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Will Botox for Migraines Be Covered by Major Medical Insurance?

I have had migraines for over 30 years. Sometimes every night in spring and fall. Will blue cross blue shield cover the cost? What medical documents do I need to take to a dermatologist or plastic surgeon.

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14 Doctor Answers | Asked by redbone5153 in Mcdonough, GA

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Will Botox for Migraines Be Covered by Major Medical Insurance

The simple answer is yes. But I'm finding the majority of the insurers are refusing reimbursement to plastic surgeons since we are not internist or neurologist with detailed headache records on the patient. So for migrane therapy use a non plastic surgeon, for cosmetic Botox therapy ONLY use a Plastic Surgeon or Dem.

Botox for Migraines Covered by Major Medical Insurance

Botox may be reimbursable by an insurance company for migraines although each company and plan is different. You will need to demonstrate a history of migraines and that other methodologies have been attempted. Detailed records are important for reimbursement.

Botox and migraines

Botox can help migraines in some individuals, but I do not know if the insurance companies will cover this indication. You'll have to check.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Botox for migraines

Even though the FDA has approved Botox for the treatment of migraines, insurance companies do not have to cover the cost of the procedure or include it in individual coverages. Hopefully with time, most if not all insurance companies will cover this very effective treatment for migraines.

Insurance coverage of Migraines with botulinum toxin

This was recently approved as a recognized treatment option and so the reimbusement patterns have not been not been completely elucidated.

Otto Joseph Placik, MD

32 reviews

Chicago Plastic Surgeon

Botox Cosmetic for Migraine Headaches - Insurance Coverage

Hi redbone5153 in Mcdonough, GA, The FDA only recently approved the use of Botox for chronic migraine patients, even though Botox has been used for years to help headaches. Insurance coverage largely depends on your insurance benefits with your insurance provider. It's best to ask your insurance company. Best of luck.

Botox for migraines

coverage depends on many factors, most importantly : medical necessity/treatment failures and insurance coverage. You are better served calling your insurance company and finding out what your coverage is, and what you would need to do/who you would need to see to help get the procedure covered.

Botox for migraine prophylaxis

As you can see, it depends on your location and your insurance plan, as well as some of the coding used by your provider. In Wisconsin, it doesn't matter what kind of doc you are, ie there is no bias against plastic surgeons. That's because botox for migraines can be performed by rehab med docs, neurologists, chronic pain docs, anesthesia, or internal medicine. My suggestion, however, is to stick with "core" physicians for those with the most... more

Will Botox for migraines be covered by insurance?

What procedures a particular health insurance plan covers is usually up to the plan administrators, therefore no one can say with certainty, whether they will cover Botox for migraines. Insurance companies very rarely cover procedures that are not FDA-approved. The good news is that now that Botox is now approved for migraines by the FDA. What I would recommend is that you contact the benefits division of your insurance company and ask whether they cover this procedure,... more

Botox for migraines

Some insurance carriers may reimburse partially the cost for Botox for migraines. You would need to check with your individual insurer and they may grant precertification, however, they will tell you that they donot guarantee payment, even if they do precertify it.

Certain insurers will cover Botox treatment of chronic migraines - recent FDA approval might help

Some chronic migraine sufferers who have failed traditional migraine treatments will benefit from Botox. I have several patients who have had life changing benefits from Botox. About half of their insurance companies cover the treatment the other half, unfortunately, need to pay out of pocket. It is possible that the recent FDA approval will help obtain authorization for this treatment in certain patients. Seek out an experienced injector since Botox treatment of migraines is not the same as... more

Botox for Migraines

Botox is an effective treatment for headaches. I know because I use it on myself for headaches and it is very effective. Each insurance plan is different and many require treatment with traditional modalities such as medication prior to approving Botox. Good luck.

This will depend on your insurance company.

Please recognize that the FDA approval was for individuals with chronic migraines. The benefit was only seen in individuals who suffer from migraines more than 15 days per month. The increase in migraine free days was seen in both the study patients who received placebo and those who received the BOTOX but the BOTOX patients had moderately more days migraine free than those who received placebo. A significant amount of BOTOX was needed to achieve migraine improvement: 150... more

Kenneth D. Steinsapir, MD

8 reviews

Los Angeles Oculoplastic Surgeon

Botox may be covered

This will depend on what insurance companies dictate in addition to Medicare. What I envision happening is that it may be covered, but there should be evidence that the patient has been suffering of this ailment for some time, the condition is causing signifiant social distress and has tried and failed other treatment modalities. A prior authorization may be required.