Medicare and TMS

Transcranial Magnetic Stimulation is an effective treatment for symptoms of Depression that can be successful when other treatments have failed.  A 2014 study of 257 patients found that after a year, 67% had a positive response to the treatment with 45.1% reaching full remission.  Because of its success, TMS is now covered by most insurance companies as well as by Medicare.

Transcranial Magnetic Stimulation is a non-invasive treatment for the symptoms of Depression.  Using powerful magnets like those used in MRIs, areas of the brain associated with Depression are targeted with pulses to stimulate function in the area.  By stimulating these areas, function may improve and symptoms may be relieved or put into remission. TMS only has a few, rare side effects and is used with patients who have not had success in finding an antidepressant or combination of them that has worked.

TMS treatments last 20-40 minutes depending on dosage and treatment periods take place 5 days a week for 4-6 weeks.  The treatments are so mild, there’s no downtime and can be repeated if symptoms return.

Medicare

More and more insurance companies now cover TMS treatments and now, so does Medicare under Medicare Part B (Medicare Part A is for hospital and in-patient services only).  However, there are a couple of qualifiers for Medicare.  

One, you must have Major Depressive Disorder and it must have been diagnosed by your Medicare-approved doctor.  TMS is not a treatment for mild depression.

Second, you must have tried to relieve your symptoms of Major Depressive Disorder using medications and failed to find relief from them.  Many people can find relief with the right medications or combinations of medications and TMS is generally recommended only if they can’t find medications that work.  However, if you cannot take these medications to health issues or you have a past history of failed medications for your depression, Medicare may allow you to bypass these requirements and begin TMS treatment right away.  

It’s important to make sure your TMS physician is not only approved by Medicare but also that they accept assignment.  If they don’t, you would most likely be responsible for paying for the TMS treatments yourself out of pocket.

You will still most likely be responsible for your annual deductible, monthly premiums, and possibly 20% of the amount approved by Medicare but your TMS provider can give you more information on your payment responsibilities. 

At GatewaysTMS, the health and wellbeing of each patient is most important to us.  Our caring staff provides TMS treatments in a relaxed, comfortable atmosphere and can answer any questions you have about the treatments or insurance and ease your mind about what to expect from the treatments.  GatewayTMS accepts assignment for Medicare. We strive to help our patients finally find the relief from Depression that they’ve been searching for.

Depression can be a debilitating disorder that can control your life.  If you are suffering from Depression and can’t find a medication that will work, take control by calling Gateway today at (314) 909-8487 and find out if TMS is right for you.  We’d love to help you.