make it simple. We are experts in getting prior authorizations approved so you can focus on your health. Here’s what coverage typically looks like for United Healthcare members in Colorado.

Deep TMS Treatment Coverage

If you’ve tried at least two antidepressants without success, your plan will likely cover TMS.

  • Typical Cost: United Healthcare should cover the majority of the cost for your 36 recommended sessions.
  • Your Copay: Based on your plan, your portion could be your typical specialist copay (an average of $30 per session).
  • TMS is covered for teens 15 and over.
  • Learn more about what TMS costs in Colorado with and without insurance here.

Spravato (Esketamine) Treatment Coverage

Spravato is also typically covered after trying two or more medications for adults 18 years old and over. We complete the paperwork to provide you with a special manufacturer coupon to make it even more affordable.

  • Typical Cost: United Healthcare covers the treatment, and we handle the paperwork.
  • Your Copay: The Spravato With Me Savings Card can cover your copay, deductible, and out-of-pocket max. This reduces your cost to as little as $10 per visit.
  • Manufacturer Rebate: With United Healthcare, you can also get a rebate for observation fees. However, you must enroll in the program.

Our team automatically enrolls every eligible patient in this savings program. We believe cost should never be a barrier to transforming your life. You may also be eligible for a rebate for observation fees so that cost is $0 per treatment if you’re eligible.

Why Aren't My Antidepressants Working?

Traditional antidepressants, like SSRIs or SNRIs, work by sending chemical messengers all throughout your brain. For many people, this works well. But for as many as 65% of people taking antidepressants, these medications don’t provide enough relief. This is called Treatment-Resistant Depression (TRD).

Some people find that antidepressants may have worked for a while, but then stopped. This is especially true for women first experiencing perimenopause. Both TMS and Spravato can help when meds and therapy have not been enough.

If this sounds like you, it doesn’t mean you’re out of options. It just means you need a more targeted approach.

Deep TMS & Spravato: A More Direct Path to Relief

Instead of a broad approach, Deep TMS and Spravato work on the specific parts of the brain affected by depression.

These treatments aren’t just another pill–they’re a way to directly help your brain heal and you can do both treatments if eligible.

Patient Testimonials

Want to learn more about TMS or Spravato from real patients? Our patient center is a great resource for your research.

Can You Tell Me How Much TMS or Spravato Will Cost With United Healthcare Insurance?

If you’d like to get a rough estimate of costs, please use our free, online cost calculators to estimate your out-of-pocket costs for TMS or Spravato. Or, schedule a free consult with a member of our team who can explain how different benefits programs work, the rebates you may be eligible for, and other options.
* The clinical studies referenced in this article provide valuable insights into mental health treatments. However, like all research, they have limitations. Outcomes may vary due to differences in study design, sample sizes, patient populations, and treatment protocols. Some findings may not be generalizable to all individuals, and newer research may expand
or refine these results. This content is for educational purposes only and should not replace professional medical advice. Please consult a qualified healthcare provider to determine the best treatment options for your unique situation.

Do I Qualify?

Your United Healthcare plan will likely cover these treatments if you meet these requirements:

  • You have an inadequate response to at least two different antidepressant medications.
  • You are currently in a moderate to severe depressive episode.
  • You have a psychiatric evaluation confirming your diagnosis (we can help with this!).
  • You can attend regular treatment sessions.

Frequently Asked Questions

1. What is the main difference between Deep TMS and Spravato?

Deep TMS is the latest generation of transcranial magnetic stimulation technology we offer at Axis Integrated Mental Health. Like rTMS, it uses external magnetic fields to stimulate your brain’s mood center, however, the coil surrounds your head simultaneously targeting multiple parts of your brain for better results. Spravato is a prescription nasal spray that works internally on a different chemical pathway to help your brain create new, healthier connections. We can help you decide which is a better fit for you, although for best results, we recommend both if no contraindications are present.

2. Will my United Healthcare plan really cover ketamine therapy and Deep TMS?

Yes. For patients with treatment-resistant depression, who have already tried two or more different classes of antidepressants, both Deep TMS and Spravato are covered medical treatments. We have a dedicated team that works directly with United to get your prior authorization approved, usually within two weeks.

3. How much will I actually have to pay out of pocket for ketamine therapy or Deep TMS?

Every plan is different and where you are in your deductible and out of pocket max can vary, but our goal is to make it affordable. For Spravato, most of our patients pay just $10 per treatment thanks to the savings card. For Deep TMS, you are typically responsible for your deductible and out of pocket maximum. We will verify your benefits and give you a clear out-of-pocket cost estimate before you start.

4. What does "inadequate response to medication" mean?

It means you took an antidepressant at the correct dose for a long enough time (usually 6-8 weeks) and still didn’t feel significantly better or had side effects like weight gain or sexual dysfunction (which is very common with antidepressants). If you’ve switched medications a couple of times because of this, you likely qualify.

5. What is the Cash Pay Price for Deep TMS if United doesn’t cover it?

Axis provides Cash Pay Discounts for Deep TMS, charging $5,500 for the standard protocol. Accelerated 6 day protocols are charged at $7,500 total.

Does United Healthcare cover ketamine therapy in Colorado?

Yes, United Healthcare covers Spravato, an esketamine nasal spray, for treatment-resistant depression. With available savings programs, patients can pay as little as $10 per treatment.

Does United Healthcare cover TMS therapy?

Yes, United Healthcare covers Deep TMS therapy for patients who have not found relief from at least two different classes of antidepressant medications and have tried therapy. Patients are typically responsible for their deductible and out-of-pocket max.

How do I get approved for TMS or Spravato with United Healthcare?

You must have a diagnosis of moderate to severe depression and have tried at least two different classes of antidepressants. A psychiatric clinic, like Axis Integrated Mental Health, will handle the prior authorization paperwork for you.

Download Your United Healthcare Mental Health Benefits Guide

Before you google “psychiatrist near me” again, get clarity on what United Healthcare mental health benefits can do for you. Download our free guide and be better prepared to navigate Colorado’s complex mental health landscape from your very first appointment. And book with Axis Integrated Mental Health to get an appointment within 7days or less.