Key takeaways
- The Humana name alone does not identify the governing TMS policy.
- Medicare Advantage uses applicable Medicare coverage criteria.
- Medicaid benefits and provider participation need their own verification.
- We check the clinical requirements, approval process, and estimated costs for your product.
Which Humana coverage do you have?
| Product | What we verify |
|---|---|
| Humana Medicare Advantage | Applicable Medicare criteria, provider network, and authorization requirements |
| Humana Medicare Supplement | Original Medicare coverage and the supplement’s eligible cost-sharing benefits |
| Humana Healthy Horizons in Florida | Florida Medicaid benefits, medical necessity, authorization, and clinic participation |
| Medicare and Medicaid together | Which benefits apply and how the programs coordinate payment |
Product
Humana Medicare Advantage
Applicable Medicare criteria, provider network, and authorization requirements
Humana Medicare Supplement
Original Medicare coverage and the supplement’s eligible cost-sharing benefits
Humana Healthy Horizons in Florida
Florida Medicaid benefits, medical necessity, authorization, and clinic participation
Medicare and Medicaid together
Which benefits apply and how the programs coordinate payment
Provide all of your insurance cards, including your Medicare information when applicable. If you are unsure which product you have, our team can help identify it.
Humana Medicare Advantage: the Florida Medicare framework
Medicare Advantage plans must follow applicable Medicare coverage criteria. For Florida TMS services, First Coast’s LCD L34522 is the relevant local framework to consider.
| Coverage question | Florida Medicare framework |
|---|---|
| Population | Adults |
| Diagnosis | Severe major depressive disorder |
| Medication history | One or more adequate failed trials and/or documented intolerance |
| Evaluation and order | Psychiatrist’s face-to-face examination, record review, and written order |
| Psychotherapy/augmentation | Not separate initial requirements listed in the Florida LCD |
| Course | Up to six weeks under the LCD; confirm the plan’s approved services |
| Repeat course | Individual review; no universal Humana interval or symptom-worsening formula established here |
| Authorization | Applicable HMO/PPO plans generally require approval; product-specific exceptions apply |
Coverage question
Population
Adults
Diagnosis
Severe major depressive disorder
Medication history
One or more adequate failed trials and/or documented intolerance
Evaluation and order
Psychiatrist’s face-to-face examination, record review, and written order
Psychotherapy/augmentation
Not separate initial requirements listed in the Florida LCD
Course
Up to six weeks under the LCD; confirm the plan’s approved services
Repeat course
Individual review; no universal Humana interval or symptom-worsening formula established here
Authorization
Applicable HMO/PPO plans generally require approval; product-specific exceptions apply
A clinical assessment also reviews whether the recommended treatment is appropriate for your circumstances.
Does Humana require four medications or ECT first?
There is no single medication count that should be applied to every Humana product. We identify the governing coverage criteria before evaluating your history.
The Florida Medicare LCD described above does not list an ECT trial as a separate initial requirement. Your clinician still reviews appropriate treatment options, and other products need their own benefit and policy review.
An insurer’s policy from another state should not automatically be used to determine Florida Medicaid eligibility.
Authorization and clinical documentation
For products requiring authorization, we prepare the request using the applicable criteria. Useful records include:
- Current psychiatric notes and symptom assessments.
- Medication doses, dates, responses, and side effects.
- Previous TMS courses and documented outcomes.
- Psychotherapy or other treatment records when relevant.
- Current medications and medical history.
If you are already in treatment and changing insurance, tell us promptly. We can review continuity requirements and the new plan’s approval process.
What will TMS cost with Humana?
Costs depend on your specific benefits and coverage arrangement. We review deductible or copayment obligations, coinsurance, network participation, and approved services.
A Medicare Supplement policy and a Medicare Advantage plan can affect costs differently. Members with both Medicare and Medicaid also need a coordinated review.
We provide an individualized estimate before treatment begins.
Frequently asked questions
Yes. Share your complete plan information. We can help identify which product and benefits need review.
Medicaid benefits require a separate review. If you also have Medicare, the coordination of your benefits matters. We check the specific programs involved.
Participation can vary by product, location, and network. We verify your specific coverage before representing services as in-network.
We explain the request and help identify the information needed. When appropriate, we can discuss reconsideration or appeal options.
Contact us for an assessment. We review current symptoms, previous outcomes, the governing policy, and the required approval process.
No. We review the actual device and schedule being recommended. A benefit for an acute TMS course does not establish coverage for every future protocol.
Check your Humana TMS coverage
Florida TMS Clinic provides TMS care in Wesley Chapel and Tampa. We can help you understand the requirements that apply to your plan and the next step in evaluating treatment.
Call (813) 867-2378 or request your Humana coverage check.
Compare TMS insurance coverage.
Policy information checked November 1, 2026. Coverage and participation depend on your product, clinical circumstances, benefits, network, and required approvals. Verification and authorization do not guarantee payment.
Official policy references
Medical information on this page is educational and not a substitute for professional advice. Individual results vary.