TMS and Aetna
Aetna covers TMS therapy for severe unipolar major depressive disorder (MDD) without psychosis, under its Clinical Policy Bulletin for Transcranial Magnetic Stimulation.
Aetna requires a diagnosis of severe MDD, along with documentation that other treatments haven't provided adequate relief. Coverage extends to adolescents 15 and older, not just adults.
TMS requires prior authorization from Aetna. Your provider submits documentation supporting medical necessity before treatment begins.
An initial course typically covers up to 30 sessions (5 days a week for 6 weeks) plus 6 taper sessions over 3 weeks. Sessions beyond that may be reviewed individually for medical necessity.
Your specific out-of-pocket cost depends on your Aetna plan. We can help you confirm your benefits before your first session.
Spravato® and Aetna
Aetna covers Spravato® (esketamine) for adults with treatment-resistant depression or major depressive disorder with acute suicidal symptoms, once clinical criteria and prior authorization are met.
You'll generally need to be 18 or older, diagnosed with moderate-to-severe MDD or treatment-resistant depression, with an inadequate response to two different antidepressants. Spravato® must be prescribed by, or in consultation with, a psychiatrist.
Precertification is required for all Aetna plans before Spravato® treatment begins, based on documented diagnosis and prior medication trials.
Spravato® must be administered under direct supervision at a clinic certified under the FDA's REMS program, with a monitoring period after each dose. Led Life LLC is a certified authorized SPRAVATO® provider.
Cost depends on your specific Aetna plan. We can help you check your benefits before treatment starts.
Coverage policies above reflect Aetna's generally published Clinical Policy Bulletins and can change — we're happy to help confirm your specific benefits before your appointment.
Questions About Your Coverage
Contact our office to confirm your specific plan and benefits before your appointment.
Phone: (507) LED-LIFE
507-533-5433
Ellicott City (textable): 240-673-3236