Being Forced Off Botox

For those of us with chronic migraine, we normally end up trying a massive amount of medications and treatments hoping to find something to at the very least ease our migraine pain and suffering. In all of the years that I have been living with chronic migraine, I have tried almost everything a doctor suggested.

Trying numerous medications

My records of things that I have tried is more than enough to fill a large binder. All the off-label pills that are used as preventatives simply never helped my migraine frequency in any way. I have also done treatments that involved having injections deep into my head and a trial surgery for a nuero stimulator. Unfortunately, none of these types of preventatives helped in my situation. Some of the prescriptions made me sicker due to side effects, while others had no effect what-so-ever. They all definitely vary per person. It just seemed like nothing was working at all for me.

Finding some relief from Botox

Botox was the only thing I had not tried for my migraines. It was not an instant relief kind of treatment by any means. I had to do multiple rounds before I started to have days where I did not have migraines. It may not sound like much, but when you have chronic daily migraines, any day without a migraine is a huge relief. The Botox took time to build up in my system but it started helping me. Throughout job changes and insurance changes, we never had an issue getting the Botox treatment approved. So at this point, I had been on Botox every three month for years.

New insurance not covering Botox

For a number of reasons, I have not been working since September. This involved me transferring my medical to my husband’s insurance policy. We honestly did not assume it would be a big deal because it was just a different version of the same company. But we were definitely wrong as far as my Botox coverage was concerned. They have absolutely refused to cover the Botox treatment. My doctor has done all kinds of appeals through the insurance and even one with the state of Texas and so far we continue to get denials. So a medical treatment that was helping me, as long as I continued my treatment every three months, has been taken away from me without much of an explanation. The insurance company feels like there is not evidence of other treatments not working for me, despite the massive binder of records that I have from all the other failed treatments.

Insurance companies control how many abortives we are able to get each month. For me, it seems they are also controlling what kind of treatment I can get for my migraines right now. While it definitely makes life harder, at the moment I am still pushing through and trying to continue with my life.

Have you tried Botox for your migraines? Have you faced insurance issues when it came to getting your Botox approved?

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

View Comments (10)
  • meshellkober
    6 months ago

    I just started Botox after being refused 3 times and had to take a list of medications they required. Finally I was approved 3 weeks ago.

  • Amanda Workman moderator author
    6 months ago

    I’m glad you finally got approved. I hope it helps you with your migraines. Just know, it can take more than one round so don’t give up if it doesn’t work after the first session!
    Amanda Workman

  • ChronicallyEverything
    8 months ago

    Texas seems to be one of the worst states for getting medicine approved. Insurance companies seem to have all the power and patients have no rights, or seem to have none. I’ve lost access to several medications suddenly and without explanation or recourse over the years I’ve lived in Texas. In 2017 the law changed regarding opiates and my doctor decided to stop prescribing everything I was taking without notifying me and it was all perfectly legal under Texas statutes. Texas Medicaid is so awful as well that it’s almost not worth having since doctors have absolutely no obligation to accept it even in rural areas or if they’re the only doctor of their type within 100 miles. It’s a mess and most definitely not patient friendly. When ppl ask about moving to Texas o always warn them away if they have health issues or a family history of them.

  • Amanda Workman moderator author
    6 months ago

    Youre not the only one. My husbands company is fighting with their current insurance company and may change it the next year if they cannot come to terms on having things covered because they just stop paying for stuff whenever they want without an explanation. It’s extremely frustrating
    Amanda Workman

  • mhrose1293
    8 months ago

    I know how you feel. Moved to a different state and forced on to a ppo. Changed to Kaiser thinking it would help with amount. Told I could only get half of what I was getting. It lasted about two weeks. Called and told the neurologist and he said I had to wait the full three months. Meanwhile I have migraines that last two weeks at a time. Had to go to the emergency room. Getting a different insurance next year

  • Linny
    8 months ago

    https://www.botoxsavingsprogram.com/?cid=sem_goo_43700029472131567

    They’ll actually help with your copay, getting it down to about $50 per treatment and even though it says they can’t help anyone on Medicare they DO accept appeals especially for fixed income like disability.

  • CMF
    8 months ago

    Hi Amanda and others.
    Have you tried a botulinum injection called Xeomin in place of Botox? They have a great patient care plan and work the same as Botox. I believe it is still “off label” for migraines, but Botox was used off label for migraines for years as well. Just a thought that you may try with your insurance.

  • Amanda Workman moderator author
    6 months ago

    I have not even heard of that one. I will have to look into it more. Thanks for the information.
    Amanda Workman

  • meshellkober
    8 months ago

    I have been battling insurance for Botox for 6 months. Insurance has a long list of abortive medications which I started taking and during this time I had a stroke. Now I can’t can’t 3/4 of the list of meds without risk of another stroke and they can find no reason on all tests why I had the stroke except because of the migraines but insurance continues to deny.
    Worse yet, because hemophiliac migraines and strokes have the same symptoms I’m being denied short term disability because they can’t figure out if lost if right side is from constant migraines or stroke. So until migraines are controlled I won’t know the level of damage done. All abortive pills are not working.
    I find it disgusting that someone who know nothing of me can tell me what is good for me.

  • pigen51
    8 months ago

    I can only offer you my sympathy, as I understand exactly what you are going through. I am sure that many others here can also echo the same thoughts.
    I tried botox before, with no luck. I also had a nerve block, with no luck. But I know that many people have had remarkable success with botox, and in some cases nearly a complete, not cure, but elimination of symptoms.
    I have also tried dozens of different kinds of medications, with no luck. I am in the process of getting off some of the many medications that I was on for years, in an attempt to control migraines. I just hate taking so many meds anymore.
    I wish you the best with your insurance company. I know that they can be a pain, at times. But don’t give up with them, because if for no other reason than to establish that you have a real condition that you have tried to fix.
    As far as your stroke, I am concerned for you. I do hope that your doctors are on top of it. Have you considered that it could have been a side effect of a medication? I believe that the triptans can sometimes have strokes as a side effect. I would think that the doctors have of course, considered medications as a possible cause.

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