DOES INSURANCE COVER PSYCHEDELIC THERAPY FOR VETERANS WITH A BRAIN INJURY?
Several nations already offer medical treatments involving psychedelics and post-traumatic stress disorder (PTSD), including Australia. There are also retreats available in Jamaica, Mexico, and Peru. However, the United States looks to finally be making progress and now, questions about insurance covering the treatment are becoming much more pertinent for the Veteran community. Below, we’re exploring coverage for psychedelics and MDMA for PTSD and depression along with how treatment is being handled stateside.
What Is Psychedelic Therapy?
Psychedelic therapy uses drugs, such as MDMA and psilocybin, in a controlled environment under medical supervision, to help with mental health.
When a Veteran is undergoing this type of therapy treatment, a medical professional will help guide them through experiencing their thoughts and emotions.
The key is to provide a supportive environment where Veterans can face their traumatic experiences and memories in a way that is safe. The goal is to help reduce the stress and anxiety they typically experience when thinking about that memory or experience.
MDMA for PTSD, Insurance Coverage, and Cost
Without FDA approval, it’s going to be hard if not impossible for insurance to cover MDMA for PTSD or any other psychedelic treatment for a related mental health issue.
As it stands, MDMA, often known as ecstasy, is a Schedule I substance and despite evidence that it can help people suffering from PTSD, most insurance plans won’t cover such treatment.
There are some instances in which exceptions may apply, particularly as the use of MDMA treatment becomes more accepted, as seen in recent developments within VA-approved studies.
Still, these are off-label applications not covered by insurance plans and if carriers do start allowing coverage, it won’t be for use outside of specific healthcare treatments, such as depression and PTSD.
It’s worth noting that while insurance doesn’t cover these healthcare costs just yet, the American Medical Association (AMA) has insurance billing codes approved for psychedelic therapy.
The cost of such healthcare is still debated as insurance carriers will have to cover the actual medicine; however, it’s the expertise and hours of labor that will surely make up a bulk of the expenses.
Estimates point to a potential cost point of $15,000 to $25,000 depending on multiple factors for an entire round of psychedelic treatment.
VA Psychedelic Therapy is Encouraging, Despite FDA Lagging
For decades, a variety of psychedelics have been known to alter consciousness, however, they’re known more for being more-or-less party drugs.
In part, because the DEA has them listed as controlled substances, research for healthcare applications has been limited as a result.
However, in recent years, more and more experts are looking at psychedelics as a potential treatment for mental health issues.
This would not simply be programs giving Veterans drugs and sending them on their way but are often in support of other forms of therapy as well.
The FDA has allowed for treatment using ecstasy in conjunction with talk therapy but did go back on its support.
In June 2024, the FDA Advisory Committee voted against approving MDMA-assisted therapy (MDMA-AT) for PTSD, citing flawed research, insufficient follow-up data, and a lack of trial diversity.
Although the FDA didn’t outright reject the MDMA treatment for PTSD, the agency is now wanting another Phase 3 trial, hoping to clear up its concerns.
Because of this, lawmakers on both sides of the political aisle and hundreds of Veterans urged President Biden to support FDA approval, with groups supporting Veterans expressing criticism over the delay.
Data shows that 1,200+ Veterans have gone abroad to take part in psychedelic therapies outside of the United States.
MDMA for PTSD: Veteran Data Needed
Experts have been pushing lawmakers and government agencies to provide more access to MDMA for Veterans.
The use of psychedelics for treating depression, PTSD, and other mental health issues has limited data especially when it comes to the Veteran community specifically.
With support from medical experts, VA psychedelic therapy is now an approved project that could provide meaningful data to help make additional opportunities available in the future.
Experts believe psilocybin can help depression with its effects lasting up to a year, however, because of the government’s stance on the drug, there isn’t much data involving the Veteran population.
Using MDMA for PTSD is still in somewhat early stages for Americans; however, the Veteran community can benefit from participating not only by reaping the benefits in their own health but by also providing necessary data to support treatment for warfighters moving forward.
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