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Does Aetna Cover Depression Treatment in Colorado
Aetna covers medication management, therapy, and alternative depression treatments like Deep TMS and Spravato esketamine therapy in Colorado. If you are searching for a “psychiatrist near me that accepts Aetna” because you’ve tried multiple medications, therapy, breathwork, yoga, clean eating and every wellness tip out there, it’s not the end of the road. It’s a sign that you need a more advanced solution. We wrote this guide for Aetna members in Colorado to help you navigate Colorado’s complex mental health infrastructure and insurance policies and feel better sooner.
What Are Some Depression Treatments Aetna Covers?
Traditional antidepressants send a flood of chemicals throughout the entire brain. This can be like trying to water one specific plant with a firehose–it’s not very precise. When this broad approach doesn’t work, it’s time to get targeted.
Deep Transcranial Magnetic Stimulation (Deep TMS): This is a safe, FDA-approved, non-drug treatment. It uses targeted magnetic pulses to gently re-tune the parts of your brain that are underactive due to depression. Standard sessions are about 20 minutes 5 days a week over 6-12 weeks. Accelerated Deep TMS have multiple 10-minute sessions done over 6 days and you can get back to your day immediately after. Moreover, clinical data in a sample size of over 1400 patients demonstrated an over 82% of people improve within 6 weeks, and 65% go into remission from depression.
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- Typical Cost: Aetna generally covers the majority of the cost for your 36 recommended sessions.
- Teenage Depression Coverage: Aetna TMS is covered for teens 15 and over.
- Learn more about what TMS costs in Colorado with and without insurance here.
- Spravato (esketamine): This prescription nasal spray works differently than any pill you’ve tried. It helps your brain build new, positive pathways, offering rapid relief for depressive symptoms and helping you see the world in a new light. Clinical data shows a nearly 80% improvement withing 3.5 months and a 53% remission rate*.
- How much Aetna Covers for Spravato: Aetna covers the treatment, and we handle the paperwork for the Spravato with Me Savings Card, REMS, and prior authorization.
- Spravato With Me Savings Card: 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 Aetna Commercial Insurance Plans you can also get a rebate for observation fees to further reduce costs to $0 per treatment if you’re eligible.However, you must enroll in the program, and we cannot do this for you.
How Much Will TMS or Spravato Cost with Aetna?
Insurance coverage can be confusing.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.
We manage all prior authorizations, savings card applications, and REMS forms. Let us handle the paperwork so you can focus on one thing: feeling better.
Download our Aetna Spravato and TMS Insurance Guide.
Hear What Axis' Patients Have To Say
Want to learn more about TMS or Spravato from real patients? Our patient center is a great resource for your research. Listen to more patients, find more articles on clinical data and the science behind these treatments, and what to do before and after treatment to maximize results.
* 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.
What Does Your Aetna Plan Cover?
Axis Integrated Mental Health works directly with Aetna to maximize your benefits and minimize your costs. While every plan is unique, here is what we typically see for our Aetna patients in Colorado.
Deep TMS Treatment Coverage
Aetna covers TMS after two or more antidepressant trials that either didn’t work or had poor side effects. TMS is covered for teenagers 15 years and older with Aetna.
- Your Cost: You are generally responsible for your specialist copay. The average Aetna copay we see is around $32 per session.
Spravato (Esketamine) Treatment Coverage
Aetna also covers Spravato for treatment-resistant depression. We make it even more accessible by using a manufacturer savings program, which can make it far more affordable than cash-pay ketamime therapy services.
- Your Cost: We automatically enroll every eligible patient in the Spravato Savings Card program. This program is designed to cover copays and deductibles, reducing your cost to as little as $10 per visit.
- Disclaimer: The copay and coverage information listed above is based on averages from over 100 Aetna plans we have worked with. Your individual health plan, deductible, and out-of-pocket maximum will determine your exact cost. We will provide a full benefits verification before you begin treatment.
Your Path to Relief: A Simple 3-Step Process
We know that taking the first step can be the hardest part, so we’ve made the process as simple and stress-free as possible.
Step:1
Book your initial intake appointment online and start with a comprehensive evaluation with one of our psychiatric specialists. We’ll discuss your history, answer your questions, and determine if TMS or Spravato is right for you. Not ready to see a provider yet?
Step:2
Don’t worry about phone calls and paperwork. Our dedicated team takes over, compiling the necessary medical documentation and submitting the prior authorization request to Aetna on your behalf. We fight for every denial and aim to get you approved within two weeks.
Step:3
Once Aetna gives the green light, you can begin your sessions. You’ll be in a comfortable, private setting with a compassionate team supporting you every step of the way as you start your journey back to wellness.
Frequently Asked Questions
Yes, for patients who meet the medical necessity criteria (like having tried other treatments first), both Deep TMS and Spravato are considered standard, covered medical procedures by Aetna and other major insurance carriers.
Aetna requires that you have tried at least two different types of antidepressants at a proper dose for at least 8 weeks without getting better. Our clinical team will document your history to meet these requirements. We also provide more details about tms cost and spravato cost on our website.
This is where our expertise comes in. If a request is denied, we immediately demand a “Peer-to-Peer” review, which your provider will coordinate. This allows our providers to speak directly with an Aetna doctor to explain the medical necessity of your treatment. We have a very high success rate with these reviews. If the appeals process is unsuccessful, we can discuss payment plan options and patient cash-pay discounts.
Apart from efficacy rates, Deep TMS (which is different than first generation rTMS), uses magnets to stimulate areas in your brain related to depression and anxiety. You will be sitting in a chair with a technician and there is no down-time afterwards. Spravato is a nasal spray administered in our office, and you will need to relax for a two-hour observation period afterward and have a ride home. You cannot drive for the rest of the day after Spravato, but you can resume normal activities after TMS.
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 Aetna insurance cover TMS therapy in Colorado?
Yes, Aetna provides coverage for Deep TMS therapy for individuals diagnosed with treatment-resistant depression. Patients typically pay their deductible and out-of-pocket max to cover the treatment.
Does Aetna cover Spravato or ketamine therapy?
Yes, Aetna covers the FDA-approved esketamine treatment, Spravato, for qualifying patients. By using a manufacturer savings card, most Aetna patients can reduce their out-of-pocket cost to as little as $10.
How do I get Aetna to approve depression treatment?
To get approval for advanced treatments like TMS or Spravato, you need a medical evaluation confirming you have tried at least two previous antidepressants without success. A specialized clinic will submit the required prior authorization paperwork to Aetna for you.
Download our Free Aetna Mental Health Benefits Guide
Ready to see what Aetna will cover for you?
Go beyond just googling “psychiatrist near me” and get clarity on what Aetna 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.
Figures above are estimates drawn from Aetna Colorado patterns and our clinic’s recent experience; individual benefits vary by plan. We verify your personal coverage and provide a written estimate before treatment. Spravato® savings program availability and amounts depend on eligibility and program rules.
