Major insurance companies in Colorado, including Cigna, Aetna, United Healthcare, and Anthem Blue Cross Blue Shield, all cover psychiatric evaluations, medication management, and alternative depression treatments like Deep TMS and Spravato. As of January 1, 2026, The State of Colorado requires every major insurance plan to cover mental health care at the same level it covers physical health care.
Written and reviewed by the Psychiatric-Mental Health Providers at Axis Integrated Mental Health, this blog will walk you through what your specific plan likely covers, what it takes to qualify for advanced treatments like Deep TMS and Spravato.
Note: At Axis Integrated Mental Health, with clinics in Denver, Aurora, Boulder, the Denver Tech Center, and Westminster, we check your benefits before your first appointment.
What Colorado Law Says About Your Mental Health Coverage
Before we get into each insurance plan, you need to understand one foundational fact that changes everything: Colorado law is on your side.
Both federal and Colorado state law require health insurance plans to cover mental health services at the same level they cover physical health conditions like diabetes or heart disease. This is called mental health parity. It means your insurer cannot charge you a higher copay for a psychiatry visit than for a cardiology visit. It cannot cap your mental health sessions if it doesn’t cap your physical health appointments. And it cannot require stricter prior authorization for mental health treatment than it does for a comparable medical procedure.
The Colorado Division of Insurance enforces these protections across all major employer plans, individual plans, small and large group plans, and Medicaid. If you believe your insurer is treating your mental health claim differently than a physical health claim, that is a parity violation. You have the right to report it.
A lot of people assume that advanced psychiatric treatments exist in some gray zone where insurance can say no freely. They cannot, not if they want to stay compliant with state and federal law.
What Does “Treatment-Resistant Depression” Actually Mean for Your Coverage?
Most major insurance plans in Colorado will cover advanced depression treatments, especially Deep TMS and Spravato. However, you need to meet what is called the medical necessity criteria for treatment-resistant depression treatment.
The specific criteria vary slightly by insurer, but the core standard across Cigna, Aetna, United Healthcare, and Anthem BCBS is broadly the same:
- You have a psychiatric evaluation documenting treatment resistance.
- Your depressive episode must be from moderate to severe.
- You have tried at least two different types of antidepressants.
- Each medication was taken at a therapeutic dose for at least six weeks during the current depressive episode.
- You did not achieve adequate relief from either medication.
That’s it. If your history matches those five points, you are likely eligible for prior authorization approval on TMS or Spravato. This describes the experience of a large number of people who thought they had simply “run out of options.”
In Denver, 65.6% of people who didn’t get treatment cited cost concerns in 2021.
At Axis, we document your treatment history during your intake appointment and build the prior authorization package on your behalf. You don’t fill out paperwork. You don’t call your insurance company and sit on hold. We do that. What we need from you is your history. We’ll help you reconstruct it even if you don’t have records from every provider you’ve seen.
Insurance Terms To Understand
- Copay – Short for copayment, it is the cost you pay for every time you visit a doctor or refill your medication.Each time you visit a provider or pick up a prescription, you pay a small, fixed amount right then and there. That amount is already set in your plan. It does not change visit-to-visit, and you can actually find it printed right on your health insurance ID card.
Here’s a real example: Say you’re coming in for your Deep TMS sessions at Axis in Denver. Every time you show up for a session, you pay your copay, and that’s it for that visit.
Depending on which healthcare plan you have, that number typically lands somewhere between $0 and $50.
The key thing to remember: your copay is the same every time. No surprises at the front desk.
- Deductibles – This amount is the minimum amount you pay for medical expenses before your insurance kick-in. This is for the big medical expenses like lab tests, MRIs, surgeries, hospital stays, and others.For example: Let’s say your deductible for the year is $1,000. That means you need to rack up $1,000 in covered medical expenses before your insurance starts contributing. Once you hit that number, your coverage kicks in.
An important detail that most people misunderstand is the ‘Negotiated Rate’. When you have insurance through a carrier like Cigna, your provider has a special deal with Cigna that lowers the price of your care. You never see the full sticker price. You only see what Cigna has already negotiated down for you.
For example: You go in for an MRI to one of the hospitals in-network with your insurance. This MRI is priced at $2000. But because you have Cigna, the negotiated rate brings it down to $400. Only that $400 gets applied toward your deductible, not the original $2000. So your deductible fills up faster, you hit your coverage threshold sooner, and your insurance starts helping you sooner.
A deductible amount is predetermined in your health insurance plan.
Deductibles cover bills for hospitalization, surgery, lab tests, MRIs and CT scans, anesthesia, doctors and therapists visits, medical devices, etc.
- Coinsurance – Once you’ve hit your deductible, you and your insurance company team up to pay the remaining bills together. That split is your coinsurance.Here’s a real example: Your plan has an 80/20 coinsurance split. That means your insurance pays 80% of the bill, and you cover the remaining 20%. So if a treatment costs $500, your insurance handles $400 and you’re responsible for $100.
- Out-of-Pocket – Your out-of-pocket maximum is the most you will ever have to pay for healthcare covered under your insurance plan in a single year. Once you hit that ceiling, your insurance covers 100% of everything else for the rest of the year.
This number includes everything you’ve paid in copays, your deductible, and your coinsurance combined. It is your financial safety net.
Here’s how it all adds up with a real example: Let’s say your plan looks like this:
- Copay: $30 per visit
- Deductible: $1,000 for the year
- Coinsurance: 80% covered by insurance, 20% covered by you
- Out-of-pocket maximum: $4,000 for the year
You start the year paying your copays and working toward your $1,000 deductible. Once that’s met, you and your insurance split bills at 80/20. As those 20% payments add up across the year, the moment your total out-of-pocket spending reaches $4,000, you stop paying. Everything after that is on your insurance for the rest of the year.
Points to keep in mind:
1. The “Order of Operations”
Insurance usually follows a specific path through your “Out-of-Pocket” journey:
Step 1: You pay 100% (at the Negotiated Rate) until you hit your $1,000 Deductible.
Step 2: You then pay Coinsurance (your 20% split) for big things like MRIs or hospital stays.
Step 3: You pay Copays ($30) for your visits.
Step 4: Once the total of all that hits $4,000, you pay $0.
2. The “Copay vs. Deductible” Nuance
On many healthcare insurance plans, mental health office visits (like therapy or TMS) are “Deductible Waived.
This means you might not have to pay that first $1,000 before your $30 copay kicks in.
3. The “In-Network” Rule
The above information is subject to staying In-Network. If you go to a doctor in Denver who does not accept your insurance:
They won’t honor the Negotiated Rate (you pay the full sticker price).
The money you pay them usually does not count toward your $1,000 deductible or your $4,000 Out-of-Pocket Max.
Which Insurance Plans Cover Deep TMS and Spravato in Colorado?
Cigna, Aetna, Anthem BCBS, and United Healthcare cover Deep TMS and Spravato treatment costs in Colorado.
Cigna: What Your Plan Actually Covers
If you have Cigna (employer-sponsored, individual cover, or through an Evernorth plan) your mental health benefits almost certainly include coverage for both Deep TMS and Spravato when you meet the medical necessity criteria above.
Here is what coverage looks like in practice for Cigna members at Axis:
Prior Authorization
Our in-house team of prior-auth experts get approvals within 2 weeks of in-take.
- Our team documents your complete clinical history, your psychiatric evaluation from your intake, and a medical necessity justification specific to your case.
- We submit the whole clinical documentation package to Cigna. When approved, your treatment is covered at your plan’s standard outpatient rates.
- That means your existing deductible and coinsurance apply, the same way they would for any other outpatient medical procedure.
- If in case your claim is unapproved, we demand a peer-to-peer review (our providers meet with doctors at Cigna) to understand the denial.
Cost-difference
Based on an average of 200+ Cigna insured patients of Axis, below is an estimate of how much TMS treatment and Spravato treatment costs. Your plan may vary from our estimates. Please speak to our team for more information.
- Deep TMS – Deep TMS treatment for treatment-resistant depression is for 36 sessions. Each session costs $300 (for the treatment) plus $300 (a one-time cost) for in-take, and $200 per follow-up. With insurance cover from Cigna for TMS treatment, this cost drops to $30.
- Spravato – Spravato treatment in Denver costs as little as $10 per treatment. The treatment spans 8 weeks (2x for the first 4 weeks, and 1x for the next 4 weeks). After the initial 8 weeks, the treatment varies based on your response to Spravato. Normally, each session costs ~$1200 (for the dose) plus $300 (a one-time cost) for in-take, and $200 per follow-up.
Note: When Cigna approves your Spravato treatment, the manufacturer of Spravato, Janssen Pharmaceuticals, offers a savings card program that can reduce your out-of-pocket cost. The savings card reimburses up to $10,000 toward your copays, deductible, and out-of-pocket maximum related to Spravato. Axis enrolls you in this program automatically.
Calculate for Free your total cost for Spravato treatment in Denver – https://axismh.com/spravato-cost-calculator/
→ Read the full Cigna mental health benefits guide for Colorado.
Aetna: Psychiatry, TMS, and Spravato Coverage Explained
Aetna plans in Colorado cover psychiatry, medication management, Deep TMS, and Spravato for qualifying patients. You can either get a referral from your primary care provider or book an intake directly with us to get a psychiatric evaluation done. Prior authorization is required for TMS and Spravato specifically, but Axis handles that process from start to finish. Telehealth is also supported for psychiatric evaluations and follow-up appointments, which makes getting started straightforward regardless of where in the Denver metro area you live.
For Aetna members, the prior authorization process for Deep TMS and Spravato follows the same medical necessity framework described above. Two documented failed antidepressants, a moderate-to-severe depression diagnosis, and a psychiatric evaluation are the foundation of the approval request.
What makes Aetna coverage worth understanding carefully:
- Aetna’s behavioral health benefits are administered in compliance with Colorado’s parity laws.
- This means your mental health copays and coinsurance should mirror what you’d pay for any other specialty care visit under your plan.
- If your plan covers 80% of outpatient specialist visits after your deductible, it should cover psychiatry and TMS treatment at the same rate.
→ Read the full Aetna mental health benefits guide for Colorado.
United Healthcare: In-Network Coverage at All Axis Locations
United Healthcare — including Optum Behavioral Health, UMR, UHCMC, and UHC employer plans — is one of the largest insurance networks in Colorado. Axis is in-network with all of these plans across our Denver, Aurora, Boulder, DTC, and Westminster locations.
United Healthcare covers psychiatry, medication management, and advanced depression treatments including Deep TMS and Spravato for patients who meet medical necessity criteria. Prior authorization is required for specialty treatments, and our team handles that submission as part of your intake process.
One thing to know about UHC specifically: United Healthcare maintains detailed clinical coverage policies for both TMS and Spravato that are publicly available. They specify the documentation required for approval. Because Axis knows exactly what those policies require, our prior authorization submissions are built to meet those criteria precisely — which is a very different experience than a clinic that submits generic requests and hopes for the best.
→ Read the full United Healthcare mental health benefits guide for Colorado.
Anthem Blue Cross Blue Shield: Broad Coverage, No Annual Session Caps
Anthem BCBS covers the full range of mental health treatment in Colorado, from your first psychiatric intake through advanced treatments for depression.
Under most Colorado Anthem BCBS plans, there is no annual cap on the number of outpatient mental health visits. That means your psychiatric follow-ups, whether monthly, every six weeks, or more frequently if your treatment protocol calls for it, are covered without a session limit. This matters more than most people realize, because a lot of people delay starting psychiatric care out of fear that they’ll hit some invisible ceiling and be cut off.
For Deep TMS and Spravato, Anthem BCBS follows the same prior authorization process. Your coverage under Anthem is tied to medical necessity, not to an arbitrary timeline or a fixed number of sessions. If the treatment is working and your provider documents ongoing clinical benefit, coverage continues.
→ Read the full Anthem BCBS mental health benefits guide for Colorado.
Why Would I Ever Want TMS or Spravato if My Antidepressants Work?
This is a fair question, and it deserves a real answer.
If your antidepressants are working well for you and the side effects are manageable, that is genuinely good. You should stay with what works.
But for people who are on antidepressants and still not feeling fully themselves: low-energy, still emotionally flat, still managing rather than living, there is a middle ground that rarely gets discussed – the experience of being medicated but not recovered.
This is what patients who move to Deep TMS or Spravato often describe as the shift. Not “I was broken and now I’m fixed.” More like: “I got myself back.”
Here’s what one of our patients said when asked about what made her get Spravato:
A post-marketing analysis published in Psychiatry Research, drawing from 1,351 patients across 21 clinical sites, found that 30 sessions of Deep TMS with the BrainsWay H1 coil produced an 81.6% response rate and a 65.3% remission rate.
And one more thing that matters: both Deep TMS and Spravato are designed to help you reduce your reliance on medication over time, not add another pill to your routine. That is the actual goal. Getting you well enough that the scaffolding comes down.
→ Learn more about how advanced treatments like Spravato are changing lives.
→ Compare your options: Deep TMS vs. Ketamine for Women.
What It Actually Looks Like to Get Your Insurance Benefits Verified at Axis
Here is the step-by-step of what happens when you reach out to us. No ambiguity. No “it depends.”
Step 1: You book an intake appointment. No referral needed. You call (720) 400-7025 or book online. This is a 60-minute appointment with one of our psychiatric providers.
Step 2: Before your appointment, we verify your benefits. Our team contacts your insurer directly, confirms your coverage for psychiatry and any advanced treatments you may be eligible for, and gets your real numbers: your deductible status, your copay, your coinsurance, and any prior authorization requirements.
Step 3: At your intake, your provider reviews your history. This is where we assess whether you meet the medical necessity criteria for TMS or Spravato. If you do, we begin building your prior authorization request the same day.
Step 4: We submit the authorization and advocate for approval. You don’t call your insurance company. You don’t translate clinical language into forms you’ve never seen before. We do all of it. If there is a denial, we appeal — and we’re effective at it.
Step 5: You know your costs before any treatment begins. Under federal law, you have the right to a Good Faith Estimate of expected charges. We provide that to every patient. No one starts a treatment protocol at Axis and then gets a surprise bill.
Why Axis Is Different from Other Psychiatric Clinics in Colorado
When you Google, ‘best psychiatric clinic in Denver’, you’ll get a list of options to choose from.
But, here is what is actually different about Axis:
We are locally owned and built for this community.
Axis was not built by a private equity group trying to scale a mental health product across 40 markets. We are a Colorado practice, built by providers who live here and treat the communities they live in Denver, Aurora, Boulder, DTC, Westminster. That is not a tagline. It changes how decisions get made. When we take on a patient, we are not optimizing for throughput. We are thinking about that person’s actual life.
We are not incentivized to keep you on medication indefinitely.
The business model of many large psychiatric networks rewards volume: more patients, more prescriptions, more follow-ups. That model is not inherently wrong, but it is also not oriented toward the goal of getting you off medication. Ours is. Deep TMS and Spravato are treatments we believe in because they have the clinical evidence to back them up. Also because they are designed to get patients to a place where they need less support over time, not more.
Our providers hold this same belief in their individual practice. Kayla Sharpe, PMHNP-BC, one of our board-certified psychiatric nurse practitioners, puts it plainly: “You don’t need to be ‘sick enough’ to deserve care. If you’re struggling, that’s enough.”
That is the standard we hold across every provider at Axis. You do not have to justify how bad it has gotten before you are allowed to ask for something better.
You are not treated by a provider. You are treated by a team.
When you become an Axis patient, your care involves your psychiatric provider, a care coordinator who manages your insurance and prior authorizations, and clinical staff trained on the specific treatment protocol you’re on. Your provider does not disappear between appointments. Your insurance questions don’t go to a call center. You have real people who know your name and your case.
We fight for your coverage.
This is not something every clinic does. When a prior authorization gets denied, the standard response at many practices is to inform the patient and suggest they appeal on their own. At Axis, a denial is the beginning of an advocacy process. We demand peer-to-peer review requests, appeals, escalation to the Colorado Division of Insurance if necessary. We have gotten approvals reversed because we know how to make the clinical case directly to the people who make the decisions.
→ Meet our providers and find someone who specializes in what you’re dealing with.
→ Read patient stories from people in your position.
Ready to Find Out What Your Insurance Actually Covers?
If you got this far, you’re ready to take the next step. Get on a 30-minute call with our experts to understand which depression treatment is best for you, how much it will cost, and when you can start.
5 Frequently Asked Questions About Insurance and Psychiatry in Colorado
How does insurance cover depression treatment in Colorado?
Colorado law requires every major insurance plan to cover mental health treatment, including depression care, at the same level it covers physical health care. This is called mental health parity. In practice, it means your insurer cannot charge you more for a psychiatry visit than for a specialist medical visit, and cannot apply stricter prior authorization rules to mental health care than to comparable physical health procedures.
For advanced treatments like Deep TMS and Spravato, coverage is typically available after you document two failed antidepressant trials. Axis verifies your specific benefits before your first appointment so you understand your real costs.
→ See our full fees and insurance guide
What does Cigna cover for TMS and Spravato in Colorado?
Cigna covers both Deep TMS and Spravato for treatment-resistant depression after prior authorization. The standard criteria are two failed antidepressant trials from different drug classes, a documented depression diagnosis, and a psychiatric evaluation. Axis handles the entire prior authorization process on your behalf. For Spravato, the Janssen Pharmaceuticals savings card program can reduce your out-of-pocket cost to as little as $10 per session, with up to $10,000 in manufacturer reimbursement applied toward your cost-sharing.
→ Read the Cigna insurance guide for Axis patients
Can I use Aetna or United Healthcare to pay for TMS therapy in Denver or Boulder?
Yes. Both Aetna and United Healthcare cover TMS therapy for qualifying patients in Colorado. Axis is in-network with Aetna, United Healthcare, Optum Behavioral Health, UMR, and UHCMC at our Denver, Aurora, Boulder, DTC, and Westminster locations. No referral is required to book your intake appointment. Prior authorization for TMS is required under both plans, and Axis submits that on your behalf.
→ Aetna insurance guide | United Healthcare insurance guide
How can I find out if my insurance covers Spravato?
The fastest way is to let Axis check for you. When you book an intake appointment, our team contacts your insurer directly, confirms your Spravato eligibility, and gives you a written cost estimate before anything begins. If you’d prefer to check yourself first, call the member services number on your insurance card and ask: “Does my plan cover Spravato esketamine nasal spray for treatment-resistant depression, and what are the prior authorization criteria?”
→ Book your intake appointment
What can I do if my insurance denies coverage for TMS or Spravato?
Under Colorado’s mental health parity law, your insurer cannot deny a mental health treatment using standards it would not apply to a physical health procedure. If Axis submits a prior authorization and it is denied, we immediately request a peer-to-peer review, where one of our providers speaks directly with the insurer’s medical reviewer. If the appeal is unsuccessful, we can help you escalate to the Colorado Division of Insurance. A denial is the beginning of the process, not the end.
