Does UnitedHealthcare cover Spravato?

UnitedHealthcare publishes 2026 coverage criteria for Spravato, but approval depends on the specific benefit plan and whether the patient meets the applicable clinical and authorization requirements.

What the 2026 UnitedHealthcare policy says

UnitedHealthcare's commercial prior-authorization policy, effective July 1, 2026, describes criteria that must be met for approval. A separate 2026 medical-benefit drug policy also describes Spravato as proven for treatment-resistant depression when specified requirements are met.

Sources: UnitedHealthcare Spravato prior authorization, effective July 1, 2026 · UnitedHealthcare Ketalar and Spravato medical benefit policy, effective May 1, 2026

What you should verify before choosing a clinic

• Whether your exact UHC or Optum plan is accepted by the clinic.
• Whether Spravato is processed through your medical or pharmacy benefit.
• Which prior-authorization documentation is required.
• Your deductible, copay, and coinsurance for both the medication and monitored visit.
• Whether the clinic handles the authorization process.

NYC provider example

Being Health currently states that it is in network with UnitedHealthcare and Optum for a majority of providers and lists Spravato among services eligible for coverage depending on plan. Provider participation can change, so verify directly.

Source: Being Health insurance page

Frequently asked questions

Does every UnitedHealthcare plan cover Spravato?

No. UnitedHealthcare publishes coverage criteria, but benefit design and approval can differ by plan.

Does UnitedHealthcare require prior authorization for Spravato?

UnitedHealthcare publishes a commercial prior-authorization program for Spravato. Verify the requirements for your specific plan.

Can a clinic tell me my final cost?

A clinic can often estimate benefits, but the final patient responsibility depends on how the claim processes under your plan.

Related guides