Insurance and Medicare Coverage for TMS Therapy Treatment for Depression

 

 

Find out if your insurance provider covers TMS Therapy.

Click on the box for the state you reside in to find a list of contracted insurance companies.
If you do no see your insurance provider, contact us using the link below and a Patient Advocate will get back with you.

Contact Us
Colorado
  • Aetna
  • Anthem Blue Cross Blue Shield
  • Banner
  • Cigna
  • Colorado Choice
  • EBMS
  • Humana
  • Kaiser (only those plans that contract through Multiplan/PHCS)
  • Medicare
  • Multiplan/PHCS
  • Rocky Mountain Health Plans
  • Tricare
  • TriWest
  • UMR
  • United Healthcare
  • Pinnacol Assurance for Worker's Comp

 

Idaho
  • Aetna
  • BC of ID
  • Cigna
  • Humana
  • Medicare
  • Multiplan
  • Regence BS of ID
  • Tricare
  • TriWest
  • UHC
  • UMR
Utah
  • Aetna
  • Cigna
  • DMBA
  • EMI Health
  • Humana
  • Medicare
  • Multiplan/PHCS
  • PEHP
  • Regence Blue Cross Blue Shield
  • Select Health (out of network, but we can obtain single case agreements)
  • Tricare
  • TriWest
  • UMR
  • University of Utah Health Plans
  • United Healthcare

 

 

Washington
  • Aetna
  • Anthem Blue Cross Blue Shield
  • Asuris
  • Banner
  • Cigna
  • First Choice
  • Group Health Cooperative
  • Health net - VA
  • Humana
  • Kaiser (certain plans)
  • Medicaid
  • Medicare
  • Multiplan/PHCS
  • Premera Blue Cross
  • Providence Health Plan
  • Regence Blue Shield
  • BCBS Idaho
  • TriWest
  • UMR
  • United Healthcare
  • Medicaid Managed Care
    • Amerigroup
    • Community Health Plan
    • Molina Healthcare of WA
    • United Healthcare Community Plan

 

Wyoming
  • Aetna
  • BCBS of WY
  • Cigna
  • Humana
  • Medicare
  • Multiplan
  • Tricare
  • Triwest
  • UHC
  • UMR

 

At TMS Solutions, we realize finances are a major factor in deciding whether or not to pursue TMS therapy. We sincerely care about you and strive to provide the highest level of care
to enable you to overcome your depression, without a heavy financial burden.

That’s why we’re excited to tell you that TMS therapy is covered by all major insurance companies, including Medicare, Medicaid (currently only in Washington state), the Veterans Administration, United Healthcare, and Blue Cross and Blue Shield.

• With your insurance, you will be responsible for your deductible.
TMS Solutions will run a Benefits Investigation at no cost to you to determine your coverage, including co-pay if one applies.

Note: Washington Medicaid covers TMS therapy. Please contact one of our Patient Advocates by clicking the Contact Us button or one of the buttons below, to set up a time to talk. 

• Don’t have insurance? Not to worry. 
TMS Solutions has many financing options, including a sliding payment scale based on income, and several lending companies that can assist you in paying for your TMS treatments. One such company is M-lend. Scroll down  to learn more about.

Frequently Asked Questions About Insurance Coverage 

Will my insurance plan cover TMS Therapy?

All insurance companies now cover TMS Therapy for an approved diagnosis. To determine if your plan will cover the cost of TMS Therapy, please contact your mental health provider and request a referral to TMS Solutions or contact us today and we will assist with this process.

 How much does TMS Therapy treatment cost?

Your costs are subject to your individual co-pay, co-insurance, or deductible. We also have self pay options available, including a sliding scale based on income, for patients who do not have health insurance or do not have an insurance approved diagnosis for TMS Therapy (examples include postpartum depression, anxiety, tinnitus, and OCD).

Our objective is to provide treatment without it being a financial burden. Please contact a Patient Advocate about your situation.

How will I know if my provider will cover TMS Treatment?

We are in-network with all major insurance plans, including the Veterans Administration (VA), Medicare and Medicaid where applicable. We make every attempt to contract with your individual insurance plan if we are not already in network, and have self pay options available when necessary.

Is there financial assistance available for TMS Therapy?

We have several financing options available for patients who are self pay or patients with high deductibles. Our billing department will go over the available options with you at your request.

What is the process to get approval for treatment from my insurance provider?

  1. A Patient Advocate will contact you to fill out new patient paperwork.
  2. Once complete, our billing department will do a Benefits Investigation (BI).
  3. We will contact you prior to treatment to review your estimated patient liability and insurance benefits, based on the coverage guidelines and your specific benefits plan.
  4. This is a pre-determination of your patient liability and is not a guarantee of benefits.
  5. Benefits are determined by your insurance company and subject to your plan determination at the time the claim is received.
  6. Once approved, we will schedule your first appointment.

What is preauthorization and is it required?

  • Preauthorization means the insurance company will review your case and verify if the treatment is medically necessary.
  • Preauthorization requirements will vary based on your insurance company and your specific plan’s guidelines.
  • Preauthorization does not mean the claim is guaranteed to be paid, nor does it guarantee the rate at which the claim will be paid.
  • Insurance companies do not guarantee benefits prior to claim submission.
  • Any information gathered from a benefits investigation or preauthorization is only an estimate, and patient responsibility will be determined by plan provisions when the claim is filed.

If my doctor said this procedure is medically necessary, will it be covered by my insurance?

Not necessarily. Insurance companies determine what procedures, tests, drugs, and services they will cover. We make every effort to attempt to obtain an authorization for services from your insurance provider. For patients whose insurance company denies coverage, we have several self-pay financing options available.

My insurance denied my authorization. What should I do?

A TMS Solutions Patient Advocate will fight to get your authorization approved so you can start living your life free from depression. 

Contact a Patient Advocate today!