brookelyn33
Greenlighter
- Joined
- Mar 29, 2017
- Messages
- 21
Insurance will pay for ketamine infusions for both depression and chronic pain. My husband and one of my good friends have a chronic pain disease called RSD (Reflex Sympathetic Dystrophy). My friend had hers done at Cleveland Clinic....Her Medicaid insurance wouldn't pick this up because we are from PA but her parents work insurance that she is also on did. A branch of a well respected NY ketamine clinic opened fairly close to where we live in PA and my husbands Medicaid insurance picked up the whole bill of 7 infusions. After my husbands last infusion we were given a script for ketamine. Regular pharmacies don't carry ketamine. You have to go to a compounding pharmacy to have the script filled. Some insurances will cover a script for ketamine. While Medicaid wouldn't pay for my husbands ketamine script, my friends ketamine script was covered by her parents insurance. It was fairly cheap to fill at $1.00 a pill.
While I was at the clinic those 7 days I got to meet and talk to a handful of people that brought loved ones in for infusions for depression. 2 of them on Medicaid, and 3 on random insurances. All of their infusions where 100% covered as were the scripts for the 3 not on Medicaid.
I got to spend a lot of time with the Dr that runs/owns the clinic here (It's a very small clinic, only 3 patient rooms and I never saw more than 1 other patient there at the same time as my husband) so I got to ask him a lot of questions. He told me that Ketamine treatment is basically a last resort for his patients and its much cheaper for insurance companies to at least let the patient try it because if it does work it's more cost effective. Think about how expensive all those pills from big pharma, your insurance pays for most of it and you have a co-pay. Think of how happy an insurance company would be if they only had to pay a percentage of say $60 for 60 pills as compared to a percentage of $600-$800 for a 30 day script of Zoloft or oxycodone. Which is why a lot of insurances are starting to become more open-minded about ketamine treatments.
While I was at the clinic those 7 days I got to meet and talk to a handful of people that brought loved ones in for infusions for depression. 2 of them on Medicaid, and 3 on random insurances. All of their infusions where 100% covered as were the scripts for the 3 not on Medicaid.
I got to spend a lot of time with the Dr that runs/owns the clinic here (It's a very small clinic, only 3 patient rooms and I never saw more than 1 other patient there at the same time as my husband) so I got to ask him a lot of questions. He told me that Ketamine treatment is basically a last resort for his patients and its much cheaper for insurance companies to at least let the patient try it because if it does work it's more cost effective. Think about how expensive all those pills from big pharma, your insurance pays for most of it and you have a co-pay. Think of how happy an insurance company would be if they only had to pay a percentage of say $60 for 60 pills as compared to a percentage of $600-$800 for a 30 day script of Zoloft or oxycodone. Which is why a lot of insurances are starting to become more open-minded about ketamine treatments.