Ambetter Drug and Alcohol TMS Treatment Coverage in Tennessee

Middle Tennessee and Its Most Visited Local Attractions and Landmarks

Middle Tennessee is a vibrant region rich in history, culture, and natural beauty, attracting visitors from all over the world. Some of the most iconic attractions include the Grand Ole Opry, known as the heart of country music, and the Ryman Auditorium, a historic venue that has hosted legendary performances. 

Nature lovers can enjoy the serene landscapes at Percy Warner Park or visit the Nashville Zoo at Grassmere, offering a family-friendly experience in the heart of the city. Beyond Nashville, Middle Tennessee offers a wealth of other attractions. The majestic Belle Meade Historic Site provides a glimpse into the region’s past, while Andrew Jackson’s Hermitage and the Cheekwood Botanical Garden and Museum of Art showcase the area’s historical and cultural richness. Adventurers can explore the mysterious Bell Witch Cave or the underground wonders of Cumberland Caverns.

Volunteer State Statistics and Info on TMS Treatment and Health Insurance Claims

In Tennessee, mental health concerns are rising, with a noticeable increase in adults reporting poor mental health in Davidson County over recent years. Nationwide, a significant portion of adolescents and adults faced major depression in 2021, underscoring the need for improved mental health support.

Tennessee continues to struggle with substance use and mental health issues. Drug overdose deaths have risen slightly, continuing a troubling trend over recent years. Alcohol use among youth has remained relatively stable, aligning with regional and national averages. These issues emphasize the pressing need for more effective care and support in the state.

Some of Ambetter Health’s Insurance Brands, Product Offerings, and Service Lines

Ambetter Health offers a range of insurance plans designed to meet various healthcare needs, including rehab and mental health services. Their product offerings are structured to provide different levels of coverage, allowing members to choose a plan that best fits their budget and care requirements.

Here are the three major plan types offered by Ambetter Insurance:

1. Bronze: Ambetter Essential Care
   The Bronze plan, Ambetter Essential Care, provides the lowest monthly premiums but higher out-of-pocket costs. This plan is ideal for those who want basic coverage and are willing to pay more when they need care. It covers essential services, including preventive care and mental health, but may have limited coverage for more extensive treatments.
2. Silver: Ambetter Balanced Care
   Ambetter Balanced Care offers a middle-ground option with moderate premiums and out-of-pocket costs. This plan provides a good balance of coverage and affordability, making it a popular choice for individuals who expect to use healthcare services regularly. It includes comprehensive mental health and rehab coverage, focusing on providing more extensive care options than the Bronze plan.
3. Gold: Ambetter Secure Care
   The Gold plan, Ambetter Secure Care, has the highest monthly premiums but the lowest out-of-pocket costs. This plan is designed for individuals requiring frequent medical care and wanting the most extensive coverage. It covers many services, including advanced mental health treatments and rehab, with lower copays and deductibles, making it the best option for those seeking more comprehensive care.

More Details About the Ambetter Select Health Plans in Tennessee

Ambetter Select Health Plans in Tennessee are designed to offer tailored healthcare coverage, focusing on affordable options to meet the insured’s specific needs. These plans are crafted by actuaries who assess risk and ensure that premiums are balanced with the coverage provided. Ambetter Select plans often include endorsements offering additional benefits, making them attractive for those seeking comprehensive healthcare coverage.

These Select Health Plans are particularly well-suited for individuals who want to balance cost and coverage. The endorsements available with these plans can enhance the policy, providing added value without significantly increasing premiums. This approach allows insured members in Tennessee to access essential healthcare services, including mental health and rehab, with confidence in the actuarial soundness of their coverage.

Are Freeman Recovery Centers TMS Programs a part of Ambetter’s Select Network?

Yes, Freeman Recovery Centers’ TMS programs are usually covered as part of Ambetter’s Select Network, meaning we accept this policy for our Transcranial Magnetic Stimulation (TMS) services. As a member of this network, we are committed to providing high-quality, affordable care to those covered by Ambetter.

We encourage you to call us at Freeman Recovery Center as soon as possible to discuss your treatment options and verify your Ambetter insurance coverage. Our team is here to guide you through the process, ensuring that you receive the support and care you deserve. For more information, visit our Network Guide or contact us directly.

Ambetter Coverage for TMS Therapy to Treat Major Depressive Disorder (MDD) Treatment

Major Depressive Disorder (MDD) is a mental condition characterized by ongoing sadness and a lack of interest in life. Transcranial Magnetic Stimulation (TMS) serves as an alternative for those unresponsive to usual treatments such as drugs and psychotherapy. TMS operates by delivering magnetic pulses to the brain, focusing on regions linked to mood, offering new hope for relief.

Ambetter typically covers FDA-approved TMS therapy for treating Major Depressive Disorder, especially when other treatments have proven ineffective. Coverage is based on the medical necessity of the treatment, meaning that your healthcare provider will need to document the need for TMS as part of your treatment plan. This makes it easier for individuals with Ambetter insurance to access this innovative and effective therapy.

Ambetter Coverage for TMS Therapy to Treat Obsessive-Compulsive Disorder (OCD) Treatment

Obsessive-Compulsive Disorder (OCD) is a condition showing unwanted thoughts (obsessions) and repetitive behaviors or rituals (compulsions) that an affected individual feels compelled to perform. These symptoms can be debilitating. TMS therapy for OCD targets specific areas of the brain associated with these behaviors, using brain connectivity modulation to reduce the intensity of symptoms and improve overall functioning.

Ambetter typically covers TMS therapy for treating Obsessive-Compulsive Disorder, especially when traditional treatments have not provided adequate relief. The coverage is often determined by an actuary who assesses the risks and costs associated with the treatment. While TMS and Obsessive-Compulsive Disorder (OCD) treatment can be covered under indemnity policies, coverage may vary depending on the specifics of your plan, such as loss, peril, and the average cost of TMS treatment. This ensures that patients can access this advanced therapy with minimal financial burden.

Ambetter Coverage for TMS Therapy to Treat Bipolar Disorder Treatment

Bipolar Disorder is a mental health illness recognized by extreme mood swings, including periods of depression and episodes of mania or hypomania. These mood changes can be intense and disruptive, making it difficult for individuals to maintain a stable and functional daily life. TMS therapy has emerged as a treatment for Bipolar by targeting brain regions involved in mood regulation.

Ambetter typically covers TMS therapy for treating Bipolar Disorder, particularly when traditional treatments have not been effective. The average cost of anxiety treatment with Ambetter insurance, including TMS and Bipolar Depression, is generally more manageable due to the insurance’s involvement. Coverage may involve settlement agreements and subrogation processes to handle claims appropriately. This support allows individuals with Bipolar Disorder to access innovative treatments like TMS with reduced financial stress.

Ambetter Coverage for TMS Therapy to Treat Post-Traumatic Stress Disorder (PTSD) Treatment

Post-Traumatic Stress Disorder (PTSD) can occur after experiencing a traumatic event, leading to symptoms including flashbacks, severe anxiety, and intrusive thoughts. These effects are debilitating and interfere with daily life. TMS therapy has been explored in various TMS clinical trials as a potential treatment for PTSD, showing promise in reducing symptoms by targeting specific brain regions involved in trauma responses.

Ambetter typically covers TMS therapy for treating PTSD, making this innovative treatment more accessible to those who need it. The question of “how much does TMS treatment cost with Ambetter insurance” depends on the specifics of your plan, including whether you have an umbrella policy that could provide additional coverage. Ambetter’s involvement helps to reduce out-of-pocket expenses, ensuring that patients can access effective care without facing significant financial barriers.

Ambetter Coverage for TMS Therapy to Treat Borderline Personality Disorder Treatment

Borderline Personality Disorder (BPD) is a complex condition characterized by intense emotional instability, impulsive behavior, and difficulties in maintaining relationships. TMS therapy, particularly using Theta Frequency Stimulation, has been studied for its potential to help regulate the emotional dysregulation associated with BPD. Research into TMS efficacy and safety continues to explore how this non-invasive treatment can benefit those with BPD.

Ambetter typically covers TMS therapy for treating Borderline Personality Disorder, though coverage may vary depending on the specifics of the plan. Insurance adjusters play a key role in defining coverage by evaluating the medical necessity of the treatment and any exclusions that may apply. Advanced techniques like Theta Frequency Stimulation in TMS therapy is increasingly recognized for its potential. Ambetter’s support can help make this cutting-edge treatment more accessible to those who need it.

Ambetter Coverage for TMS Therapy to Treat Auditory Hallucinations in Schizophrenia Treatment

Auditory hallucinations are a symptom of schizophrenia, where individuals hear things that are not present. These hallucinations can be distressing and disruptive, making it hard for individuals to function in daily life. TMS therapy has been explored as a treatment option for auditory hallucinations in schizophrenia by targeting specific brain regions in the processing of auditory information. 

Ambetter typically covers TMS therapy for treating auditory hallucinations in schizophrenia, making this innovative treatment more accessible to patients. Coverage through Ambetter helps mitigate the financial burden that might otherwise be a concern, especially considering the high costs of mental health treatments. TMS providers and clinics in the Ambetter network are equipped to offer this therapy, but it’s important to verify specific coverage details with your insurance provider. For those wondering, “How much does TMS treatment cost without insurance?” the answer can be daunting. Still, Ambetter’s coverage can significantly reduce these expenses.

TMS Treatment and Depression Statistics in Tennessee

• The number of emergency room visits due to suspected drug overdoses peaked in 2020 but has been slowly going down since then. So far, in 2024, there have been 278 such visits, which is about the same as in the first part of 2018.
• Most of these visits (77%) were related to non-heroin opioids. In Davidson County, about two-thirds of the people who went to the emergency room for drug overdoses in 2024 were men, and 31% were between 25 and 34 years old.
• Approximately 70,000 people in Tennessee are struggling with opioid addiction, leading to a significant issue in the state with overdoses and deaths. To address this crisis, new laws have been enacted to reduce the availability of opioids. As a result of these efforts, there has been a slight decrease in the number of opioid prescriptions being issued.
• For kids aged 12–17 in Tennessee, the percentage of those who drank alcohol in the past month stayed about the same between 2002–2004 and 2017–2019. During 2017–2019, around 9.1% of Tennessee teens (about 47,000 people) reported drinking alcohol in the past month. This percentage is similar to the regional average of 9.2% and the national average of 9.4%.
• In 2022, 3,826 people in Tennessee died from drug overdoses. This was a small increase of 0.3% compared to 2021. Between 2018 -2021, the number of overdose deaths kept going up every year, but 2022 was the first year where the increase wasn’t as big. The biggest jump in deaths happened between 2019 and 2020.
• In 2021, 20.1% of teens (ages 12-17) and 8.3% of adults in the U.S. reported going through a major depressive episode within the past year.
• The percentage of adults in Davidson County who reported experiencing poor mental health for 14 or more days in the past month stayed fairly stable between 2015 and 2017, ranging from 14.0% to 13.8%. However, it slightly increased to 15.8% in 2019.