11/17/2022
It is the time of year when you have the opportunity to select your health insurance. If you are considering TMS treatment for depression, then the insurance you select can make a big difference in your out of pocket costs and whether the insurance will cover you.
Our clinic accepts BCBS, Aetna, United, Cigna, Tricare and Medicare. Each insurance company has different policies for qualifying a patient for TMS. United has the most stringent policy requiring 4 medication trials and therapy. BCBS is 2 medications. Medicare will only require 1 medication trial next year.
If you qualify for Medicare, we do not recommend choosing a Medicare Advantage plan. See link below for an article giving more details, but generally traditional Medicare gives access to any participating provider, Medicare Advantage plans limit care to doctors and hospitals in their networks. So for example, we would not be in network with a Humana Medicare Advantage plan. Also, the authorization for TMS is done by the plan, so for example United would apply their strict guidelines rather than Medicare's.
You can also lower your out-of-pocket expenses by choosing a plan with a lower co-insurance and max out-of-pocket.
Read more at:
Retired NC doctor: Iām talking to you Medicare recipients. Beware of Medicare Advantage plans. | Opinion
