Can botox be covered by insurance?
Botox is one of the most well-known cosmetic procedures performed all over the world.
With men and women reaping the benefits from this procedure, it was originally a popular treatment among women initially, but now plenty of men are wanting to get rid of their wrinkles and boast a more youthful appearance.
In this guide, we’ll be taking you through everything you need to know about Botox from what it actually is to whether it can be covered by insurance and what kind of medical conditions it can be used to treat.
By the end of this guide, you’ll be able to determine whether Botox is the right choice for you and whether it is going to benefit your life.
Table of contents
What is Botox?
Before we delve into whether Botox is covered by insurance, it’s important to understand what Botox actually is.
Botox is known as a derivative of botulinum toxin which is not detrimental to your health and is a popular treatment that is easily accessible.
The main reason why people receive Botox is due to the aesthetic appeal, meaning that people receive Botox for cosmetic reasons.
However, there are medical reasons why Botox is administered due to its ability to relax muscular tension, making it a suitable option for those who have issues such as Temporomandibular Joint Disorder.
What is the Temporomandibular Joint?
The Temporomandibular Joint, commonly known as the TMJ, is an articulation that provides a connection between the lower jaw and the temporal bone in the skull.
This allows us to perform crucial movements such as opening and closing the mouth, chewing, speaking, and yawning. If the TMJ isn’t functioning properly, then we cannot do these things, leading to all sorts of problems.
There is a condition called Temporomandibular Joint Disorder, known as TMD, which is when the TMJ is not functioning properly, and you will need to visit a dentist to receive treatment.
Symptoms associated with TMD
- Clicking sounds when the mouth is opened and closed
- Jaw getting stuck when attempting to open the mouth
- Pain in the ear, jaw, neck, or all of them.
- Pain in your face
- Ringing in the ears
- Swelling in the jaw
These symptoms can be extremely painful and are highly likely to reduce the quality of your life.
Experiencing one or a combination of the above symptoms is a sign that you may need to seek assistance from a medical professional.
Knowing what the causes of TMD are will help you to determine whether you do have issues with your TMJ.
The most common causes of TMD you should know
- Bruxism which is the excessive grinding of the teeth
- Contractures of the neck muscles
- Trauma to the face that has caused harm to the jaw or teeth
There are many ways that TMD can be treated. While Botox is a popular treatment for TMD as it can help to relax the muscle and ease the pain, here are some other treatments that are often advised or implemented:
- Applying warm towels to help reduce pain
- Maintaining a softer diet that helps to alleviate stress from the masticatory muscles
- Massaging the articulation with the assistance of a chiropractor
- Taking muscle relaxants or painkillers
- Use ice packs to reduce the levels of swelling
What makes Botox a good treatment for TMD is that it helps to block the signals between the nerves and the muscles thanks to the toxins.
This means that it will be impossible to contract which in turn will soften the muscles and relieve the pain and tension felt in the TMJ.
Does My Insurance Cover the Cost of Botox?
When it comes to insurance policies that cover Botox, this can be quite tricky to find.
While more and more insurance policies are starting to include Botox in their list of treatments, it’s important to know that the Botox treatment must be medicinal.
This means that you can only claim Botox on your insurance if it is helping with treatments and your doctor has recommended it.
If you are seeking to have Botox for purely cosmetic purposes, the vast majority of insurance companies do not include the treatment there.
This is because the treatment is only serving to improve your appearance, and while this may improve your confidence, and in turn, your mental health, this isn’t classed as medical.
If you find an insurance policy that potentially covers Botox, ask further questions as to what this means specifically and what the terms and conditions are.
This is because while almost all the insurance policies that include Botox will only allow it if it is for medical reasons, they may only cover a certain number of injections or up to a certain amount.
You want to be sure what you are signing up for precisely before you sign the dotted line.
Who Can Administer Botox?
There are many medical professionals who can administer Botox, and the price can vary depending on whom you visit. Here is a list of the most common administers of Botox:
Regardless of what kind of medical professional you visit to administer your Botox, they all must receive further training and qualifications from specific courses in Botox administration beforehand.
This means you can be assured that they know how to properly administer the injection and know how much to put in.
In conclusion, more and more insurance companies are including Botox in their individual plans.
If Botox is something that you wish to try due to medicinal reasons, then it may be worth sending in an inquiry to your insurance company to see if they can add Botox treatments into your policy.
Bear in mind that if you wish to have Botox for cosmetic purposes, it may be more difficult to find an insurance policy that will cover such treatments.
This is because the treatment will be serving an aesthetic purpose rather than a medicinal purpose.
However, there may be some policies that allow it, although this is a lot rarer than finding a policy that includes Botox for medicinal reasons.
Frequently Asked Questions
A cosmetic procedure is one that improves your appearance but doesn’t treat a medical condition. For example, if you want Botox treatment to address wrinkles, it’s considered a cosmetic procedure. This is almost never covered by any insurance company, including Medicare.
A single unit of Botox costs around $10 to $15, and an average treatment can include 30 to 40 units, the American Society of Plastic Surgeons (ASPS) reported in 2019. That means a typical treatment can run anywhere from $300 to $600.
There is no upper age limit for people who want to have Botox. In fact, many women enjoy the refreshed look they can get from Botox and complementary treatments when they are in their 60s or older.