Insurance and Botox

By Suffering in SC Thursday, December 20, 2007

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I'm new to this site and feel like I'm finally with people who understand my world. I work part-time instead of full time because I've had migraines for over 30 years and cannot work regular hours. Luckily I've found a job where my boss understands my condition and will allow me to stay home if I have a terrible migraine. My gripe concerns the insurance companies refusal to cover Botox injections for migraines. I had them several times about a year ago and they were the first hope I've had of getting rid of these headaches. After two or three sessions my insurance company stopped payment and will not pay anything towards the treatment. I've tried every medicine under the sun...and most migraine meds (Imitrex, Maxalt, etc.) do not seem to help me either. I feel like I'm only taking pain meds when I get a headache instead of doing something to prevent them. Has anyone else's experience been similar????

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Nancy Harris Bonk, Health Guide

12/21/07 9:35am

Hello, and welcome to MyMigraineConnection.com!

We're glad you found us too becasue we do understand Migraine disease.

Botox, can be very effective for some people, but some have a hard time getting their insurance companies to pay for the treatment. They claim that it is an experimental treatment, not approved for Migraine prevention. Have you tried to appreal their decision with your doctor's help? One idea is to talk to the insurance company regarding the various medications they have covered for you. This SharePost by Teri Robert really gets into this topic and has some great ideas on how to handle your insurance company. Migraine, Medications, and Insurance Companies

Please don't give up hope! There are over 100 different medications that can be used for Migraine prevention. When we think we have tried all of them, it really just feels like we have, honest! Click HERE for more information.

Thank you for creating a SharePost. SharePosts are a form of blogging, and there are many things you can do with them. You can share an experience, suggest something that's helped you, use SharePosts as a Migraine and headache journal, and many other things.

We also have a discussion forum that you may want to check out. Especially if you have questions or are looking for information, you may find the interaction on the forum to be quite helpful. To get to the forum, just look for the orange box marked "Manage" and click on the Migraine Forums link. Because our forums are maintained by a third party, you'll need to register for the forum. You can use the same information you used to create your community log-in if you like. If you want to go directly to the forum, you can click HERE.

Along with your personal "My Home" page and the discussion forum, you'll find links to a great deal of helpful information on the main page of our site, http://www.MyMigraineConnection.com.

If you have any questions, please feel free to post them to the forum or send me a message through my profile.

Welcome again,

Nancy Bonk
MyMigraineConnection.com Expert

PS: If you receive this message from more than one of us, please excuse the overlap. Thanks!

Anonymous

12/29/07 11:57am

I understand your dilemma. I also have gone through every possible medication, including high blood pressure and anti-seizure. The insurance company is also preventing me from trying new meds not considered for migraines but have been helpful. I really don't know what to do. Good luck.

Christine

12/29/07 10:11pm

I used to use Botox for migraines a few years ago and appealed my insurance company's decision to cover the procedure.

It was a lengthy process, but if it works for you, as Botox worked for me, it is worth it. I supplied documentation of all the medication I had tried in the past. I also supplied them with the most recent research on the latest studies. You have the opportunity to state your case. I even appeared at the insurance company's office in person. Many companies prefer to do it via conference call. However, I wanted them to see me as a real person with real problems who has tried many methods.

Each state has different insurance laws on the appeals process and it is worth looking into.

Suffering in SC

1/ 1/08 11:16am

Did this end up working? Since this has happened we have also changed insurance companies. I've tried to see if the new company (BCBS of Illinois) will cover Botox for migraines but they have declined also. Maybe I just need to keep pushing...???

Christine

1/ 1/08 12:14pm

Once you get an official denial from your insurance company you have a right to appeal that denial. You should call your state's Department of Insurance to find out the appropriate steps to appeal an insurance company's denial of coverage. As a consumer you have a right to an appeal.

I did this a few years ago and my insurance company ( I forget the name) approved the use of Botox for me on a provisional basis as long as it continued to work for me. I used Botox for about 2 years and then discontinued when I changed insurance and moved to a different state.

Insurance and Botox

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