Are you wondering if your insurance will cover TMS?
NeuroStar TMS Therapy is the top choice recommended by physicians for addressing mental health concerns. It holds FDA clearance for treating Depression, Anxiety, and OCD. This safe and effective therapy is typically covered by most insurance plans for Major Depressive Disorder (MDD) and MDD with anxious depression. Additionally, more insurers are regularly adding OCD to their covered conditions. If you're dealing with OCD, it's advisable to inquire with your insurance provider regarding TMS coverage for OCD treatment.
While insurance policies vary, most major providers offer coverage for TMS Treatment if:
Major Depressive Disorder (MDD), or MDD with Anxious Depression:
- You're an adult diagnosed with moderate to severe Major Depressive Disorder (MDD).
- Your depression hasn't improved after trying at least two antidepressant medications (some insurers may require up to four failed medications).
- You’re not pregnant or nursing.
Obsessive-compulsive Disorder (OCD):
- You're an adult diagnosed with OCD.
- You may be eligible if your symptoms persist despite trying at least two medications and psychotherapy hasn't been effective.
- You're not pregnant or nursing.
Which insurance providers cover TMS?
We are in-network with the following major insurance providers and can obtain your authorization within a couple of days:
-
✅ Aetna
✅ Blue Shield / Magellan
-
✅ Cigna
✅ HealthNet Commercial Plans
-
✅ TriCare
✅ United Health Care/ Optum
Each insurer has its own criteria and policies. Kindly contact our office so we can obtain your authorization and/or obtain about your eligibility.
Is there an out-of-pocket cost?
Generally, you'll have a co-pay for each TMS treatment session. The amount varies based on your insurance plan.
NeuroStar collaborates with organizations like CareCredit and Advance Care to offer financing options for patients whose insurance doesn't cover treatment or to assist with co-pays, deductibles, and full cash payments.
What if coverage is denied?
If you're ineligible for coverage according to your insurer's criteria, you can opt for TMS treatments through self-payment.
NeuroStar partners with organizations like CareCredit and Advance Care to offer financing options for uninsured patients or to assist with financial aspects.
Since coverage and payment terms differ per plan, it's advisable to contact your insurer directly for verification and clarification on TMS treatment coverage.
For further assistance, please reach out to our office at 310.857.4946, and we'll gladly assist you in determining your eligibility.