Getting mental healthcare covered by insurance can be difficult. Far too many people have paid out of pocket for visits to medical professionals and for treatments for mental health conditions.
That’s all because the insurance system has been somewhat slow to treat mental health with the same seriousness as physical health. And that’s a problem because in order to get coverage, you typically need insurers to think the care was medically necessary.
Fortunately, all of that is changing. More good news: one leading-edge option is getting different treatment from insurance carriers. Let’s talk about transcranial magnetic stimulation (TMS).
TMS: A surprisingly quick coverage from insurers
TMS isn’t just covered by most major insurance groups, including Aetna, Blue Cross Blue Shield, UnitedHealthcare, United Behavioral Health, and Cigna. It was also fairly rapidly adopted by the insurance industry as a covered type of care.
Take Medicare as an example. This health insurance program is typically one of the last to extend coverage, but TMS proved different. Thanks in large part to the sizable body of evidence in its favor, TMS got quick coverage from Medicare.
TMS works by sending safe, noninvasive magnetic pulses into your brain through a specialized helmet you wear. Those magnetic pulses help to activate parts of your brain that are underactive.
Our team can tailor the magnetic stimulation based on your symptoms. We use it to help people with depression, and it can be particularly helpful for those with treatment-resistant depression. TMS also helps with obsessive-compulsive disorder (OCD) and smoking cessation, but those treatments can be more difficult to get covered by insurance.
For depression, insurance carriers typically approve requests to cover TMS. But it does often depend on how you want to use it and what you’ve tried before. Taking certain steps makes it more likely to get approved.
Getting the right care team to get coverage
The most compelling body of evidence behind TMS right now focuses on how it helps people with depression. The FDA has also cleared TMS for the treatment of major depressive disorder. This backing makes insurers more likely to approve requests for coverage for insureds with depression.
The key is getting TMS prescribed by a medical professional and showing the insurance company how it can help you. If you’ve tried other treatments for depression but haven’t seen your symptoms improve to the level you like, we can help you document that. This way, when the insurance company reviews your case, they have clear validation that TMS is medically necessary.
Every person is different, and your mental healthcare needs are unique to you. Our team can help you figure out if you’d benefit from TMS and, if so, if we can get it covered by your insurance.
We work with you to get the documentation your insurer needs to understand how this treatment could benefit you. The big takeaway here is that TMS for depression commonly gets covered by insurance today, and we can help.
For support with all of this, contact our team at Neurology, Psychiatry and Balance Therapy Center to make an appointment today.
