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Posted: October 12th, 2022

Does Tricare Cover TMS Therapy?

Posted in: General

Yes, Tricare covers Transcranial Magnetic Stimulation (TMS) as an outpatient procedure.

Transcranial Magnetic Stimulation (TMS) is a therapy used to treat Major Depressive Disorder (MDD) in adults.   During a TMS session, an electromagnetic coil is placed against the scalp.  This coil delivers a magnetic pulse that stimulates nerve cells in the region of the brain which regulates mood.  TMS activates regions of the brain that have decreased activity in depressed individuals.

Transcranial Magnetic Stimulation PET Scan

In 2016, Tricare, a health care plan issued by the United States Defense Health Agency (DHA), approved coverage for Outpatient TMS therapy for active duty or retired members of the armed forces. Spouses and children of serving or retired members of the military and members of the National Guard or Reserve are also eligible for Tricare TMS coverage if the beneficiary:

  • Is 18 years of age or older
  • Has severe Major Depressive Disorder (single or recurrent episodes)
  • Has not responded positively to a less intensive form of treatment or that less intensive intervention is not more appropriate.

TRICARE West’s TMS Coverage

TRICARE West is a division of Tricare that covers western regions of the U.S. These regions include the following States:

 

  • Arizona
  • Alaska
  • California
  • Colorado
  • Hawaii
  • Idaho
  • Kansas
  • Minnesota
  • Montana
  • Nebraska
  • Nevada
  • New Mexico
  • North Dakota
  • South Dakota
  • Oregon
  • Utah
  • Washington
  • Wyoming

 

TRICARE West covers TMS as a limited benefit.  This means that prior authorization is required. To expedite the authorization process, Tricare West recommends that a patient submit a Letter of Attestation form for TMS. This can be found on the Tricare West website.

 

Veterans and Depression

 

Veterans are at an increased risk of certain mental health disorders. A 2008 study by Veteran Affairs estimated that 1 in 3 Veterans reported having some symptoms of depression to their primary care physicians.  1 in 5 reported having severe symptoms of depression.

 

The primary treatment for Depression is pharmaceutical medication.  This includes medications like Selective serotonin reuptake inhibitors (SSRIs) like Lexapro and Prozac, Serotonin-norepinephrine reuptake inhibitors (SNRIs) like Cymbalta and Effexor, and Atypical Antidepressants like Wellbutrin and Remeron.  However, these medications don’t always work for everyone.  A person’s unique biological makeup can cause these medications to be ineffective.  Some of these medications also cause unwanted side effects which can make them difficult to take regularly.

 

Luckily there are other options for people with Treatment-Resistant Depression. Transcranial Magnetic Stimulation (TMS) is an effective FDA-cleared treatment that is known to decrease symptoms of depression.  Recent studies have shown it may also be effective in treating other disorders like PTSD, and tinnitus. Because of their experience during active duty, many Veterans can be especially susceptible to these issues.  TMS is effective in reducing the negative symptoms of Depression, Anxiety, Obsessive-Compulsive Disorder, and some forms of Post-Traumatic Stress Disorder (PTSD).

 

Get Your Consultation Today

Mind Spa Denver is proud to support active military personnel, veterans, and their families.  If you think TMS might be right for you or a loved one and you live in the Denver area, contact Mind Spa Denver today to schedule a consultation.

 

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