It gives hope to people who didn’t feel better with usual treatments.
Now, the question is: Does my insurance pay for TMS therapy?
Good news! Many insurance companies now cover TMS because they see it works.
But be careful, the details of your coverage can be different.
So, it’s important to figure out the insurance details before getting TMS.
Requirements For TMS Coverage
However, insurance might only pay for TMS if a psychiatrist says you have serious depression (MDD).
You also need to try two depression meds that didn’t work and do talk therapy without success.
Ask your insurance if they cover TMS if you meet these rules.
TMS Therapy Cost With Insurance Coverage
If you use insurance, your cost per session will be between $10 and $70, based on your plan’s copay or coinsurance rate.
You need to attend 36 sessions in total, along with one brain mapping session, to finish the treatment.
TMS Therapy Cost Without Insurance Coverage
TMS therapy may be costly for some, with sessions ranging from $400 to $500 at providers like New Era.
Most people need multiple sessions, leading to a total cost of around $15,000.
Currently, not all insurance companies cover TMS therapy, and coverage varies.
For instance, Blue Cross Blue Shield covers TMS treatment for adults who haven’t found success with therapy or antidepressants.
Before starting TMS treatment, check with your mental health professional and insurance plan to see if you’re covered.
Hopefully, more coverage options will be available in the future, making TMS therapy more affordable for many.
How To Improve Your Chances Of TMS Coverage
If you have a temporary health issue, like pregnancy, that makes you ineligible for insurance to cover TMS treatment, you can delay starting until later.
However, you must show proof that you tried other treatments first.
To boost your chances of getting insurance coverage for TMS, keep accurate treatment records and be truthful about your progress with your doctors.
It’s crucial to follow your treatment plan, take all medication, and attend therapy appointments.
If there’s proof you missed doses or appointments, your insurance might not cover TMS.
How Can I Get TMS Therapy Covered By Insurance?
To get your insurance to pay for TMS therapy, ask your doctor for a letter saying you have major depressive disorder (MDD).
Also, make sure your medical records prove you tried other treatments for MDD, like therapy or medications. If you had a head injury before, your insurance might not cover it.
Potential disqualifications for TMS coverage
Some policies might reject you for coverage if you:
- Are pregnant or nursing
- Have a high risk of suicide
- Are dealing with ongoing substance abuse
- Have diagnosed neurological conditions like epilepsy, seizure disorders, or dementia
- Have magnetic-sensitive medical devices or objects, such as cochlear implants, stents, or bullet fragments
Anne Mitchell: Reporting Expert in Business Commerce Insurance
Location: New York, NY
Expertise: Global Markets, Economics, Insurance
- Passionate reporter delivering accurate and verified news impacting investors.
- Joined Insurance Blob in 2023.
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- Bachelor of Arts in Business Commerce with Insurance Emphasis from Texas State University, USA.