If you’re struggling with treatment-resistant depression in Utah and wondering whether your University of Utah Health Plan (UUHP) covers Spravato (esketamine), you’re not alone. Navigating insurance coverage for newer mental health treatments can feel overwhelming, but the short answer is: yes, University of Utah Health Plans can cover Spravato, though coverage depends on your specific plan and meeting certain clinical criteria.
This guide walks you through everything Utah residents need to know about getting Spravato covered through University of Utah Health Plans, how the Huntsman Mental Health Institute (HMHI) connects to your coverage, and how Anew Therapy, a REMS-certified, HMHI-partnered clinic, can help you access treatment without the runaround.
What Is Spravato (Esketamine)?
Spravato is an FDA-approved nasal spray containing esketamine, which is a derivative of the anesthetic ketamine. It was approved in 2019 specifically to treat:
- Treatment-Resistant Depression (TRD): Major depression that has not responded to at least two adequate antidepressant trials
- Major Depressive Disorder (MDD) with Acute Suicidal Ideation or Behavior
Unlike traditional antidepressants, which can take weeks to work, Spravato targets NMDA receptors in the brain to rapidly restore neural connections. Many patients experience measurable relief within hours of their first session, which makes it a critical option for those in urgent need.Spravato is not a take-home medication. It must be administered in a certified healthcare setting under medical supervision, and patients are monitored for at least two hours after each dose. This supervised model is part of the FDA’s Risk Evaluation and Mitigation Strategy (REMS) program for Spravato.
University of Utah Health Plans: An Overview
University of Utah Health Plans (UUHP) operates as part of the University of Utah Health system, and offers several plan types relevant to Utah residents:
- UUHP Individual & Commercial Plans – For individuals and employer groups across the Wasatch Front and broader Utah market
- Healthy U (Medicaid) – Utah’s Medicaid managed care plan for eligible low-income residents
- Healthy U CHIP – Children’s Health Insurance Program coverage for qualifying children and families
Each plan has its own Spravato prior authorization criteria. Understanding which plan you’re on is the essential first step.
Do University of Utah Health Plan Cover Spravato?
UUHP Individual & Commercial Plans
For most commercial members, Spravato is a covered benefit when medical necessity criteria are met and prior authorization is obtained. Coverage under commercial plans generally follows standard clinical guidelines aligned with FDA-approved indications.
Healthy U (Medicaid)
University of Utah’s Healthy U Medicaid plan follows Utah Medicaid guidelines for Spravato. Utah Medicaid does have a prior authorization pathway for Spravato, and coverage is possible but the criteria are very stringent. Patients must typically demonstrate:
- A diagnosis of moderate to severe major depressive disorder
- Failure of at least three antidepressants from three different classes at maximum tolerated doses for at least 8 weeks each
- An inadequate response to intravenous ketamine treatment
- An inadequate response to Electroconvulsive Therapy (ECT)
- No recent history of substance abuse or alcohol use disorder
This “step therapy” approach means Healthy U Medicaid members face a higher documentation bar than commercial plan members. Patients pursuing this route will need comprehensive psychiatric records and provider advocacy.
Healthy U CHIP
The Healthy U CHIP plan follows the same Spravato prior authorization criteria as Healthy U Medicaid (Policy PHARM-CHIP-069, effective October 2025). The same clinical documentation requirements apply.
Criteria for Spravato Coverage Under University of Utah Health Plans
While requirements vary by plan, most UUHP coverage pathways share these core clinical criteria:
1. Confirmed Diagnosis
Documentation of a DSM-5 diagnosis of treatment-resistant depression (TRD) or major depressive disorder (MDD) with acute suicidal ideation or behavior is required.
2. Documented Treatment Failures
You must show an adequate trial history, including medications tried, doses used, duration of treatment, and documented reasons for failure or inadequate response.
3. Psychiatric Oversight
Spravato must be prescribed by or in consultation with a board-certified psychiatrist. Through its partnership with HMHI, Anew Therapy is able to meet this requirement and coordinate the psychiatric oversight needed for insurance approval under University of Utah Health Plans.
4. REMS Program Compliance
Anew Therapy is fully REMS-certified, and through our HMHI partnership, we are in-network for most University of Utah Health Plans. The patient, prescribing provider, dispensing pharmacy, and treatment center must all be enrolled in the FDA-mandated Spravato REMS program.
5. Prior Authorization
Prior authorization is required for all UUHP plan types. Your provider must submit clinical notes, diagnosis documentation, and treatment history to the plan before treatment begins. If one of our providers think you would be a good candidate for Spravato, Anew Therapy will do all the heavy lifting when it comes to submitting and coordinating your prior authorization.
Why the HMHI Partnership Matters for Your Spravato Coverage
The Huntsman Mental Health Institute (HMHI), located at the University of Utah’s Research Park in Salt Lake City, is Utah’s premier psychiatric treatment and research institution. Backed by a landmark $150 million gift from the Huntsman family, HMHI is part of the University of Utah Health system and has been at the forefront of ketamine-based depression treatment in the state for years, including through their Treatment Resistant Mood Disorder (TRMD) Clinic.
HMHI’s standing within the University of Utah Health network is what makes it such a meaningful partner for independent clinics seeking to serve UUHP members. Anew Therapy’s partnership with HMHI is the key reason we are able to accept University of Utah Health Plans, including most commercial UUHP plans, for Spravato treatment. Rather than navigating a large academic hospital system, this partnership allows Anew to offer the same insurance access in a more personalized, accessible clinical setting.
In other words: you get the credibility and insurance reach of the HMHI/University of Utah Health network, delivered through the individualized care experience that Anew Therapy is built around.
Comparing Spravato Coverage: UUHP vs. Other Utah Insurers
Ready to Start Spravato Treatment in Utah?
If you’re a University of Utah Health Plan member ready to explore Spravato, Anew Therapy is a REMS-certified Spravato provider serving patients across the Wasatch Front. We accept most major Utah insurance plans, including UUHP, thanks to our partnership with HMHI.
At Anew Therapy, we understand that getting to treatment is half the battle. Our team specializes in navigating the prior authorization process, so you don’t have to figure it out alone. Here’s what sets us apart:
- REMS-Certified: Fully enrolled in the FDA-mandated Spravato REMS program, meaning we’re authorized to legally prescribe and administer esketamine treatment
- HMHI-Partnered: Our institutional partnership with the Huntsman Mental Health Institute is what makes University of Utah Health Plan coverage possible at our clinic
- Insurance-Friendly: We work with most major Utah insurance carriers and handle prior authorization coordination on your behalf
- Holistic Approach: We offer both Spravato and intramuscular (IM) ketamine therapy, building individualized treatment plans around your unique clinical history and goals
- Rapid Access: We know that for patients with treatment-resistant depression, time matters. We work to get you into treatment as quickly as possible
- Personalized Care: Every patient receives a thorough psychiatric evaluation and a treatment plan tailored to their specific needs and budget
Whether you’re just starting to explore your options or you’ve already been denied coverage once, our team can help you understand your path forward and fight for the coverage you deserve.
Just schedule a free consultation today or call our team at (801) 980-2690.
Frequently Asked Questions (FAQ)
Does the University of Utah Health Plan cover Spravato?
Yes – for UUHP Individual & Commercial plan members who meet medical necessity criteria and obtain prior authorization. Healthy U Medicaid and CHIP members may also access coverage but face more stringent step-therapy requirements, including failed trials of ECT and IV ketamine.
How many antidepressants do I need to have tried before UUHP will cover Spravato?
For commercial UUHP plans, the standard requirement is failure of at least two antidepressants. For Healthy U CHIP specifically, the plan requires failure of at least three antidepressants from three different classes, plus inadequate response to IV ketamine and ECT. Always confirm current criteria with your provider or UUHP directly, as these policies are reviewed annually.
How long does Spravato treatment last?
The initial induction phase involves two sessions per week for four weeks. Based on your response, your psychiatrist may move you to a maintenance schedule of once per week, then once every two weeks. Total duration varies by individual. Some patients continue maintenance treatment for months or longer.
What if UUHP denies my Spravato prior authorization?
A denial is not necessarily final. You and your provider can file a formal appeal, submitting additional clinical documentation, peer-reviewed literature supporting Spravato’s efficacy, and a detailed letter of medical necessity. Many initial denials are overturned on appeal. Anew Therapy’s team has experience navigating appeals and can support you through the process.
Is Spravato covered differently than IV ketamine in Utah?
Yes! Because Spravato is FDA-approved for depression, it has an established insurance coverage pathway. IV and intramuscular (IM) ketamine are considered off-label treatments and are almost never covered by insurance, typically costing $300–$500 per session out of pocket. This is a major financial distinction for Utah patients seeking ketamine-based therapy.
Are you a University of Utah faculty or staff member wondering what mental health treatments are covered by your University of Utah Health Plan? Anew Therapy now accepts HMHI coverage and offers therapy, TMS, and ketamine-assisted treatment in Utah. Schedule a free consultation today.
