Botox Insurance Help

Hyperhidrosis treatments have undergone major improvements over the years. For example, Botox injections for the treatment of axillary hyperhidrosis have helped transform the lives of many patients. By "turning off" the process that leads to sweating excessively, Botox treatments allow sufferers to lead more normal lives -- free, at least temporarily, from the overwhelming symptoms of hyperhidrosis. Results of Botox injections last about six to nine months, and maintenance injections can provide continued control.

But, Botox can be costly and seeking coverage for this treatment from insurance companies can be daunting. There are, however, some promising avenues that can be explored when considering Botox treatment for hyperhidrosis.

AbbVie, Inc., the company that owns Botox, tries to help hyperhidrosis patients who are under- or uninsured get treatment through the following programs:

Botox ONE: This is a secure online portal that clinicians and their staff can use to help patients obtain Botox treatment by requesting benefits verification and reimbursement support related to Botox for medical use (like for hyperhidrosis). The website offers access to Botox reimbursement support and guidance about Botox savings programs (see below). It also allows healthcare providers to conduct electronic benefits verifications and prior authorizations.

Botox Savings Program: Through this program, eligible axillary hyperhidrosis patients can save on out-of-pocket costs related to Botox medicine and even the injection procedure, depending upon the state in which they live (for residents of certain states, the offer applies only to the cost of Botox).  Office visit co-pay costs are not covered by this program. Patients with any kind of commercial insurance (it’s not for Medicare or Medicaid patients) are encouraged to find out if they're eligible and to enroll online or by calling toll-free in the U.S. at 1-800-44-BOTOX (1-800-442-6869). Reasons for ineligibility for the Botox Savings Program include:

  1. Any government issued insurance such as Medicaid or Medicare
  2. Any military issued insurance
  3. Anyone under the age of 18 (however, a parent or caregiver of a patient under the age of 18 who is receiving Botox treatment may be eligible to apply)
  4. Anyone living outside of the United States

myAbbVieAssist:  To receive help from myAbbVieAssist (Patient Assistance Program), patients must:  be under the care of a licensed U.S. healthcare provider, be uninsured or underinsured, meet certain income criteria, and be a resident of the United States. Through this Program, AbbVie will donate Botox vials for the treatment of financially eligible patients.  Medical providers will need to assist their patients in applying for this program.  For more information on the application process, call 1-800-222-6885.

We love to highlight acts of generosity, kindness, and support! AbbVie's Botox programs are great examples. By giving patients with hyperhidrosis the opportunity to pursue this costly but very effective treatment, AbbVie is providing a life-changing service to sufferers.

Christine Fleckenstein, Support Specialist with the International Hyperhidrosis Society, has a lot of interaction with the people in our hyperhidrosis community. She says the beauty of AbbVie's prorgrams is that they open up a whole new world of opportunities for patients.

"Patients need to know about the assistance programs for Botox because they increase their treatment options. I receive so many emails from patients saying that they do not have medical insurance and would love to get Botox, but simply cannot afford it. AbbVie's programs can put Botox treatment within reach. There are eligibility requirements and a process involved, but it's worth a shot to get that prize at the end - effective treatment and dry days. Perhaps if physicians knew about the Botox assistance options - like those that provide training, support, and help with reimbursement to decrease denied claims – they would more readily treat hyperhidrosis patients with Botox. These are real solutions."

And don't forget that patients also have opportunities throughout the year to receive free treatment when they volunteer for clinical trials or participate at our physician training events. These opportunities help patients and researchers learn more about the condition and its therapies. Always be sure to read our blog for announcements about these opportunities and visit our clinical trials page often to learn who's recruiting now.

Looking for codes? Here they are:

Botulinum Toxin Injection Procedure Codes

64650 - Chemodenervation of eccrine glands, axillae

64653 - Chemodenervation of eccrine glands, other areas (eg, scalp, face, neck)

64999 - Other procedure of the nervous system (use for extremities, i.e. hands and feet)

J0585 -  Injection, onabotulinumtoxin A, per unit

ICD-10 Codes

L74.5 - Focal Hyperhidrosis (L74.5 and L74.51 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail)
L74.51 - Primary Focal Hyperhidrosis
L74.510 -  Primary Focal Hyperhidrosis, Axilla
L74.511 -  Primary Focal Hyperhidrosis, Face
L74.512 – Primary Focal Hyperhidrosis, Palms
L74.513 – Primary Focal Hyperhidrosis, Soles
L74.519 – Primary Focal Hyperhidrosis, Unspecified
L74.52 - Secondary Focal Hyperhidrosis

L74.8 Other eccrine sweat disorders
L74.9 Eccrine sweat disorder, unspecified

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