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Insurance & Cost13d agoPinned

Medicare open enrollment runs Oct 15 – Dec 7: what to check if you might need TMS in 2027

Medicare's annual open enrollment runs from October 15 to December 7, and any plan change takes effect on January 1. If TMS might be part of next year, a few things are worth checking before you pick a plan. Original Medicare (Parts A and B) covers TMS for depression when you meet the criteria in your region's local coverage determination. For outpatient treatment you usually pay 20% coinsurance after the Part B deductible, unless a Medigap policy picks that up. Medicare Advantage plans have to cover what Original Medicare covers, but they can require prior authorization and limit you to a network. Before you switch, check that a TMS clinic you could actually get to is in the plan's network, and what the plan charges for outpatient mental health visits. A practical way to do it: ask the clinic you'd use which Medicare Advantage plans they accept, then compare those plans on the Medicare.gov plan finder. Full guide: https://tmslist.com/blog/medicare-open-enrollment-tms-2027/ If you've had TMS on Medicare, did you go through Original Medicare or an Advantage plan? Any surprises with prior authorization? This is general information, not medical or insurance advice.

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