What TMS costs in Illinois and how insurers approve it

Every major insurer operating in Illinois covers TMS for major depressive disorder, but all of them require documented failure of prior treatment first. Blue Cross and Blue Shield of Illinois, Aetna, Cigna, UnitedHealthcare, Humana and Health Alliance typically require trials of two to four antidepressants from more than one class, usually alongside a course of psychotherapy. Medicare covers TMS in Illinois under the local coverage determination administered by National Government Services, the Medicare contractor for Jurisdiction 6, which requires trials of four medications or documented intolerance. Coverage under Illinois Medicaid and its managed care plans — including Meridian, Molina, Aetna Better Health, Blue Cross Community Health Plans and CountyCare — is more limited than commercial coverage and prior authorization is strict; confirm with the clinic before you start. Most Illinois clinics handle the authorization paperwork for you — ask before your consultation.