Botox for Hemifacial Spasm Covered by Insurance?

Your insurance may be able to cover your treatment. The best thing to do is to contact your insurance provider to find out if your treatment would be covered.

I would contact the plastic surgeon, ENT, oculoplastic surgeon, neurologist or dermatologist that you plan to use and ask to speak with their insurance staff to inquire about their specific experiences with insurance coverage which can be regional and vary state by state, by insurance plan and by insurance policy.

I have treated several patients for hemi-facial spasm. We have not had good success getting the Botox covered by their insurance companies. However, the doses typically need are small 4-12 units in my experience so at least the cost is low. Hope this helps.

Ostensibly, use of Botox for certain medical conditions like hemifacial spasm, essential blepharospasm, spasmodic dysphonia are covered by insurance companies.  However, this varies with the company, the individual policy, and sometimes luck of the draw.  As Dr. Shelton stated, many insurance companies will "pre-approve" a claim, only later to "de-approve" the same claim for no particular reason.  I always advocate that in situations like this, the patient should become actively involved in motivating the process to move forward.  Call your insurance company.

Botox has been used for conditions such as hemi-facial spasm far longer than for cosmetic uses. As a matter of fact, it was treatment of bleharospasm (eyelid twitching uncontrollably) that led to the discovery of Botox for cosmetic wrinkles. If the causes are well documented and you have been evaluated by a qualified specialist in conditions such as these, insurance may cover treatment. This will also depend on coverage issues and if you chosen doctor participates in the insurance plan.