The Public Service Health Care Plan (PSHCP), administered by Canada Life, covers approximately 1.5 million federal public servants, retirees, and dependants. PSHCP's prior-authorization pathway for Spravato (intranasal esketamine) via Form M7520 (Canada Life's Spravato request form) is one of the most established Canadian private insurance routes to psychedelic-assisted therapy, and is particularly relevant for Ottawa's federal workforce. The pathway has documented operational maturity since Spravato's Health Canada approval in May 2020. Eligibility typically requires documented TRD (treatment-resistant depression) with failed antidepressant trials, Spravato + concurrent oral SSRI/SNRI per the Health Canada-approved indication, and administration in a Janssen Journey-certified clinical setting. Reimbursement is at 80% of the lowest-priced generic equivalent as of January 2024. This article walks through the PSHCP Spravato pathway in detail.
Key takeaways
- PSHCP (administered by Canada Life) covers ~1.5 million federal public servants, retirees, dependants — particularly relevant to Ottawa workforce.
- Form M7520 is the documented prior-authorization form for Spravato.
- Eligibility: documented TRD with failed antidepressant trials; Spravato + concurrent oral SSRI/SNRI; Janssen Journey-certified clinical setting.
- Reimbursement: at 80% of lowest-priced generic equivalent (PSHCP standard) since January 2024.
- One of the most established Canadian private insurance pathways for any psychedelic-assisted therapy product.
- Practical access: through Canadian Spravato providers — Royal Ottawa BMO Innovative Clinic for Depression, Jewish General Hospital Montreal, Edmonton hospital affiliates, Numinus locations, other Janssen Journey-certified clinics.
- ATMA CENA's role: supports preparation and integration via coordinated care; ATMA CENA's Janssen Journey certification specifically for Spravato administration should be confirmed at intake.
Who is PSHCP-eligible?
The Public Service Health Care Plan covers:
- Active federal public servants in core public administration
- RCMP regular members and dependants
- Canadian Armed Forces members on retirement (active CAF members are covered through Canadian Forces Health Services; retirement transitions to PSHCP)
- Federal retirees and their dependants
- Surviving spouses and dependants of eligible federal employees
Approximately 1.5 million Canadians are PSHCP-covered. The plan is administered by Canada Life (formerly Great-West Life). For coverage details and active-member access, see the PSHCP Member Site at Canada Life.
The Ottawa concentration is meaningful: as Canada's federal capital, Ottawa has a substantially elevated proportion of PSHCP-covered residents relative to other Canadian cities. For the Ottawa-specific Spravato landscape, see Ketamine Therapy in Ottawa.
Spravato — what's covered
Spravato (esketamine intranasal) was Health Canada-approved in May 2020 for adults with treatment-resistant major depressive disorder, in combination with oral SSRI or SNRI, after failure of at least two adequate antidepressant trials in the current depressive episode (DIN 02499290).
PSHCP covers Spravato when it meets the Health Canada-approved indication and prior-authorization criteria:
- Documented treatment-resistant depression (TRD)
- Failed antidepressant trials: typically two or more antidepressants at adequate dose for ≥6 weeks each in the current depressive episode
- Spravato + concurrent oral SSRI/SNRI (per Health Canada label)
- Janssen Journey-certified clinical setting for administration (mandatory ≥2-hour observation post-dose)
- Psychiatric/specialist prescription with treatment plan
For the Spravato modality detail, see Intranasal Ketamine and Spravato.
Form M7520 — the prior authorization
Form M7520 is Canada Life's documented Spravato prior-authorization form for PSHCP. The form's specific URL and current 2026 version is at Canada Life PSHCP Form M7520.
What the form typically requires
- Patient identifiers and PSHCP coverage details
- Diagnosis: TRD with documentation
- Antidepressant trial history: which medications, doses, durations, response — typically requires two or more adequate trials
- Current treatment plan: Spravato dosing schedule + concurrent oral SSRI/SNRI
- Provider certification: prescribing physician details; Janssen Journey-certified clinical setting
- Treatment goals and monitoring plan
Submission process
The prescribing physician (typically psychiatrist) completes the form and submits to Canada Life. Patient typically signs consent for release of medical information. Review timelines: typically 5–15 business days; specific pathways may require additional documentation.
Reimbursement structure
PSHCP reimburses prescription drugs at 80% of the lowest-priced generic equivalent as of January 2024. For Spravato (which has no generic), this means PSHCP reimburses at 80% of the Spravato cost itself, subject to:
- Annual deductible
- Plan coverage maximums
- Co-insurance
Practical net out-of-pocket for typical PSHCP-eligible patients with prior auth: often $0–$300 per session despite list price ~$800–$900. Specific net costs depend on individual plan, deductibles, and co-insurance.
Why this is one of the most accessible Canadian private insurance pathways
Several factors make the PSHCP Spravato pathway notably accessible:
- Documented prior-auth form (M7520) — many private insurers require similar documentation but do not have a single named form; PSHCP's named form simplifies the process.
- Aligned with Health Canada-approved indication — Spravato is approved for TRD, so the prior-auth criteria align with established clinical practice.
- Federal workforce concentration in Ottawa — Ottawa-based clinical providers are familiar with PSHCP processes.
- Established reimbursement structure — the 80% framework has operational maturity.
- Plan coverage of mental-health treatment — PSHCP includes meaningful psychiatric coverage that supports the broader Spravato + oral antidepressant treatment plan.
For the broader Canadian insurance landscape, see Insurance Coverage for Psychedelic-Assisted Therapy in Canada.
Practical access — Canadian Spravato providers
Spravato administration requires a Janssen Journey-certified clinical setting. Canadian providers documented or marketed as offering Spravato include:
- The Royal Ottawa BMO Innovative Clinic for Depression — particularly relevant for PSHCP-eligible Ottawa patients
- Jewish General Hospital Montreal — psychiatric services
- Edmonton hospital affiliates
- Numinus locations (multi-province)
- Other psychiatric private practice with Janssen Journey certification
Confirm a specific clinic's Janssen Journey certification and PSHCP-pathway experience before booking. ATMA CENA's intake can orient you to appropriate Canadian providers.
For the Ottawa landscape specifically, see Ketamine Therapy in Ottawa — the Ottawa-specific cluster article references the Royal Ottawa Spravato pathway.
ATMA CENA's role for PSHCP patients
ATMA CENA's role for PSHCP-eligible Spravato-pathway patients:
- ATMA CENA's Janssen Journey certification for direct Spravato administration should be confirmed at intake. Where ATMA CENA is not directly Janssen Journey-certified, the pathway routes to certified providers via the coordinated care model.
- ATMA CENA supports preparation and integration for Spravato-pathway patients regardless of where dosing happens. The three-phase psychedelic-assisted therapy model adapts to Spravato's induction (twice-weekly for 4 weeks; weekly weeks 5–8) and maintenance phases.
- coordinated care model is particularly valuable for PSHCP patients in Ottawa — supporting integration with the patient's existing psychiatrist, the Spravato-administering provider, and the broader treatment team.
Frequently asked questions
What's PSHCP? The Public Service Health Care Plan, administered by Canada Life. Covers ~1.5 million federal public servants, RCMP, retirees, and dependants.
What does PSHCP cover for Spravato? PSHCP covers Spravato through a documented prior-authorization pathway via Form M7520. Eligibility requires documented TRD with failed antidepressant trials, Spravato + concurrent oral SSRI/SNRI, and Janssen Journey-certified clinical setting.
What's Form M7520? Canada Life's Spravato prior-authorization form for PSHCP. Available at the Canada Life PSHCP page.
What's the reimbursement level? 80% of the lowest-priced generic equivalent (PSHCP standard since January 2024). For Spravato specifically, this means 80% of Spravato cost subject to deductibles and co-insurance.
Net out-of-pocket per session? Typically $0–$300 per session for PSHCP-eligible patients with approved prior auth, despite list price ~$800–$900. Specific costs depend on individual plan and current deductible/co-insurance.
Who applies for the prior auth? Your prescribing physician (typically psychiatrist) completes Form M7520 and submits to Canada Life. You typically sign consent for medical information release.
How long does prior-auth review take? Typically 5–15 business days. Complex cases may require additional documentation.
Where can I get Spravato in Ottawa? Royal Ottawa BMO Innovative Clinic for Depression is the primary Ottawa Spravato provider. Other psychiatric private practice with Janssen Journey certification exists. The ATMA CENA intake can orient you to current providers.
Does ATMA CENA directly administer Spravato? ATMA CENA's specific Janssen Journey certification should be confirmed at intake. Where ATMA CENA is not directly certified, coordinated care arrangements with certified providers apply.
What if my prior auth is denied? Appeal options include resubmitting with additional documentation (more antidepressant trial details, specialist consultation, alternative treatment failure documentation) or pursuing alternative pathways (off-label IV ketamine, SAP psilocybin if eligible).
What if Spravato isn't appropriate for my situation? The PSHCP Spravato pathway is specifically for documented TRD. For PTSD without TRD, MDMA-AT via SAP (with VAC if veteran) or off-label ketamine therapy may be appropriate. For end-of-life distress, psilocybin SAP is the foundational pathway. The ATMA CENA intake call walks through alternatives.
Can I switch from Spravato to off-label ketamine if my prior auth ends or is denied? Possibly. Discuss with your prescribing physician. Off-label IV/IM/sublingual ketamine is generally not privately covered but is more broadly accessible. ATMA CENA's KAT pricing applies.
What about ketamine coverage through PSHCP? PSHCP does not have an off-label ketamine equivalent of Form M7520. Off-label ketamine for psychiatric use is generally not covered by PSHCP or other private extended-health plans.
What about psilocybin or MDMA through PSHCP? PSHCP does not cover psilocybin or MDMA. Both are SAP-only with no Health Canada approved indication. Therapy fees (preparation/integration) may be partially covered as standard psychotherapy under PSHCP's psychology benefits.
What are PSHCP's psychology benefits? PSHCP covers psychology services up to plan-specific maximums. This applies to Registered Psychologist sessions (e.g., preparation/integration psychotherapy for psychedelic-assisted therapy). Specific coverage levels depend on plan tier.
Sources
- ATMA CENA — find care near you: https://psychedelic.healthcare/find-care
- Canada Life — Spravato Prior Authorization Form M7520 (PSHCP): https://www.welcome.canadalife.com/content/dam/canadalife/documents/forms/you-and-your-family/1-0-employer/1-3-request-an-assessment/1-3-2-prior-auth-drugs/en/pshcp/spravato-m7520.pdf
- PSHCP Member Site — Canada Life: https://www.welcome.canadalife.com/pshcp
- Health Canada DPD — Spravato: https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=98903
- Daly EJ, et al. (2018). Phase 2 dose-response esketamine in TRD. JAMA Psychiatry. https://pubmed.ncbi.nlm.nih.gov/29282469/
- Popova V, et al. (2019). TRANSFORM-2 — esketamine + new oral antidepressant in TRD. Am J Psychiatry. https://pubmed.ncbi.nlm.nih.gov/31109201/
- Wajs E, et al. (2020). SUSTAIN-2 — Spravato long-term safety. J Clin Psychiatry. https://pubmed.ncbi.nlm.nih.gov/32316080/
Related articles
- Insurance Coverage for Psychedelic-Assisted Therapy in Canada
- Alberta Blue Cross PAT Coverage
- VAC Coverage for Psychedelic-Assisted Therapy
- Workers' Compensation for Psychedelic-Assisted Therapy
- Intranasal Ketamine and Spravato
- Ketamine Therapy in Ottawa — Ottawa federal-workforce context
- Find care near you
Last updated: 2026-05-06