Could Botox Prevention For Chronic Migraine Be Covered By Your Insurance?


Chronic MigraineIf you’re one of the 3.2 million adults in the US currently struggling with Chronic Migraine, you’re no doubt reaching breaking point with having to put up with persistent pain on a daily basis. Luckily, there is a solution - Botox.

That’s right - Botox is an FDA-approved treatment for preventing Chronic Migraine. It is already helping people up and down the US to better cope with Chronic Migraine, and at Austin Family Medicine we’re raising awareness of the procedure to ensure that as many people as possible in the Austin area can take advantage of this fantastic treatment. Not only is Botox clinically proven to be a successful preventative of headaches and migraines, but it is also covered for most Chronic Migraine patients by their medical insurance.

How Botox treats Chronic Migraine

Botox is a neurotoxin which inhibits nerve function in order to cause mild muscle paralysis. This sounds scary, but when used in small doses it can have some brilliant effects. When used as a cosmetic treatment, Botox works to relax muscles which cause wrinkles and lines in the skin in order to create a smoother appearance to the face. When it comes to Chronic Migraine, it works to inhibit nerve cells in pain pathways in order to reduce the frequency and severity of headaches and migraines.

Patients who undergo Botox for Chronic Migraine are given two treatments, each one twelve weeks apart. With each treatment, Botox is injected via a very thin needle into seven different muscle areas in the neck and head. The effects aren’t immediate, but over the course of 24 weeks patients find that the frequency of their headaches gradually diminishes and on average, they find that the number of headache days experienced each month is reduced by around 50% or more.

If after the first two Botox treatments both patient and doctor are satisfied with the positive effects, ongoing treatments are required once every 12 weeks or so. With each treatment taking as little as 15 minutes and with no downtime, Botox is proving to be an incredibly convenient preventative treatment for Chronic Migraine sufferers.

Botox available on medical insurance

Providing that you have been diagnosed with Chronic Migraine, it’s likely that your medical insurance will cover Botox prescriptions as a reoccurring treatment for the condition. However, the majority of people who undergo Botox for Chronic Migraine must meet certain requirements. Namely that they have trialed some oral preventatives for the condition.

Statistics into medical insurance coverage show that 77.5% of patients must have trialed two or fewer oral preventatives before Botox is covered by their policy. 12.8% must have trialed three or more oral preventatives. However, if you’ve been suffering from Chronic Migraine for some time, it’s likely that you’ve already tried some preventative treatments. On average, Chronic Migraine suffers have tried 3.9 preventative treatments. As a result, the majority already meet their insurance policy requirements for Botox treatments.

If you’ve only recently been diagnoses with Chronic Migraine, or you think you may have the condition but are yet to be diagnosed, be mindful that you may have to trial oral preventatives before your insurance will cover Botox.

As with any type of treatment and condition, coverage will differ from insurer to insurer and policy to policy. You must check the conditions of your policy and consider an extra out-of-pocket costs. However, statistics show that 97% of Chronic Migraine sufferers with commercial insurance policies are able to undergo Botox. 100% of Medicare patients are covered, so it’s highly likely that you too can access this pioneering treatment.

If you’d like to talk to your doctor about receiving Botox treatment for Chronic Migraine, please get in touch to book an appointment.