Second-Line Treatment

Second-line treatment in behavioral health refers to the next set of therapeutic options used when initial treatments (first-line treatments) do not provide sufficient relief or improvement.

Transcranial Magnetic Stimulation is a non-invasive, non-pharmacological approach to treat Treatment Resistant Depression (TRD). It is a covered benefit on all Select Health Plans, starting September 1, 2024, including Select Health Community Care (SHCC). A pre-authorization is required on all plans, please see Select Health TMS policy (#241) for further details.

Spravato, also known as Esketamine, is a CIII medication, FDA approved for treatment of Treatment Resistant Depression (TRD) in adults. Spravato is currently not a covered benefit on Select Health RxCore Formulary Plans. It is currently a covered benefit on Select Health RxSelect Formulary Plans, however it requires a pre-authorization. It is possible that members on either formulary plan could be approved for Spravato coverage through the appeals process.

Ketamine is not currently FDA approved for treatment of Treatment Resistant Depression (TRD) in adults. However, intravenous, intra-muscular and even nasal and oral Ketamine is currently being prescribed and administered throughout the community to treat TRD.  As Ketamine treatment and coverage is a rapidly evolving field and subject to change, providers are encouraged to contact their Select Health provider representative with any questions.

Currently, Psychedelics, such as Lysergic acid diethylamide (LSD), 3,4-Methylenedioxymethamphetamine (MDMA) and Psilocybin, are not FDA approved for usage for any mental health treatment and are not covered in any form by any Select Health Plan or pharmacy formulary at this time. However, the use of Psychedelics to treat mental health conditions is an evolving field and subject to change.