I'm getting my first Botox treatment in November, and I'm trying to get my insurance to cover it. I know for a fact it is considered investigational (the funny thing is that from 2004 through May 2009 it wasn't and my compay paid for it). I know I'm going to have to pay out of pocket for my treatment when I get it done, but I'm hoping to get my insurer to reimburse the cost in the long run.
I'm actually doing a pre-service appeal. I've written my letter, complete with references to the Phase 3 clinical trials, the UK approval, several journal articles related to my specific symptoms, and a full APA style bibliography. (Let's see what they make of that! HA!) I'm also going to see if I can get my doctor to provide a letter of Medical Necessity for me.
I'm just wondering, has anyone had any luck getting thier insurance to cover Botox on an appeals basis? If so, do you have any tips?