ave you been researching TMS therapy and wondering is TMS covered by Medicaid? Or other insurance plans?
You definitely have options when it comes to paying for your TMS therapy.
If you haven’t gotten relief from your medications, then you aren’t alone! Over 50% of people that fail to find relief from their medications have an excellent response to TMS therapy.
And a third of these people can go into full remission from depression symptoms!
If you want to know if Medicaid covers TMS and how you can afford it, then keep reading this guide to find ways you can afford your TMS treatments!
TMS therapy is non-invasive and uses magnetic fields. These magnetic fields stimulate the nerve cells in your brain. This stimulation helps to treat the symptoms of depression and your mood too.
TMS therapy is usually done when standard psychotherapy and medication have not effectively treated your Major Depressive Disorder.
Before having TMS, you will need a physical exam as well as a psychiatric evaluation to talk about the symptoms of your depression.
TMS Therapy Side Effects
The great thing about TMS therapy is that it generally has mild side effects that decrease over time. You may notice:
- Scalp discomfort
- Feeling lightheaded
- Tingling or twitching of facial muscles
If you find you are experiencing side effects, let your doctor know. They can adjust the level of stimulation to make you more comfortable.
Contraindications for TMS Therapy
Some things can prevent you from being a candidate for TMS therapy. There is a strong magnetic field produced with TMS, so you won’t be able to have it done if you:
- Have aneurysm clips
- Have stents anywhere in your body
- Any implanted stimulators
- Implants in your ears
- Have bullet fragments
- Any metal device in your body
- Are pregnant
Any brain damage from illness or traumatic injury can also prevent you from having TMS therapy. Medical conditions like strokes, seizures, bipolar disorder, psychosis, or substance abuse will disqualify you.
Affording TMS Therapy
TMS therapy is FDA approved and has decreased in cost over the years as technology has improved. You do have options when it comes to affording TMS therapy.
Now, most major insurance companies like Aetna, Blue Cross, Anthem, and Cigna will pay for the cost of TMS therapy. Neurostar health insurance policies are also widely available now.
Most major insurance companies have similar requirements with paying for TMS therapy.
These requirements usually include taking two to four rounds of two different classes of antidepressant medications, and psychotherapy. Your individual policy will tell you what specific requirements you need to meet.
Does Medicaid Cover TMS?
Medicaid is a government-funded healthcare program that provides you with basic healthcare needs as long as you qualify.
This answer is a little complicated, but generally speaking, yes, Medicaid may pay for a percentage or all of TMS treatment, depending on the specific Medicaid plan you have. Please call us at 845-471-1807 to speak with our team to confirm your coverage options.
Does Medicare Cover TMS?
It’s important to remember that Medicare and Medicaid are not the same! The good news is Medicare will pay for TMS if you have been diagnosed with major depressive disorder, as long as one of these criteria have been met:
- You have tried four rounds of antidepressants with no good response
- You can’t tolerate the side effects of antidepressant medications
- You had an excellent response to TMS therapy in the past
Medicare can also limit your coverage for TMS treatments if you have a history of seizures, psychotic episodes, heart disease, dementia, or severe head trauma.
Medicare will only cover TMS therapy for Major Depressive Disorder and not for anxiety or other conditions.
TMS therapy is covered by Medicare Part B and will require payment of an annual deductible. Medicare Advantage plans also provide some coverage for TMS therapy, but you will need to check your individual policy information.
Financing Your Treatment
If you cannot use your insurance coverage to pay for TMS therapy, you have other financing options available.
Both you and your employer contribute to Health Savings Accounts. If you have one, check to see what your options are for withdrawing money.
The next option you have is taking out a line of credit. If you have a good credit score, you can take out a personal line of credit at your bank to cover your treatment costs.
If you have a credit card with a low interest rate, then you could consider paying for your treatments with it. Generally, this is not the best option but it may be worth considering if you can afford the monthly payments.
If you have 401(k), you can take a loan or line of credit from that. And don’t forget to think of a home equity loan or line of credit, especially if you have a good amount of equity in your home.
Finally, ask about medical financing at your TMS therapy consultation. TMS therapy clinics often offer medical financing or give you information on where to apply.
Is TMS Covered by Medicaid
We accept most major insurance plans and offer treatment financing along with over ten years of TMS therapy experience!
Make sure you contact us today. We can help you take control of your major depression and your life.