We already publish a full guide to Spravato cost and insurance and a full TMS vs esketamine comparison. This page pulls the checkable facts out of both into one list, so you can run through it before or during a call with a clinic.
Methodology. Every point below restates a sentence already published on this site, in either our Spravato cost guide or our TMS vs esketamine comparison. Nothing here is a new number or a new claim. Compiled and pulled July 14, 2026.
Insurance and payer questions (from our Spravato cost guide)
- Commercial insurance often covers Spravato for people who have tried other antidepressants without enough relief; you typically pay a copay or coinsurance per visit rather than the full price.
- Medicare generally covers Spravato when it is administered in a clinic, though specific costs depend on your plan.
- MO HealthNet (Missouri Medicaid) is accepted by some Missouri clinics for Spravato when it is medically necessary and prior authorization is approved.
- Prior authorization is required by most insurers before they cover Spravato, typically documenting that you have taken an adequate course of two or more antidepressants without enough relief. The clinic normally handles this paperwork, not you.
- Out-of-pocket cost depends heavily on your insurance, your deductible, and how many doses you receive; when covered, most people pay a per-visit copay rather than the medication's full price.
- Manufacturer savings program may lower costs for eligible patients with commercial insurance.
- A clinic can run your specific coverage and give you a realistic estimate before your first appointment; that estimate is the single most useful number, since there is no honest one-size-fits-all price.
Source: Spravato cost and insurance in Missouri: what to expect.
Logistics that affect your day (from our TMS vs esketamine comparison)
- TMS schedule: typically short sessions on most weekdays over roughly four to six weeks.
- Esketamine schedule: given in the clinic, usually twice a week at first, then tapering to less frequent visits.
- Driving: after TMS you can drive yourself and return to normal activities right away; after esketamine you are monitored for about two hours and cannot drive yourself home that day.
- Side effects to plan around: TMS's most common effects are scalp discomfort or a tapping sensation and occasional headache; esketamine can bring temporary dizziness, a dissociated feeling, nausea, or a short rise in blood pressure during the monitoring window.
- Both require specialized equipment, training, and monitoring, so they are only offered at certain clinics; it helps to seek out a program that actually provides them rather than assuming your current provider does.
Source: TMS vs esketamine (Spravato): how the two compare.
The bottom line
None of this replaces a real conversation with a clinic that can check your specific plan. What it does is put the checkable, already-published facts about paying for Spravato and TMS on one page, so you are not re-reading two full guides to get ready for a phone call.