Coverage and cost
Will my insurance cover TMS?
This is the question that stops most people. Here is the plain version.
The short answer
TMS is widely covered
Most major carriers cover TMS, and it is included in a great many plans.
What varies is what your particular plan requires before it will approve a course of treatment. That is the part worth understanding before you start making calls yourself.
What plans ask for
Usually, a history of what has already been tried
Insurers generally want evidence that depression has been treated and has not responded. In practice that means a record of antidepressant trials, and usually therapy alongside them. How many trials a plan wants to see differs from plan to plan.
That is the part that takes paperwork, and it is the part we do for you. We gather the history, submit the authorization, and follow it through the payer’s process.
What it will cost
An estimate, never a quote
Once we have checked your benefits we can tell you what we expect your share to be. We will call it an estimate, because that is what it is. Deductibles reset, benefits change mid-year, and plans apply rules no clinic can see from the outside.
Be cautious of anyone who gives you a guaranteed figure before your plan has responded. We would rather tell you what we expect and tell you plainly that it is an expectation.
How we check
Four steps, and you are not committed at any of them
- Consultation. Free, about 30 minutes. Bring your insurance card, or send photos ahead and we will get a head start.
- Verification. We confirm your benefits and what your plan requires.
- Authorization. We submit on your behalf and track the decision through to an answer.
- Your estimate. Once the payer responds, you get a number before anything is scheduled.
You will not be asked to commit to treatment before you know where you stand.
If you would rather just ask
Call us and we will tell you what we can
Have your insurance card handy if you have it. It makes the answer considerably more useful. Call (435) 900-7816, Monday to Friday, 9am to 6pm.
The other two questions people ask are whether it works and whether it hurts.
Talk it through with a Medical Provider
The consultation is free, takes about 30 minutes, and commits you to nothing. Bring your questions.