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.
Does Insurance Cover Botox or Not?
Doctor Answers (13)
Best to ask your insurance provider
The best thing to do is to contact your insurance provider to find out if your treatment would be covered.
Insurance Coverage for Botox
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.
Insurance coverage for Botox
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.
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Only for medical problems
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.
Insurance does not cover Botox Cosmetic treatments
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.
Botox is NOT covered by insurance if for wrinkles, but may be for excess sweating or migraines.
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!
Botox for wrinkles is NOT covered by insurance
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.
Insurance never covers cosmetic
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.
Insurance coverage for Botox
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.
Botox for cosmetic reasons is not part of any insurance plan
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.