Insurance Coverage for TMS Therapy

Does my insurance cover TMS Therapy?

To find a list of contracted insurance companies for your state, click on the coinciding box.
If you do no see your insurance provider, contact us and a Patient Advocate will assist you.

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

 

Insurance FAQs

TMS Solutions realizes finances can be a major factor in deciding
whether or not to pursue TMS therapy. We strive to provide
the highest level of care possible without a heavy financial burden,
so that you can focus on restoring your mental health.

How will I know if my insurance plan covers TMS Therapy?

Most insurance companies now cover TMS Therapy for an approved diagnosis such as Major Depressive Disorder. TMS Solutions is in-network with most medical insurance providers, but if we aren't, we will make every attempt to contract with your individual insurance provider. To determine if your plan will cover the cost of TMS Therapy, please contact a Patient Advocate to assist you.

 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 an income-based sliding scale 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.

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 insurance benefits and estimated out-of-pocket cost based on the coverage guidelines and your specific benefits plan. This is a only pre-determination of your cost - not a guarantee of benefits.
  4. Benefits are determined by your insurance company and subject to your plan at the time the claim is received.
  5. 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 treatment 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 best life! 

Contact a Patient Advocate Today!

For questions or to get more information about TMS Therapy, contact a Patient Advocate

844-537-6747
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