Does Medicare Cover Migraines

 

Medicare may cover Botox for chronic migraines when deemed medically necessary by your doctor.

David Minaya
June 16, 2023

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Although older people  tend to have fewer headaches than younger folks, women have more migraines than men. Furthermore, research shows  migraine may not improve after menopause. Over a 3-month period, 20% of American women report migraines or severe headaches.

Medicare May Cover Botox for Chronic Migraines

Medicare does NOT cover Botox injections for cosmetic reasons. However, Medicare may cover Botox treatments to help prevent  chronic migraines.

Chronic migraine is more likely to affect women  and rarely stop after menopause. Migraines can be severe enough to disrupt your life, making the pain unbearable. Furthermore, chronic migraines are frequent or long-lasting.

To receive a diagnosis  of chronic migraines, you must have the following:

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Headaches or migraines at least 15 days per month for three months
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Migraine symptoms at least 8 days per month for three months

Botox Injections for Chronic Migraines

The FDA approves Botox injections for chronic migraines that last 4 hours a day  or longer. The recommended injection sites include:

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Above the eyebrows and forehead area
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Side of the head (temple) and above the ear
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Back of the head inline with the ears
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Back of the neck (trapezius)

Botox is a neuromuscular blocking agent. This migraine treatment can inhibit signals from nerve cells to muscle cells. Thus, Botox can help prevent migraine pain.

Medicare Coverage for Botox Injections

Medicare Part B may cover Botox injections for chronic migraines. During this outpatient procedure, your doctor injects Botox into 31 head/neck muscle area  sites. If you have Original Medicare, your out-of-pocket cost is 20% of the Medicare-approved amount. You are also responsible for paying the Part B annual deductible and monthly premiums.

Beyond Botox, many effective migraine medications don’t require needles. Call Senior Healthcare Direct at 1-833-463-3262 to speak with a licensed Medicare agent.

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LEGAL DISCLAIMER: The above is meant to be strictly educational and not intended to provide

medical advice or solicit the sales of an insurance product or service of any kind.

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