Depression is a common mental health condition that can affect adolescents and adults. Untreated depression can lead to severe consequences. While antidepressant medications and talk therapy are the most commonly prescribed treatments, they may not be effective for you. However, alternative options are available.
Transcranial magnetic stimulation (TMS) therapy is a unique FDA-approved treatment that has over a decade of research data to support its effectiveness against depression symptoms. It is suitable for adolescents and adults, and the treatment has fewer side effects than antidepressant medications. It also does not demand the same level of effort required for psychotherapy or talk therapy.
Many people have questions about insurance coverage for TMS therapy in Bedford, TX. Although insurance companies may provide coverage and benefits, policy limitations and exclusions can vary. Certain general factors influence whether your insurance covers TMS therapy, and specific steps could help you maximize your benefits.
TMS is a non-invasive, non-systemic targeted therapy. It uses a computer-controlled device to deliver electromagnetic pulses to areas of the brain that are associated with mood regulation, typically the prefrontal cortex.
The computer regulates the intensity and depth of the electromagnetic pulses to protect your brain and ensure the best results.
Research shows that stimulation activates neurons and improves your brain’s neuroplasticity. This, in turn, reduces or eliminates the symptoms of depression. Unlike antidepressant medications that have a systemic effect on the body, TMS focuses on one specific area of the brain.
If you are exploring treatment options, insurance coverage could help cover your TMS therapy in Bedford, TX. While antidepressant medications often come with side effects, such as nausea, vomiting, and an increased risk of suicide, side effects of TMS tend to be minor and typically resolve within the first week of treatment. These may include:
Each session lasts approximately 20-40 minutes and is conducted five times a week for four to seven weeks.
Most insurance providers in Bedford, TX, offer coverage for TMS therapy. The FDA approved TMS for individuals diagnosed with treatment-resistant depression. This diagnosis applies when you have not experienced any benefit from at least one antidepressant medication. However, some insurance providers require you to have tried at least two or three antidepressant medications before they provide coverage for treatment.
Your insurance coverage depends on your insurance provider and the plan you purchased. Federal law mandates that insurance providers offer mental health coverage that matches the level of coverage they provide for other medical and surgical treatments. However, your specific benefits and limitations will depend on your insurance plan and medical necessity.
It is essential to understand your insurance company’s limitations, exclusions, and requirements for treatment to receive maximum insurance benefits for TMS therapy in Bedford, TX. This information is outlined in your insurance documents. Insurance companies cover only medically necessary treatments, which are determined using a standard applied by insurance adjusters to decide whether treatment is covered and to what extent.
In many instances, your insurance provider will require prior authorization before you can receive TMS treatment. If you do not receive prior authorization before treatment, most providers will not offer coverage. Prior authorization requests include documentation of the medical necessity for treatment. This could include letters from your primary care physician or psychiatrist that document your poor response to at least one and up to three antidepressant medications.
Your depression diagnosis must also be documented, and your insurance company may require further documentation. To maximize your benefits, you must work with your insurance company and provide all the required paperwork to meet their requirements.
Depression is a common yet challenging mental health condition that affects your everyday life. If antidepressant medications have not provided relief, we encourage you to call our office and schedule a consultation to explore a non-invasive treatment. We can answer your questions about insurance coverage for TMS therapy in Bedford, TX, and help determine if you are a good candidate.