FAQ about insurance coverage for migraines.

We understand that insurance benefits can be confusing and unclear to most patients. It is always best to call us for any clarifications or to review your benefits with your carrier.

Most insurance carriers will pay for all or part of your visit to the Migraine Relief Center. Anything that is not covered by your insurance will be your responsibility. Our financial counselors will review your benefits and assist you in any way they can.

We have reasonable consultation fees and payment plans for patients who make multiple visits.

We request payment at the time of your appointment for any services that are not covered by insurance. Your insurance company may also require you to make a co-payment at the time of your appointment. When necessary, our staff will work closely with patients who require payment plans.

If you have any questions regarding which insurance plans we accept or any billing concerns, please call us. Questions about your coverage and benefits should be directed to your employer or insurance company.

Frequently Asked Questions

What if I Do Not Have Insurance or You Do Not Accept My Policy?

You can still be treated by a doctor, but you would be considered self-pay or self-insured. Please call for more information.  You may expedite the “new patient” process by reviewing and signing the downloadable forms for new patients.

How Much Will My Out-of-Pocket Cost Be?

Out-of-pocket cost depends on your insurance plan. Your Patient Care Manager can gather your insurance information and provide a free quote before you start.  Usually, the procedure costs a portion of your deductible and out-of-pocket maximum, which determine your total cost.

What Insurance Do You Accept?

We work with most private insurance carriers, and our insurance team will handle the approval process from start to finish. However, we do not accept Medicare, Medicaid, Tricare, or Humana at this time.

How Much Will It Cost to Speak to a Patient Care Manager?

There is NEVER a charge for the services of your Patient Care Manager, or our insurance experts and medical reviewers. Our goal is to make your journey to migraine relief as painless and affordable as possible.

What Does Prior Authorization Mean?

Prior authorization is a process in which your provider asks your insurance company to cover your medication as prescribed. Typically, it is required when you need medication in a quantity and dosage that differs from the standard insurance coverage your policy offers.

If you believe prior authorization may be required, please notify us. If you experience difficulty obtaining your medication as prescribed, ask us how to get prior authorization so you can resolve the issue.

Do I Need Prior Authorization for BOTOX(R) Treatment?

Most insurance companies do cover BOTOX treatment but only for a patient fitting a predetermined profile. BOTOX is not a first-line treatment, and you must provide documentation that other treatments have been unsuccessful. However, the FDA approved BOTOX injections for the treatment of chronic migraines, so your chances of insurance approval are excellent.

Also, Allergan, the pharmaceutical company that distributes BOTOX, offers a savings program to supplement the insurance payment. For many patients, the savings program lowers their out-of-pocket cost to $0.

At the Migraine Relief Center, treatments start as low as $400 dollars for targeted areas to $1600 for a full migraine protocol if you are interested in paying for your BOTOX treatment with cash.

What If My Insurance Company Refuses to Pay for Treatment?

We can help you wage an appeal. You can build an effective appeal by following these tips.

  • Make an appointment to see your doctor or make sure you have had a recent appointment. Ask your doctor’s nurse to act as an advocate for you. Your provider should know what you have already tried and what treatments did not work.
  • Get a recent copy of your insurance carrier’s formulary. If you depend on a prescription to treat migraines, your doctor can streamline the process by beginning with drugs on the formulary since they are covered.
  • Compare coverage of your desired migraine treatment annually before you renew your health insurance.
  • Be your own advocate and stay informed of your personal coverage. We are happy to assist all our patients with insurance questions, but you can help by being knowledgeable about your insurance coverage. Connect with a human at your insurance company for assistance.
  • Keep a migraine diary and update it frequently. Then you will have data to show the treatments you have tried, what works, and what doesn’t work. The diary should include the names of the medications and treatments and how long you were on them. Also keep track of missed days of work, quality of life issues, and other factors impacted by your migraines.

Remember, you are the best expert on your condition. We will advocate for you, but you are more likely to receive authorization and coverage if you help us maintain a complete record of your health and treatment, and remain informed of your insurance coverage.

Get started today. Let our migraine specialists show you how we can help.