Ketamine (Spravato) Therapy for Individuals with Illinois Medicaid

Reviewed by: Michelle Dees, MD | Last Reviewed: 1/4/2026
Luxury Psychiatry | Ketamine (Spravato) Therapy for Individuals with Illinois Medicaid

Spravato is a prescription nasal spray that contains esketamine, a medication approved for certain treatment-resistant mental health conditions such as depression. Many people know esketamine treatment simply as “ketamine therapy,” but it is important to note that Spravato (nasal spray) and IV ketamine infusions are different drugs, approved and regulated in distinct ways. 

Spravato can only be administered in a certified medical clinic, where you are monitored by trained healthcare staff throughout and after each dose.

For Illinois Medicaid plan members, including those enrolled in managed care plans, some coverage may be available for Spravato therapy if specific medical criteria are met. If you are facing symptoms that have not improved with other treatments, there may be options for you.

What Is Spravato?

Spravato is the brand name for esketamine, a medication closely related to ketamine treatment, but not the exact same chemical compound. While both are part of the same drug class, Spravato’s esketamine is an FDA-approved treatment specifically developed for chronic, treatment-resistant depression and certain other approved depressive conditions.

Unlike traditional antidepressants, Spravato is delivered as an intranasal spray, right in your provider’s office or clinic, with a healthcare professional providing supervision before, during, and after treatment. This close monitoring is important because Spravato can cause side effects such as dissociation, dizziness, sedation, or changes in perception. It requires a structured treatment plan around dosing sessions to monitor these potential adverse effects.

Does Illinois Medicaid Cover Spravato Therapy?

Some Chicago, Illinois Medicaid plans may offer coverage for Spravato therapy if certain criteria are met. You generally need:

  • To be enrolled in a qualifying Illinois Medicaid managed care plan (such as CountyCare, Meridian, Aetna Better Health, Blue Cross Community MMAI, or other local plans)
  • A formal diagnosis of a treatment-resistant mental health condition eligible under your insurance policy
  • To meet established medical necessity requirements; this usually means you have tried and not seen results with several other antidepressant treatments
  • Prior authorization or written approval from your Medicaid managed care plan before you begin treatment

Our clinic can help you navigate each of these requirements. Before you start Spravato therapy, we work with your insurance plan to verify your coverage and take care of as much paperwork and approvals as possible.

Meet Our Psychiatry Team with Your Medicaid Plan

Our experienced psychiatry team is proud to serve individuals with Medicaid in Chicago, offering compassionate, evidence-based mental health care in an outpatient setting. By selecting a provider from the carousel below, you can schedule your first appointment with a psychiatrist or psychiatric nurse practitioner who is in-network with your Medicaid plan. Whether you’re seeking a psychiatric evaluation, medication management, or ongoing mental health support, our team is here to guide you every step of the way.

Appointments are in person for all initial and annual appointments for the completion of paperwork. Please allow 60-90 minutes. Tele Medicine appointments can be available for routine follow-ups subject to the provider. Tele Medicine is subject to change depending on insurance guidelines. Book appointments online or download our mobile app. We do not communicate via text or email other than appointment reminders. *

*All Florida patients will be seen (Central Standard Time | CST).    

*If you’re asking or are on a controlled substance, the first and yearly appointments must be in person. Follow-up appointments can be made via telemedicine. 

Ready to Book An Appointment With Our Psychiatrists?

Luxury Psychiatry | Ketamine (Spravato) Therapy for Individuals with Illinois Medicaid
Luxury Psychiatry | Ketamine (Spravato) Therapy for Individuals with Illinois Medicaid
Luxury Psychiatry | Ketamine (Spravato) Therapy for Individuals with Illinois Medicaid
Luxury Psychiatry | Ketamine (Spravato) Therapy for Individuals with Illinois Medicaid
Luxury Psychiatry | Ketamine (Spravato) Therapy for Individuals with Illinois Medicaid
Luxury Psychiatry | Ketamine (Spravato) Therapy for Individuals with Illinois Medicaid
Luxury Psychiatry | Ketamine (Spravato) Therapy for Individuals with Illinois Medicaid
Luxury Psychiatry | Ketamine (Spravato) Therapy for Individuals with Illinois Medicaid
Luxury Psychiatry | Ketamine (Spravato) Therapy for Individuals with Illinois Medicaid
Luxury Psychiatry | Ketamine (Spravato) Therapy for Individuals with Illinois Medicaid

What if Insurance Doesn't Cover Spravato?

If your insurance, including Illinois Medicaid, does not cover Spravato therapy, you still have several options to consider. You can ask your prescribing provider if you might qualify with further documentation or by meeting additional medical criteria; sometimes insurance coverage can be reconsidered on appeal or with added information.

If you are denied coverage after trying all available approvals and appeals, you may choose to self-pay for Spravato treatments, though the costs can be significant. Some clinics and providers can help you understand treatment costs up front or offer payment plans. No matter what your situation is, it is worth speaking directly with your clinic’s insurance or patient assistance team.

How Spravato Differs From IV Ketamine Therapy

Although many people use the term “ketamine therapy” for both IV infusion and Spravato treatment, there are key differences:

IV Ketamine Therapy Features

  • Low-dose (sub-anesthetic) IV ketamine is delivered through an intravenous (infusion) line, administering doses of ketamine. It is usually short-term.
  • Insurance coverage is rare because, despite people saying it increases their well-being, IV ketamine is not officially FDA approved for depression; most use of ketamine is considered “off-label.”
  • Treatment protocols may vary by clinic; there is less formal standardization for treatments and follow-up.
  • Ketamine is used for a range of mental health concerns since it is off label, including depression and post-traumatic stress disorder.

Spravato (Esketamine Nasal Spray) Features

  • Spravato uses esketamine, an approved medication with well-defined dosing and observation requirements.
  • It’s FDA approved for adults with treatment-resistant depression and depression with suicidality.
  • Illinois Medicaid managed care, and a growing number of commercial and public insurance plans, may cover Spravato after certain authorizations.
  • By law, each dose must be given in-office at a certified site, with observed pre- and post-dose monitoring for at least two hours after each administration.

Both treatments are considered controlled substances.

If you are living with depression that has not responded to standard therapies and are covered by Illinois Medicaid, Spravato may offer the help you need and deserve to improve your overall wellness.

Treatments We Offer Alongside Spravato

Our clinic offers a comprehensive, personalized approach to care for individuals undergoing Spravato therapy. In addition to Spravato, we can provide several other types of treatments that can be incredibly beneficial when used alongside it.

Medication Management

Our psychiatric providers carefully monitor and adjust other medications you may be taking for depression, anxiety, or related conditions to help maximize results and minimize side effects.

Psychotherapy (Talk Therapy)

We provide therapy to help you process emotions, develop coping skills, and create longer-lasting changes alongside Spravato treatment.

Cognitive Behavioral Therapy (CBT)

CBT is a highly researched form of therapy proven effective for depression, anxiety, and trauma. It helps you identify unhealthy thinking patterns and make positive shifts in your behaviors.

Contact Luxury Psychiatry Clinic To Schedule Your Consultation

If you have questions about Spravato therapy, treatment options, or insurance coverage, the team at Luxury Psychiatry Clinic is here to help. Our staff can walk you through your eligibility and discuss all possible treatment options. Contact Luxury Psychiatry Clinic today to schedule a consultation with one of our mental health clinicians.

Schedule your appointment:

* Any patient needing a controlled substance needs a face-to-face appointment with the provider prior to the prescription being sent to be compliant with the DEA guidelines.

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    Select your desired appointment type.
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    Choose your staff member and desired location or leave as “ALL,” and we will match you!
  • Step 3
    Search for your date range and select from available times.

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