The FDA recently approved the use of BOTOX to treat migraines, which leads many hopefuls to ask, will BOTOX for migraines be covered by my medical insurance company? The answer depends on what is right for you, your medical history, and your insurance. However, don’t expect your insurance to pay for top cosmetic treatment if you have just had a few migraines. Let’s take a look at the studies that led the FDA to approve BOTOX for migraine treatment, some likely insurance limitations, and how you can determine your best treatment options.
The Science behind the FDA’s Approval of BOTOX for Migraines
First you must realize that the FDA approval was for individuals with chronic migraines, with benefits observed only in individuals who suffer from migraines at least 15 days per month—in other words, more than half of your days you experience serious migraines. As you can imagine or may already experience, such high frequency of migraines can be debilitating, and individuals who fit this provile need help from a doctor to find a solution. While many adults experience migraines at times, most do not endure them this often.
The studies that led to the FDA approval showed increase in days without migraines in both patients who received a placebo and in patients who received BOTOX. But the BOTOX patients did experience a moderately higher amount in migraine-free days than the placebo group, which is crucial to demonstrating a given treatment’s efficacy in these kinds of studies. For these individuals, about 150 units of BOTOX—a significant amount—was needed to achieve improvement. There was an additional 1% of study participants who experienced a worsening in their migraines, while another 2% of study participants dropped out due to side effects.
Given the variety of responses in this trial, we see that BOTOX is probably not going to be a cure-all for anyone who has ever had a migraine. Will this treatment be right for you? Maybe. That depends on a lot of factors like your medical history, your current condition, and what kind of response you have to the treatment.
What Are Some Likely Insurance Stipulations?
Your insurance company will probably want to see significant documentation about your condition before they agree to pay for these treatments. So be sure to get appropriate authorization before you seek this treatment. Your general practitioner or specialist can help you with this, but be sure to take responsibility for finding out what all you need to do. It may be beneficial to call your insurance company and ask them for more details about your insurance plan and coverage.
Your insurance company likely won’t allow your cosmetic surgeon to provide this type of treatment, and instead they may prefer for your treatment to be performed by a neurologist. This will help them to prevent fraud and abuse. If you are simply looking for a way to have someone else pay for your cosmetic treatment, your insurance probably won’t cover it and there is no reason why they should. However, if you are a true candidate for BOTOX for migraines then you may qualify for insurance coverage. Talk to your doctor and insurance provider to learn more about your situation.
Your Treatment Should Be Appropriate to Your Situation
If you have very frequent migraines, you and your doctor can discuss appropriate treatments or lifestyle changes to improve your health. If you are dissatisfied with your appearance due to issues like forehead wrinkles, frown lines, and pinched features, it is also a good idea to consult with a top cosmetic physician to find out if BOTOX or anther treatment like the facelift is right for you. But if you have both migraines and aging facial features, does this mean that BOTOX is the best option for both and that your insurance will cover BOTOX? Not necessarily.
Migraines and aging features are separate issues, so it is important not to take any medical shortcuts or be dishonest with your insurance company or doctor. There is professional medical help for both migraines and your aesthetic goals, but trying to “kill two birds with one stone” is not a reasonable approach. We advise you to talk to your general practitioner or neurologist openly about the nature of your migraines, and be truthful about why you are inquiring about BOTOX. We also advise you to talk openly with a leading BOTOX cosmetic surgeon to find out how treatment from the best BOTOX doctor can meet your aesthetic goals. These conversations will help your doctors to determine the best treatment plan for you.
Help with BOTOX in Los Angeles
Dr. Steinsapir is a leading cosmetic surgeon in Beverly Hills and at UCLA who focuses on minimally invasive treatments that emphasize natural results for balanced facial features. He is respected for being among the finest and most qualified BOTOX providers, and his patented Microdroplet BOTOX treatment is popular among high profile executives and celebrities who wish for natural, youthful improvements. To find out how the best BOTOX can meet your needs, contact us today.