Insurance Coverage for TMS
While the benefits of TMS treatments for a variety of conditions are well documented, some health insurance companies are still hesitant to cover all of the costs, which are comparable to the cost of treatment for other serious medical conditions.
For the diagnosis of Major Depressive Disorder, more and more insurance companies, including Anthem Blue Cross, Blue Shield of California, United Health Care, Magellan, Optum, and MHN (HealthNet), have revised their policies to reflect that TMS may be medically necessary if certain criteria are met. If the insurance company determines that TMS treatment is medically necessary for the patient, then they may consider partially covering out-of-pocket expenses.
Dr. Stubbeman’s Office and Insurance
Dr. Stubbeman is an In-Network provider of TMS for Blue Shield of California, Anthem Blue Cross, Magellan, Optum, MHN (HealthNet), Cigna and we are able to enter into Single Case Agreements (SCA) with Aetna. We are currently Out-of-Network and do not bill directly for all other insurance carriers. Our team will work with you to review the possibility of health insurance coverage. The first step is to call our office for an initial evaluation. During this appointment, Dr. Stubbeman can determine if you meet the criteria for insurance coverage or reimbursement. Most insurance companies partially reimburse this introductory appointment if you have Out-of-Network benefits. We are committed to helping you navigate the insurance claims process and maximizing the possibility of obtaining coverage for your treatment.
Please note that in order to provide the optimal level of patient care, we have opted out of Medicare. This means that Medicare will not reimburse for any services rendered by Dr. Stubbeman. If you are a Medicare beneficiary and want to see Dr. Stubbeman, you will need to sign a private contract, agreeing not to submit any claims to Medicare.