Insurance companies do not usually pay for medications that are given for “off-label use”. “Off-Label” use of a medicine is very common actually. Think of the use of aspirin for people with heart disease. Aspirin was not originally made and tested for that use, but its chemical properties made it beneficial for people with heart disease.  In the early 1960’s, the FDA approved Ketamine for anesthetic use. Further research on Ketamine in the 1990s began to focus attention on its therapeutic benefits on the treatment of chronic pain and because of its benefits, many insurance companies cover the costs of ketamine infusions when given for pain.  Many studies looking at the benefits of ketamine for mental health issues have been published, but currently the FDA has not approved Ketamine for the treatment of depression or other mental health issues. This may change in the near future.