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woman getting medical botox - uses and insurance

Medical Botox: Uses, Mechanism, and Insurance Coverage.

If you’ve watched TV or movies at all in the last twenty years, chances are high you’ve seen lighthearted jokes about Botox injections for cosmetic reasons. But what you may not be as familiar with are the medical treatments that Botox can provide – scientifically verified, well-studied treatments that offer relief for a variety of conditions and ailments. Because these are full medical processes that contribute to quality-of-life improvements, they are often covered by insurance, too.

 

What is medical Botox used for?

The four most common uses for medical Botox are:

1. Treatment of migraines:

The injection sites for migraine treatment are nearly identical to those used for cosmetic Botox. For many sufferers of migraines, it is one of the most effective and complete forms of relief available.

2. Temporomandibular Disorders (TMD):

Botox can lessen the tension along the temporomandibular joint (TMJ), which is responsible for issues like teeth grinding (bruxism) and difficulty chewing.

3. Hyperhidrosis:

Excessive sweating is caused by constant firing of nerve signals to sweat glands, and Botox injections can eliminate this to a large degree.

4. Cervical dystonia (neck spasms):

People with the “hunched neck” of this condition often experience painful spasms or muscle pain along their neck and shoulders, which Botox can alleviate.

 

There are many other applications for medical Botox in various stages of approval for use, such as treatment for bladder conditions, poor circulation, cerebral palsy, and seizures.

 

How does medical Botox work?

Botox (and other similar injections) are based on a specific type of neurotransmission blocker that affects the way electric signals are passed between nerves. They interrupt the signal that tells muscles to contract, causing overall relaxation of tissues that would otherwise be rigid and inflexible. This makes Botox great for a wide variety of muscular disorders or issues: 

  • For TMD and teeth grinding, the Botox is injected into your masseter muscles, causing it to relax with lessened tension and weaker force. 
  • For hyperhidrosis, Botox is superficially injected near the affected area. It prevents the glands’ receptors from getting signals from the nervous system, and in turn, their production of sebum, oils, and sweat comes back into equilibrium.
  • For migraines, Botox targets the pain modulators present in the head and neck. It prevents sensory nerves from becoming overactive and hyper-sensitive, keeping sensations of pain from being passed on and further muscle contractions from occurring in painful areas.

 

Does my insurance cover medical Botox?

Generally, yes, but as with any medical treatment, there will be some specific requirements to meet. 

The easiest condition to treat without much hassle from insurance is hyperhidrosis. You don’t need any particular proof that you sweat a lot or suffer from this condition; the only stipulation is that you’ve tried DrySol antiperspirant, and it didn’t do enough to stop the problem. If this fits your experience, then you qualify for insurance coverage for Botox for hyperhidrosis.

Other conditions, such as TMD, migraines, and cervical dystonia will also often be covered by most insurance providers, if the right conditions are met. With migraines, for instance, you must have a diagnosis of chronic migraines, as well as proof of previous treatments with preventative medications that were ineffective.

 

Process for medical Botox insurance coverage:

At Bardöt, our process looks like this:

  • When you come in, we do a medical assessment to ensure that you are a good candidate for Botox treatments.
  • We fill out all the relevant forms with you, then send them to your insurance provider (these are usually done online, but we have paper versions in the clinic, too). We deal with all the major providers, such as Sunlife, Blue Cross, etc.
  • We hear back within 7 days, and we call in the prescription to the Shopper’s Drug Mart pharmacy down the street from the clinic. You can pick it up before your appointment.
  • Bring it in and we’ll proceed with treatment. 

Note that while the product will be covered by your insurance, the process is not; the injection itself will cost $250 the first time, and $150 each time after that. This is because a nurse practitioner is needed for the first shot and the subsequent injection plan, but after that, other team members can take over.

 

If you have any other questions about medical Botox – or its cosmetic cousin – we’re always happy to help out, so call or message us at your convenience. We’ll see you at the boutique!

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