Does Insurance Cover Botox or Not?

Unfortunately, your insurance probably won't cover your BOTOX injections if they are for cosmetic purposes, such as wrinkles or to recontour your jawline. However, if you are seeking treatment for therapeutic reasons, such as to treat chronic migraines, then 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.

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.

Dear Mike,
Most insurance carriers do not cover elective, cosmetic procedures like wrinkle reduction.
BOTOX has some medical, non-cosmetic applications which could be covered by insurance.
I hope this helps, and best regards.

Dear Mike
BOTOX and the newly approved Dysport are botulinum toxin A products that are used for both cosmetic and medical problems. The most remarkable thing about these products is the range of conditions that can be benefited by treatment with these agents.
The actual coverage of a typical health insurance plan very much varies not just by the particular insurance company but also by what an employer group chooses to include is it health insurance benefits. So it is important to confirm with your health plan what is and is not covered, and what services require prior approval.
Medical conditions that are treated with botulinum toxin A generally include conditions caused by chronic muscle spasm. These conditions can be severe and disabling such as cervical torticollis, essential blepharospams to give just two examples. Treatment of these conditions with BOTOX and Dysport have been a major advance in improving the quality of life for people suffering from these conditions. Treated for these types of conditions is generally covered with some limitations by health insurance plans.
BOTOX and Dysport are also used in much smaller doses to improve facial appearance. We may not like the line between our eyebrows but obviously it is not disabling. Treating the line with these agents makes us look better but like most cosmetic services, this is not a covered benefit under health insurance.
By the way, asking your doctor to tell your tell your health insurance company that your are getting cosmetic BOTOX treatment for a medically necessary condition when it is in fact for cosmetic reasons is called fraud. Your doctor can loose their medical license for this and you both could be subject to criminal prosecution.
Dr. Steinsapir

Thank you for your question! 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. Best of luck!

Insurance will not cover Botox if it is used for cosmetic purposes.  Occasionally Botox will be covered if it used for medical purposes (ie. muscle spasms, migraines, etc) but it will depend on the individual policy.  If you are wanting Botox for a medical purpose, contact your carrier to see if it is a covered benefit.  They should also be able to give you a list of providers in your area that will perform the treatment under policy guidelines.

Thank you for your question Mike in Georgia. I understand your concern. Botox is a purified protein used to address wrinkles associated with facial expression. When injected into the skin Botox will relax the muscles and smoothen out the overlying wrinkles. The most common areas of treatment are in the upper face. These include the horizontal lines seen on the upper forehead when one raises the brows, the vertical lines seen between the brows when one frowns (frown lines), and the crow's feet seen around the eyes when one smiles.It is difficult to make an assessment without a formal exam where the entire medical history is reviewed. However, I hope the information provided here is useful.The investment for a Botox treatment varies from office to office. It depends on the region, office, and injector. The total investment also depends on how much product is required, the areas treated, and the individual. For example, if someone has a larger forehead, a higher dose will be required. If multiple areas such as frown lines and crow’s feet will be treated the investment will be more than that if only a single area is treated. In general, men have stronger muscles than women both on the body and on the face. For this reason, men usually require higher doses than women. Please click the link above for more information. I recommend that patients look for a qualified injector instead of the best price. Look for experience, before and after photographs, and testimonials. The investment range for a Botox treatment is $200 - $500 per area. Areas include frown lines, crow’s feet, etc.

A common question when discussing the investment for a Botox treatment is whether it is covered by insurance. In general, the answer is no for Botox cosmetic. There is another product called Botox therapeutic, which is the exact same product, but packaged differently and sold by different representatives. In some cases, such as for migraine headaches Botox may be covered by insurance. However, since Botox is usually costlier to insurance companies, they frequently require other interventions such as oral medications prior to approval of Botox. It is best to contact your insurance company to see if the treatment may be covered.
With any injection, there are risks such as pain, bleeding, bruising, redness, swelling, tenderness, and infection. We take special precautions to minimize these risks such as using a painless technique. We also treat bruises with a laser as early as the next day. Bruises usually resolve within two weeks if untreated. After a laser treatment bruises usually resolve in 1-3 days, but may still take two weeks for full resolution. In addition to these risks, with Botox there is also a risk that the product spreads or diffuses to nearby structures. Spread to nearby muscles can lead to side effects such as the temporary appearance of droopy eyelids or a temporary asymmetric smile.
After a Botox treatment, I recommend that my patients avoid heat exposure, alcohol consumption, and strenuous exercise for 24 hours and not lie down flat for four hours. This is because all of these activities may possibly lead to the movement of the product and consequent side effects such as droopy eyelids. Although there have been no definitive studies shown that these actually occur and some physicians do not provide such aftercare instructions, in the absence of data I err on the side of caution and recommend that my patients avoid such activities.

Please consult with a doctor for specific recommendations. Good luck!

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.

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.

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!