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.
Answer: 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.
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CONTACT NOW Answer: 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.
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CONTACT NOW Answer: Is Botox for migraines covered by insurance? As with most insurance-related questions, this all depends on a number of factors: 1) The insurance company - some insurance companies are more likely to pay than others. 2) The patient - many insurance companies will only pay for Botox if the patient meets the very specific criteria set forth by the FDA, when Botox was approved for migraine headaches in 2010. This includes 15 or more headaches per month, and 4 or more hours per headache. 3) The amount - many insurance companies will reimburse only if the exact amount of Botox recommended by this same FDA study: 155 units over 7 muscular sites. If more or less is used, the claim could be rejected (even though many patients are known to not require the full amount) 4) The frequency - many insurance companies will pay for Botox only every 3 months, although some patients may require it more frequently. 5) The price - many Botox experts do not participate in insurance, and charge more than the insurance company is willing to pay. So even if your insurance company pays, you may be responsible for the difference between what the insurance company pays and what the doctor charges. Regardless of the above factors, insurance companies typically respond to well-organized documentation and persistent follow up.
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CONTACT NOW Answer: Is Botox for migraines covered by insurance? As with most insurance-related questions, this all depends on a number of factors: 1) The insurance company - some insurance companies are more likely to pay than others. 2) The patient - many insurance companies will only pay for Botox if the patient meets the very specific criteria set forth by the FDA, when Botox was approved for migraine headaches in 2010. This includes 15 or more headaches per month, and 4 or more hours per headache. 3) The amount - many insurance companies will reimburse only if the exact amount of Botox recommended by this same FDA study: 155 units over 7 muscular sites. If more or less is used, the claim could be rejected (even though many patients are known to not require the full amount) 4) The frequency - many insurance companies will pay for Botox only every 3 months, although some patients may require it more frequently. 5) The price - many Botox experts do not participate in insurance, and charge more than the insurance company is willing to pay. So even if your insurance company pays, you may be responsible for the difference between what the insurance company pays and what the doctor charges. Regardless of the above factors, insurance companies typically respond to well-organized documentation and persistent follow up.
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June 3, 2015
Answer: It depends on your policy... Most insurance policies require that you have tried several migraine medications without successful alleviation of the migraines. Only after will most insurance companies consider covering botox as treatment for migraines.
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CONTACT NOW June 3, 2015
Answer: It depends on your policy... Most insurance policies require that you have tried several migraine medications without successful alleviation of the migraines. Only after will most insurance companies consider covering botox as treatment for migraines.
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November 19, 2010
Answer: 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.
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CONTACT NOW November 19, 2010
Answer: 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.
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October 25, 2010
Answer: 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 experience with botox: plastic surgery, facial plastic surgery, oculoplastic surgery, or dermatology.
Overall trends regarding insurance coverage are on the decline. In my experience here in Wisconsin, we fought for coverage and saw steady iimprovement from the late 1990's through mid 2000's. In the last three years that has clearly been reversed, to the point that it is exceptional to get coverage at this point. Sad, but true. Especially since it is effective for those properly screened, in the majority of cases. Most patients also had to first prove "failure or significant side effects" using other meds like beta blockers and imitrex.
Call the benefits number on the back of your insurance card and ask them directly if Botox for migraines is a covered expense, as well as if there are restrictions (provider, frequency, proof of prior treatments).
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CONTACT NOW October 25, 2010
Answer: 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 experience with botox: plastic surgery, facial plastic surgery, oculoplastic surgery, or dermatology.
Overall trends regarding insurance coverage are on the decline. In my experience here in Wisconsin, we fought for coverage and saw steady iimprovement from the late 1990's through mid 2000's. In the last three years that has clearly been reversed, to the point that it is exceptional to get coverage at this point. Sad, but true. Especially since it is effective for those properly screened, in the majority of cases. Most patients also had to first prove "failure or significant side effects" using other meds like beta blockers and imitrex.
Call the benefits number on the back of your insurance card and ask them directly if Botox for migraines is a covered expense, as well as if there are restrictions (provider, frequency, proof of prior treatments).
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October 24, 2010
Answer: 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.
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Answer: 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.
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