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Spravato
PacificSource Health Plans
PacificSource Health Plans Coverage for Spravato
All
6
Commercial
3
Health Exchange
2
Medicare
1
Commercial
Commercial - PPO
PA Required
Step Therapy
Quantity Limit
See Details
Commercial - HMO
PA Required
Step Therapy
Quantity Limit
See Details
Commercial - Employer
PA Required
Step Therapy
Quantity Limit
See Details
Health Exchange
Health Exchange - PPO - Health Insurance Exchange
PA Required
Step Therapy
Quantity Limit
See Details
Health Exchange - POS - Health Insurance Exchange
PA Required
Step Therapy
Quantity Limit
See Details
Medicare
Medicare - Medicare Advantage Part D
PA Required
Step Therapy
Quantity Limit
See Details
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Does PacificSource Health Plans Cover Spravato? 6 Plans (2026)