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Anthem BCBS

How Your Anthem BCBS Plan Covers Life-Changing Depression Treatment in Colorado

Just googling “psychiatrist near me” isn’t going to get you the relief you need from depression and anxiety. You need to not only know what cutting-edge treatments are available–which many psychiatrists do not have access to–and also, what your insurance will pay for. Advanced treatments like Deep TMS and Spravato esktamine therapy are helping people find lasting relief, with studies showing success rates of over 80% and remission rates over 65%.

At Axis Integrated Mental Health, we specialize in making these transformative therapies accessible and affordable for Anthem Blue Cross Blue Shield members across Colorado. We are experts at navigating Anthem/BCBS’s system to get you the coverage you deserve.

Your Advanced Treatment Options

Deep TMS (Transcranial Magnetic Stimulation)

Deep TMS is a non-invasive therapy that uses magnetic pulses to stimulate the areas of your brain that control mood.

Success Rate: 82% of patients see improvement, and 65% achieve full remission within six weeks.
Treatment Schedule: Sessions are 5 days a week for 6-9 weeks. Each session lasts 30-40 minutes.
Side Effects: The most common side effects are mild headaches and scalp discomfort.

Spravato™ (esketamine) Ketamine Therapy

Spravato is an FDA-approved nasal spray derived from ketamine that works by promoting the growth of new, positive connections in the brain.

Success Rate: Nearly 80% of patients experience improvement, with 53% achieving remission.
Treatment Schedule: Treatment typically starts at twice a week for four weeks, then moves to once a week for the next four weeks.
Side Effects: Common side effects include temporary dizziness, nausea, or a feeling of being disconnected. Sessions include a 2-hour monitoring period in our clinic.

The Axis Advantage for Anthem Members

We act as your dedicated partner to ensure a smooth, stress-free process.

We Maximize Your Benefits

Affordable Copays: The typical copay for our Anthem/BCBS patients is just $30, based on an average of over 350 patients. Please note individual plans vary.
Spravato Savings: For Spravato treatment, we automatically enroll you in a manufacturer savings program that can reduce your cost to as little as $10 per visit. This program provides up to $8,150 annually to cover copays, deductibles, and your out-of-pocket max.

We Handle the Paperwork

Fast Approvals: We are experts at getting prior authorizations approved, often within two weeks of your first appointment.
Comprehensive Submissions: Our team prepares a complete clinical documentation package with medical necessity justifications to send to Anthem/BCBS.
We Advocate for You: If a request is ever denied, we immediately demand a Peer-to-Peer review to have our doctors speak directly with Anthem/BCBS doctors on your behalf.

We Offer What Telehealth Can't

While Anthem/BCBS offers helpful telehealth options like Anthem Virtual Care via the Sydney Health app and LiveHealth Online, these platforms cannot provide the advanced, in-person treatments required for persistent depression. We provide that next level of care using your same Anthem/BCBS coverage.

* The clinical studies referenced in this article provide valuable insights into mental health treatments. However, like all research, they have limitations. Outcomes may vary due to differences in study design, sample sizes, patient populations, and treatment protocols. Some findings may not be generalizable to all individuals, and newer research may expand
or refine these results. This content is for educational purposes only and should not replace professional medical advice. Please consult a qualified healthcare provider to determine the best treatment options for your unique situation.

Am I a Candidate for Coverage?

Your Anthem/BCBS plan will likely cover these treatments if you meet the following criteria:

You have tried at least two different types of antidepressants.
Each medication was taken at a therapeutic dose for at least six weeks during the current depressive episode.
Your current depression is diagnosed as moderate to severe.
You have a psychiatric evaluation documenting your treatment resistance.
You do not have active substance abuse issues.
You at least 18 years old.
You are able to attend regular treatment sessions.

Frequently Asked Questions

1. How is this different from the therapy I can get on the Sydney Health app?

Telehealth apps like Sydney Health are excellent for virtual therapy and basic psychiatry. However, they cannot offer medical procedures like Deep TMS or administer medically supervised treatments like Spravato, which are designed for depression that hasn’t responded to other methods.

2. What kind of financial help is available if I have questions?

We have financial counseling available to all patients. Our team can walk you through your benefits as well as our pro bono program and ensure you understand your costs before beginning treatment.

3. The requirements mention a "therapeutic dose for 6 weeks." What does that mean?

This means you took the medication at the dose level recommended by a doctor for it to be effective, and you took it for a long enough period (at least 6 weeks) to see if it would work for you. Our team will help document this from your medical history.

4. What is the Cash Pay Price for Deep TMS if Anthem doesn’t cover it?

Axis provides Cash Pay Discounts for Deep TMS, charging $5,000 for the standard protocol. Accelerated 6 day protocols are charged at $7,000 total.

Does Anthem Blue Cross Blue Shield cover TMS therapy in Colorado?

Yes, Anthem BCBS covers Deep TMS treatment after a patient has a history of trying two or more failed medications and a therapy trial. Treatment costs will go towards your deductible and out-of-pocket max .

Does Anthem BCBS cover Spravato ketamine therapy?

Yes, Anthem BCBS covers Spravato after two or more failed medication trials. A manufacturer savings card can reduce the out-of-pocket cost to as little as $10 per visit.

What is required to get Anthem to approve advanced depression treatment?

To get coverage, you must have a history of trying at least two different antidepressants for a minimum of 6 weeks each, have a moderate-to-severe diagnosis, and have a psychiatric evaluation documenting your condition.

anthem_bcbs-book - Axis Integrated Mental Health

Download Our Anthem/BCBS Mental Health Benefits Guide

Go beyond just googling “psychiatrist near me” and get clarity on what Anthem mental health benefits can do for you. Download our free guide and be better prepared to navigate Colorado’s complex mental health landscape from your very first appointment.