Insurance & Payment Options

If your insurance isn’t listed here, please give us a call. We may still be able to work with your plan, especially for out-of-network mental health benefits.

TMS and Spravato Coverage

TMS and Spravato are advanced treatments for depression. Insurance coverage depends on your provider and medical history. Most plans, including Aetna, Blue Cross Blue Shield, Priority Health, Medicare, and United Healthcare, require that you’ve already tried at least two antidepressants without success. Some insurers may also ask for a history of psychotherapy or additional documentation from your mental health provider.

Once Dr. Tareen determines that TMS or Spravato is appropriate for your care, we’ll take care of the paperwork. Our team submits prior authorizations, communicates directly with your insurance provider, and tracks the status of your approval. 

If your treatment is approved, we’ll provide a full breakdown of what’s covered and what your out-of-pocket cost may be, depending on your plan’s deductible, co-insurance, or copays. If your request is denied, we’ll walk you through an appeal or help you explore other options, including self-pay or financing.

Spravato (esketamine) coverage is sometimes limited to acute treatment phases, so booster or maintenance sessions may not be fully covered by all insurers. If that applies to you, we’ll talk through every option to make care as accessible and affordable as possible.

Before Your First Appointment

We strongly recommend contacting your insurance provider before your initial evaluation to confirm your mental health coverage and verify that Kalamazoo TMS & Behavioral Health is in-network.

If you’re pursuing TMS therapy, our team will begin the prior authorization paperwork after your initial evaluation. Once you’re approved, we’ll explain the coverage process, including any out-of-pocket estimates.

What If I’m Out of Network?

Even if we’re not in-network with your current plan, you may still be able to receive care with us. Some insurance plans offer out-of-network mental health benefits or reimbursement options. We’ll provide a detailed receipt (superbill) that you can submit for potential reimbursement, and we’ll still support you with documentation, billing codes, and any paperwork you may need. We also offer discounted self-pay rates to make advanced treatments as accessible as possible.

Financing Options

We understand that cost can be a concern especially for long-term treatments like TMS or Spravato. If your treatment isn’t fully covered or you’re paying out of pocket, ask us about setting up a custom payment plan. We also work with third-party healthcare financing partners to help you spread out costs in a manageable way.

Our team is happy to explore every option available to make sure finances don’t stand in the way of your mental health.exp