Wednesday, January 18, 2012

Insurance Appeal

It appears my migraine doc is appealing my insurance companies decision to not allow me to do another round of Botox. The doc said the Botox can provide more benefit the longer taken - and that it would really takes 3 or 4 injection before I knew for sure if it will reduce the frequency of the migraines. As you can imagine the insurance company doesn't see it that way.

Honestly, I didn't even know they were going to do this but am really glad they decided to. That's not to say that I hold onto much hope that the insurance company will decide to go ahead and allow it just because of the appeal - in face I have no confidence in them at all.

Still, I must admit I appreciate the effort by all those in my doc's office who will now have extra work on my behalf. And who knows, what a great surprise it would be if we won the appeal.

Have you ever had to make an appeal to your insurance company? How did it turn out?


  1. I sure hope the doctors will win this appeal. i haven't done an appeal yet, although I almost did when they refused to cover celebrex. I take meloxicam instead and it works just as well. If it didn't though, I would have to appeal. Good luck! I do hope the botox will help relieve your migraines. headaches are no fun, I know. I have had one for about 7 years now and there isn't anything they can do about it except when it is more painful than normal.


  2. I went through the exact same thing! I haven't gotten it in awhile though because my new Neuro doesn't think it's effective. I was kinda sad she wouldn't do it....but in all reality, it didn't help my pain. I just miss the wrinkle free forehead. In fact, I'm about to go pay to have my forehead done by a plastic surgeon purely for cosmetic reasons.

    I hope you're insurance company pulls through on at least deserve a real chance! And I have heard people say it has worked for them, I just wasn't one of the lucky ones!

  3. I will be getting my fourth round of Botox injections in my sub-occipital area and sternoclidomastoid muscles. The treatment is covered for me, but my extended health care through work will not cover the cost of the Medical Botox itself (totally different medication from the kind used to remove wrinkles).

    However, since my last treatment, the Province had officially declared Medicinal Botox a legitimate treatment for migraine. That means that at some point the provincial health care system will cover it. I can't wait! That stuff is not cheap!

    Good luck with your appeal!