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Does Medicare Cover Ketamine Infusion for Depression?

Ketamine infusion therapy is one of the leading experimental treatments used to treat mental health conditions, illnesses and disorders. This includes major depressive disorder, anxiety, bipolar disorder, and post-traumatic stress disorder.

Unfortunately, millions of patients worldwide are experiencing depression. And conventional treatments fail many of them.

However, ketamine infusion therapy has been the focus of some promising research in treating mental illness. And there may be a chance it will become the conventional treatment for several mental disorders.

Does Medicare Cover Ketamine Infusion for Depression?

At this time, Medicare does NOT cover ketamine infusion for depression. Medicare typically only covers drug treatments approved by the Food and Drug Administration (FDA). And ketamine infusion for depression is not currently FDA approved for the treatment of major depressive disorder or bipolar disorder.

However, insurance coverage may be available. Some clinics that offer this treatment get coverage for patients from private insurance companies. Also, if you can’t afford the cost of Ketamine treatment for depression, you can look into enrolling in a clinical trial.

How Much Does Ketamine Infusion Cost?

Ketamine infusions can cost from $400-$2000 depending on the provider, and location.

Costs depend on the ketamine dose, duration of infusion, and treated condition. This is because some conditions require a lower concentration of Ketamine.

According to Ketamine Advocacy Network, Ketamine infusions can cost between $400-$800. You can also expect an additional initial fee for consultation and assessment of around $350.

For Depression

For Depression, Ketamine infusion can cost between $400-$800 per treatment. Most clinics perform six treatments over 2 to 3 weeks. However some providers offer four treatments over 1 to 2 weeks.

Many ketamine clinics will determine if subsequent infusions are necessary depending on the results of the first infusion. Depending on the price per infusion, a full series of ketamine infusions can cost from $1600 to $4800.

For Pain

For pain, a single infusion can cost between $700 to $2000 per treatment.

Ketamine infusions for pain are more expensive than others. This is because ketamine drugs are used per infusion, and the infusions last longer. Though some ketamine doctors offer a single infusion, most perform a series of 2-8 infusions.

Depending on the price per infusion, a series of infusions can cost from $1400 to over $12,000. After initial treatments, patients usually require a maintenance IV (once per month), costing $400 to $800 per treatment.

For Other Conditions

For PTSD, OCD, and other conditions, ketamine infusions can cost from $400 to $800 per treatment. Patients may require a few to a dozen infusions to successfully treat other complex mental disorders. There is no standard series of infusions on treating PTSD, OCD, and other psychiatric conditions.

What is Ketamine?

Ketamine is a medicinal substance that’s historically been used for its anesthetic effects. The substance provides pain relief and sedation when used in clinical doses, making it effective on chronic pain. Discovered in 1962, the US approved of its use eight years later. 

What Is Ketamine Infusion Used For?

Besides being used as an anesthetic, Ketamine is also used to treat Major Depressive Disorder, Anxiety, and Post-Traumatic Stress Disorder. Though initially designed for human use, Ketamine is also used as a surgical anesthetic for large mammal species.

Is Ketamine Safe?

Multiple studies show Ketamine is safe for use as an acute treatment method for several mental illnesses and disorders such as:

  • Severe Depression
  • Obsessive-Compulsive Disorder
  •  Suicidal Ideation

After years of supervised therapeutic applications and research, the use of Ketamine in clinical settings has been deemed safe. However, it does have some serious side effects. Be sure to check with your health care provider to see if it’s a good, safe option for you.

How Long Will It Last?

How long the effects of Ketamine last depend on the person getting the treatment.

Most patients who had their first infusion of the substance felt relief for several days. Patients who suffer from chronic depression are often held back by self-defeating thoughts that have been around for an extended period. After the infusion of Ketamine, patients are relieved of the disorder’s symptoms. They can have long-term positive effects on their well-being.

How Many Infusions Of Ketamine Are Necessary?

The number of infusions will depend on the severity of your mood disorder and your medical history. Still, most Ketamine clinics administer no less than two infusions for new patients.

Many clinics administer two infusions three or four days apart from each other. After that, doctors will determine if subsequent infusions are necessary.

How Long Will It Take For It To Affect Your Body?

Those receiving Ketamine infusion therapy were found to get anti-depressant benefits within 24 hours of the treatment. (This is according to research conducted at the Icahn School of Medicine at Mount Sinai.) This is faster compared to other treatment methods, which may take months to effect. 

Note: Medicare changes all the time. Always be sure to double check with your health care provider and/or Medicare insurance provider about what is and isn’t covered by your plan.

Additional Info on Medicare Coverage

This article is part of our series on “What does Medicare cover?”

Or check out another article in this series: Does Medicare Cover Tooth Implants?

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