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    I finished my 6 weeks course at the end of January. I was scared of slipping back into the pit. TMS did help me significantly. I wish my m.d. had done a better job of prepping me for the end of treatment. I had to wait a month to get a follow up appointment. By then I was slipping. We decided to do a maintenance treatment which I had to pay for !00% since there apparently isn’t even a procedure code to use to apply for insurance. The treatment helped but only for about a week. I can’t pay for a weekly maintenance dose. I have an appointment with m.d. tomorrow to talk about going back on meds which I hate. I had so hoped the feeling I had would last. It makes me wonder If I was just experiencing a placebo effect. Has anyone else done maintenance? Help.



    Hi Sheba, I completely understand where your at. The lack of maintenance has been my issue as well. I’m on round 3 of TMS. And the dip between round 1 and round 2 was horrific. It was like having my hope taken away. So, between round 2 and 3, my doctor and I made sure that didn’t happen again.

    At this time insurance will not cover maintenance. It’s a catch 22: they claim there are no tests to show maintenance works, but the tests would be too expensive, so…However, your doctor should have attempted to get you covered for maintenance so that there is a record. Enough recorded proof that maintenance would help and eventually it may be covered. My doctor applies for maintenance with each patient who would benefit from it so there is a history for each patient and a cumulative history of denials – and then repeat rounds of treatment. The insurance companies are paying more not providing maintenance.

    If your paying out of pocket then your doctor should offer a discounted rate. I have paid out of pocket for some maintenance, but my doctor charges me about 1/3 of what is billed to insurance. Not because he’s overfilling insurance but as a courtesy to his patient. Insurance should pay for another round after three months of the end date of your last round if you become depressed enough. Perhaps talk to your doctor about some sort of discount for a once a week or every other week treatment to tide you over until the next round. The combo that has worked for me has been: one, making sure I have a maintenance plan (i.e. a discounted rate I can afford) so when I start feeling the dip I can go in for a treatment. One treatment can make a difference, but catch that dip right away. Two, preparing to apply for another round if I’m not getting better. Three, I started taking SAM-e, which has been beneficial to me. Lifts my mood a bit without the side effects of medication.



    I agree completely with zsazsa, “one, making sure I have a maintenance plan (i.e. a discounted rate I can afford) so when I start feeling the dip I can go in for a treatment. One treatment can make a difference, but catch that dip right away.” My doctor told me that as soon as I notice a slip to call his office and set up the maintenance treatments (unless things change) we have decided that 3 treatments asap can restore me to the state of my initial 6 weeks of treatment. The longer a patient waits the more treatments are needed to restore remission.
    I pay out of pocket for maintenance too so knowing that is what I need about once a year, I set up a special account and save a little each week towards treatment. It alleviates the stress of not knowing whether I will have the money for maintenance or not.
    Every doctor has their own business model so some offer discounts, others may not offer discounts but rather a payment plan. Your coordinator probably knows the options.
    Options are out there for you. Sometimes it takes a bit longer to find them, but keep trying.
    Sending optimism!!!

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