Insurance Coverage and Verification
Coverage for VNS Therapy for the adjunctive long-term treatment of chronic or recurrent depression for patients over the age of 18 who are experiencing a major depressive episode and have not had an adequate response to four or more adequate antidepressant treatments is likely to be based on each individual's unique clinical circumstances until payers have an opportunity to implement formal policy. The Cyberonics reimbursement team is currently working with payers to develop medical policy for VNS Therapy for depression.
Until such time as favorable coverage policies are established for VNS Therapy in TRD and psychiatrists and Americans with TRD have the same universal access to VNS Therapy as neurologists and Americans with refractory epilepsy have today, VNS Therapy nurse case managers are ready, willing and able to assist you with insurance verification, and case by case prior authorization, if needed
Through 9/29/2008, case by case approvals and/or reimbursement have been obtained from 336 different payers including:
- 1-888-OhioComp
- 21st Century Health
- Access Administrators
- Acordia National
- ACS/Healthnet of N.E.
- Administrative Enterprises, Inc. (AEI)
- Aetna - 8 plans
- Affinity Health Plan
- Air Force Insurance Fund
- Allegiance Benefit Plan Management, Inc
- Alliance Health Plan
- American Administrative Group, Inc.
- American Family Insurance
- American Lifecare
- American Sterling Insurance Company
- Antares / EHP (Employee Health Plan)
- Anthem Health Plans Inc.
- Anthem Health Plans of Kentucky
- Anthem Health Plans of Virginia, Inc.
- Anthem HealthKeepers
- Anthem Insurance Companies Inc.
- Anthem Senior Advantage
- Appalachian Benefit Administrators
- Aransas County Indigent Health Care
- Automobile Mechanics' Local 701 Union Welfare Fund
- Avera Health Plans
- Banner Health Plan
- BCBS - 47 plans
- Benefit Administrative Systems, LTD
- Benefit Planner
- Benefit Services
- Benefits Management Service
- Benesight, Inc.
- Benesys/The Benefit System
- BMI Health Plans
- Cambridge Integrated
- Carpenter District Council
- CBA (Cooperative Benefit Administrators
- Central Benefits Mutual Insurance Company
- Central States
- CHAMPVA
- CHCC Health Plan
- Chesterfield Resources, Inc.
- CIGNA - 16 plans
- City of Mesa Employee Benefits
- CMR - Case Management Resources
- CMS - Claim Management Services, Inc.
- CNA Insurance
- Commerce Benefits Group
- Community Insurance Company
- Connecticare Inc
- Cooper Standard
- Coresource
- Cox Health Plans
- Dakota Care
- Definity Health
- Delta Health Systems
- Department of Labor
- Devon Healthcare
- Dunn & Associates Benefit Administrators, Inc
- E.S. Beveridge & Associates
- Emerald Health Network, Inc.
- Employee Benefit Management Corp.
- Entrust, Inc.
- Epoch Group
- Equitable Insurance
- Fallon Community Health Plan, Inc.
- Federated Claims Service
- Federated Mutual Insurance
- First Administrators
- First Choice
- First Health
- First Service Administration
- Fiserv Health
- Fiserv Health Harrington
- GEHA-Health Plan
- Geisinger Health Plan
- Genworth Life and Annuity
- GHI
- Golden Rule
- Group & Pension Administrators
- Guardian
- Gundersen Lutheran Health Plan, Inc.
- Harrington Benefits
- Harvard Pilgrim Health Care, Inc.
- HCH Administration
- Health Alliance Medical Plan
- Health Alliance Plan of MI
- Health Choice
- Health Design Plus
- Health Link
- Health Net, Inc.
- Health Partners Organization
- Health Plans, Inc
- Health Plus
- Health Plus of Louisiana, Inc.
- Health Spring
- Healthcare Management Administrators
- HealthChoice
- Healthnet, Inc.
- HealthScope Benefits
- HealthSmart - Claims
- Humana
- IHS-Innovated Health Systems
- ILWU - PMA Welfare Plan Benefits
- Independent Health Assoc Inc - 1 plans
- ISP Financial
- JSL Administrators
- Kaiser
- Keystone Health Plan Central
- Loomis Company
- Lumenos Insurance
- Lutheran Preferred
- M Plan Inc
- Magnacare Group, Inc.
- Managed Care of America, Inc.
- Managed Care Systems
- Marsh Advantage America
- Mechanics Local 701
- Med Cost
- MedBen
- Medica Health Plans
- Medicaid - 22 plans
- Medical Mutual
- Medicare
- Memorial Hermann Health Net Providers Inc (MHNP)
- Meritain Health
- MESSA - Michigan Education Special Services Association
- Midwest Operating Engineers
- Mutual of Omaha
- MVP Health Plan
- NCAS-National Claims Administrative Services
- NeCa-IBEW Welfare Trust Fund
- NGS American Inc.
- North America Administrators - 1 plans
- North American Administrators
- North American Health Plans
- Novasys
- OH Carpenters Health & Welfare Fund
- OH Casualty
- OneNation Benefit Administrators
- Optima Health Plan Inc
- Oxford Health Plan, LLC
- Oxford Health Plans of NY
- Oxford Health Plans-Connecticut
- Pacific care
- Pacific Life Insurance Company
- Paramount Care, Inc
- Parkview Signature Care
- Personal Care - A Coventry Health Care Plan
- Personal Choice
- Physician Hospital Community Organization
- Physicians Health Plan of Northern Indiana
- Physicians Plus Insurance Corporation
- Pinnacle Health Systems Inc
- Prairie States Enterprises
- Preferred Care
- Preferred Health Plan
- Preferred Health Systems
- Preferred One
- Preferred Plus of Kansas
- Premier Health Systems, Inc
- Presbyterian Health Plan
- Primary Physician Care
- Principal Financial Group
- Priority Health
- Providence Health Plans
- Providence Insurance & Administrative Services
- Qual Care Inc.
- QualChoice
- Regence Federal Employee Program
- RH Administrators, Inc.
- SAMBA - Special Agents Mutual Benefit Association
- SB Howard - Simmon Foods
- Scott & White Health Plan
- Secure Horizons Direct
- Secure Horizons Health Plan
- security health plan
- Sedgwick CMS
- Select Health
- Select Health - Care Plus
- SelectCare
- Self Insured Plans, LLC
- Shaw Medical
- Sheet Metal Workers Local Union No. 49
- SiHo Insurance Company
- Sioux Valley Health Plan
- Sisco Insurance
- Spectrum Administration
- State Accident Fund
- State Compensation Insurance Fund
- State Employee Group Benefits
- State Farm Health Division
- The Health Plan of the Upper Ohio Valley
- TLC Benefit Solutions
- Total Claims Solutions
- Travelers
- TRICARE for Life
- TRICARE North
- Trinity Health Plan
- Ucare of MN
- UFCW
- Unicare
- Unified Group Services
- Union Labor Life
- Unison Advantage Plan
- United Health Care - 20 plans
- United Medical Resources
- Univera Healthcare
- Univera Healthcare - Corporate Headquarters
- University of Chicago Health Plan
- UPMC Health Plan Univ of Pittsburgh Medical Center
- US Department of Labor - Workers Comp
- Veterans Administration
- Volusia Health Network
- Vytra Healthcare Plan
- Wausau Benefits
- Wels Benefits
- Wenatchee Valley Medical Plan
- Wheatlands Administrative Services
- Windsor Health Plan of Tennessee
- Wisconsin Carpenter's Health Fund
- Worker's Compensation of WV
- Writer's Guild Health Plan
Most state Medicaid agencies have yet to develop their own coverage policy for VNS Therapy for depression. A licensed nurse case manager can provide you with information specific to your state. In addition, a national coverage decision from Medicare has not yet been developed.
To have your insurance benefits verified for VNS Therapy, you can either speak with a nurse case manager by calling 1-877-NOW-4VNS (1-877-669-4867) or complete an Insurance Verification and Patient Education Authorization form, known as an IVEA. The IVEA form is HIPAA compliant (protects patient privacy) and provides a nurse case manager with your insurance information to facilitate insurance benefits verification. The IVEA form can be downloaded by clicking here, completed and then faxed to (888) 577-7205. Once your IVEA Form is received, a case manager will contact you to discuss your insurance benefits.
In addition to the assistance of VNS Therapy nurse case managers, many resources and documents are available to assist your psychiatrist with insurance coverage and reimbursement, and may be accessed on this website in the healthcare professionals section of TRD Insurance Coverage and Reimbursement.
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