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Short Sighted Decision Making of Insurance Companies Regarding Migraine Treatments

As many of us living with chronic migraines know well, if your doctor suggests a medication or treatment that is more expensive than most, your insurance company can almost always be counted on to make a fuss about paying for it.

Considering that most insurance companies are for profit corporations, cost obviously is part of what they consider in deciding whether to cover a treatment or procedure. However, it seems incredibly sort sighted to me when an insurance company refuses to cover a potentially life-changing procedure like Botox injections for a patient with chronic migraines.

People with chronic migraines can be expensive patients to cover, but if a sometimes slightly more expensive preventive medication or treatment like Botox injections is effective in reducing the frequency and intensity of their attacks, ultimately the insurance company will spend less money on that patient. The patient will be much less likely to need expensive visits to the emergency room for treatment of unrelenting migraine attacks and will use less of their at home treatment medications.

Not only that, but we pay our premiums just like everyone else, including many patients who barely cost the insurance company anything. Considering that not very many patients are as expensive to insurance as we can be, doesn’t it all kind of balance out.

Why does it seem like it’s so hard for insurance companies to see the big picture when they’re making decisions about whether to cover a treatment or procedure? I guess what they really want are patients who make them money and we just get in the way of that.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • Amy Baker
    7 years ago

    I have had to fight for every medication I have been on and every procedure I have tried. I always ask my doctor to send in a verification to the insurance company when he changes my medication so I can skip that inevitable step in the long process. Insurance Company’s do not understand that each and every migraine patient is different on how they interact with the medication or the procedures that are available.

  • Emilio Barco
    7 years ago

    So true!

  • Darin Ball
    7 years ago

    I have struggled with headaches for years now. Some are severe, and others just a dull pain that stays for days. I am sorry you struggle with migraines, they are horrible.

  • Kathy Lowery
    7 years ago

    $600 for 18? that’s outrageous you poor thing. here zomig is $22 for 4 except I’m on a benefit so its $8 for 4 and I can have as many as I want for that.

  • Carly Schaps
    7 years ago

    My insurance does not cover prescription drugs, so if I want Maxalt, which is not generic but works better than Imitrix (which is), I have to pay for it out of pocket. It costs $600 for 18.

  • Kathy Lowery
    7 years ago

    they don’t pay for it in the land of socialised medicine too. Its about 2 grand to pay a plastic surgeon.

  • Mariel Moya
    7 years ago

    I will try anything as long as my migraine stop or have less!

  • Marquita Fuchs
    7 years ago

    yes very true, but I still wonder could this be gender based( not that men do not get migraines) but women may be the majority of uses of meds. and treatments. My company only allows one to have 4 triptans at each refill per 2 weeks, is this not insane.

  • Ayisha Zaharah Howard
    7 years ago

    Not too sure about introducing Botox to Mr. Migraine…..hmmm

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