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Does Insurance Cover Botox or Not?

I have heard both information that insurance covers Botox and that it doesn't. I was hoping to get some clarification on this subject, and how well is it to proceed if insurance is a possibility? Thanks so much for your help in advance.

Doctor Answers (12)

Insurance Coverage for Botox

+1

Botox can be covered by insurance. However, it is based on your individual insurance plan and the indicated use of the botox.  If it is deemed medically necessary by your insurance plan, they will cover. If they feel that is for cosmetic reasons, they generally will not.

West Palm Beach Plastic Surgeon
4.5 out of 5 stars 14 reviews

Insurance coverage for Botox

+1

Hi Mike,

Some uses for Botox are covered by insurance, but unfortunately not the cosmetic uses. Some common conditions that are covered:

  • cerebral palsy
  • hyperhidrosis (sweaty palms and armpits)
  • muscle spasms including around the eye
  • migraine headaches

Any use that is specific to wrinkles or cosmetic enhancement will not be covered by insurance.

Web reference: http://www.celibre.com/botoxba.aspx

Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 6 reviews

Only for medical problems

+1

Botox is used to treat many spasticity disorders in children and adults.  In these instances insurance may pay for the treatment as it is not cosmetic but functional.  Insurance will not pay for Botox Cosmetic to be used for facial wrinkles.

Fairfax Plastic Surgeon
5.0 out of 5 stars 13 reviews

Insurance does not cover Botox Cosmetic treatments

+1

Hello Mike,

Some insurance companies will cover Botox Therapeutic treatments for blepharospasm, neck muscle (SCM) spasm or torticollis and dystonia, migraine headaches and excessive sweating in the underarm, hand or feet that has failed to respond to a variety of other treatments. Typically pre-approval is required.

I have yet to see a company cover any Botox Cosmetic treatments.

Good Luck!

Seattle General Surgeon

Botox is NOT covered by insurance if for wrinkles, but may be for excess sweating or migraines.

+1

Thanks for your question.

Very simply explained, insurance does NOT cover Botox for cosmetic use. So, insurance will never cover Botox for wrinkles or anti-aging. However, insurances occasionally do cover Botox usage for hyperhidrosis (excess sweating) or migraines, but these covered services usually have to be approved by your insurance through your physician's office. Sometimes, the covered Botox treatment for migraines may also diminish the appearance of forehead wrinkles.

Hope this helps!

Beverly Hills Dermatologist
5.0 out of 5 stars 1 review

Botox for wrinkles is NOT covered by insurance

+1

Botox was used for numerous medical conditions (including migraines, hyperhidrosis, muscle spasm, cerebral palsy, etc) well before Botox Cosmetic was introduced. The Botox Cosmetic was specifically introduced for the FDA approved indication of treating the frown lines between the eyebrows. Insurance companies are very difficult to work with when trying to get reimbursement for Botox for legitimate medical diagnoses. They will NEVER pay for any cosmetic indication. I'm afraid you are on your own.

Portland Plastic Surgeon

Insurance never covers cosmetic

+1

If you have blepharospasm, the treatment with Botox by your opthalmologist will be covered. So,too, is the use of Botox for other medical conditions (headaches, crosssed eyes, vocal cord spasm, other spastic conditions).

The use of Botox for wrinkles, is never covered.

Web reference: http://www.drmarylupo.com

New Orleans Dermatologist
5.0 out of 5 stars 8 reviews

Insurance coverage for Botox

+1

Whether an insurance company covers Botox for medical diagnoses such as hyperhidrosis, migraine headache, blepharospasm (eyelid twitching) depends on the individual insurance plan.  Botox for cosmetic reasons (wrinkle reduction) is never a covered insurance benefit.

Good luck.

San Diego Dermatologist
5.0 out of 5 stars 4 reviews

Botox for cosmetic reasons is not part of any insurance plan

+1

Hello,

Botox for cosmetic reasons is not part of any insurance plan.  Botox can be used in certain medical conditions and then it may be part of an insurance benefit.  So if it is wrinkles/creases you are worried about, Botox is an elective, non-covered benefit.

Santa Rosa Plastic Surgeon
5.0 out of 5 stars 11 reviews

Does insurance pay for botox

+1

All insurence policies, no matter how deluxe, clearly state that they will NOT pay for anything that THEY consider cosmetic. IF botox is used to treat a Bonefide medical condition such as facial muscle spacity or headache then t hey MIGHT pay for it.

Any attempt to falsify a medical record is insurance fraud and is treated as a felony.

Bronx Plastic Surgeon
5.0 out of 5 stars 1 review

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.