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Insurance Guide
TMS Insurance Guide
Does Insurance Cover Mental Health Treatment?
When you seek mental health treatment for conditions, you may be worried about the cost. Fortunately, there are laws in place to make insurance coverage of mental health services more likely. For example, the Mental Health Parity and Addiction Equity Act (MHPAEA) requires that if insurance companies cover mental health services, they cover them to the same extent that they cover medical services. This means that if your co-pay is $30, the co-pay for a visit with a psychologist cannot be more than $30. The caveat to this law is that it does not require insurance companies to cover mental health services in the first place, but many do.
Another law, the Affordable Care Act, ensures more comprehensive coverage of mental health services. This is because all plans purchased through the government marketplace under this act are required to cover mental health services as essential benefits. According to provisions of this law, marketplace plans cover services such as the following:
- Inpatient mental health care
- Appointments for counseling or therapy
- Treatment for addiction
While plans will vary in the specific services they cover, the above services are generally included on marketplace plans. Your specific insurance provider can help you understand what services your plan covers and how much you can expect to pay out-of-pocket for mental health treatment, regardless of whether you have private insurance or a plan purchased through the government marketplace.
Mental Health Insurance Statistics
Given the provisions of laws like the Affordable Care Act, there has been interest in insurance coverage rates among people with mental health disorders. According to recent statistics, there has been an increase in the number of adults with mental illnesses and addictions who are covered by health insurance since the Affordable Care Act put expansions in place.
After the Affordable Care Act expansions took effect, the following improvements were seen:
- 5.4% reduction in the number of people with mental health disorders who were uninsured
- 5.1% decrease in uninsurance rate for people with addictions
- 2.1 % increase in usage of mental health services
In summary, this law has successfully expanded insurance coverage for behavioral health treatments, including those for mental health conditions. Given increases in insurance coverage, many people who need mental health treatment will be able to get these services covered.
INSURANCE COVERAGE
In working with Pulse TMS, our psychiatrist can determine if you are a good candidate and our team can determine if insurance will cover treatment. Almost all insurance companies cover TMS treatment. To learn more, contact us as we can guide you through the process.
Our team can assist you with:
- – Verification and determination for candidacy
- – Filing the claim with your insurance company
- – Informing patients of their TMS benefits
Have questions about your insurance coverage for TMS? Our team will verify your insurance benefits over the phone. Call (310) 272-5026
We Are In-Network With:
We Accept Most PPO Policies:
Treatment at Pulse TMS
If you seek treatment for depression, Pulse TMS is located in Los Angeles and provides transcranial magnetic stimulation (TMS) treatment for depression. This FDA-approved treatment modality stimulates pathways in the brain that are involved with mood. Research has shown that TMS effectively reduces depression, and it is even safe in vulnerable populations, including pregnant women. At Pulse TMS, we can treat patients with depression and those with obsessive-compulsive disorder (OCD), as a large body of research indicates that TMS is effective for reducing symptoms of OCD.
This is just a partial list. Please contact us or your insurance provider to see what is covered.
If you don’t have insurance, we’re happy to discuss your situation, review your history, and discuss costs confidentially with you. We can go over financing and payment plan options.
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