Medicare and Botox: Are You Covered?

medicare coverage, botox

This article was updated on July 31, 2020.

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Botox carries a stigma, but there is much more to it than most realize. Botox has been found to be helpful for palliative care, as well as just cosmetic reasons. Medicare and Botox can sometimes work together.

What is Botox?

Botox is made from the neurotoxin called botulinum. This is the same toxin that causes a life-threatening type of food poisoning. Small doses of the bacterium Clostridium botulinum in Botox can treat health problems.

The way that the Botox injection works is by paralyzing or temporarily weakening certain muscles and blocking nerves. Botox injections can be effective from three months to an entire year, depending on what is being treated.

Uses for Botox, other than cosmetic 

According to the American Osteopathic College of Dermatology (AOCD), the Food and Drug Administration (FDA) has approved Botox for the following uses:

  • Crossed eyes, or strabismus
  • Eyelid spasms, or blepharospasm
  • A neurological movement disorder called cervical dystonia
  • Excessive sweating, known as primary focal hyperhidrosis

According to an article in the journal Toxins, evidence shows that Botox can help treat an overactive bladder.

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People have also used Botox for FDA UN-approved conditions like:

  • Alopecia Areata, a condition that causes hair to fall out in small patches
  • Psoriasis, a skin disorder that causes skin cells to multiply up to 10 times faster than normal
  • Dyshidrosis, a skin condition that causes small, fluid-filled blisters to form on the palms of the hands and sides of the fingers
  • Postherpetic neuralgia, a painful condition that affects the nerve fibers and skin
  • Vulvodynia, chronic pain in the vulva
  • Raynaud syndrome, a rare disorder of the blood vessels, usually in the fingers and toes which causes the blood vessels to narrow when you are cold or feeling stressed.
  • Achalasia, an issue with the throat that makes swallowing difficult
  • Anismus, a dysfunction of the anal muscle
  • Sialorrhea, a condition in which the body produces too much saliva

Medicare coverage for Botox

Medicare Part B may cover Botox for certain medical reasons, such as migraines. It will not cover costs for cosmetic reasons, such as crow’s feet or fine lines.

However, there are some exceptions. These might include cosmetic Botox when the surgery is needed due to an accidental injury or if it is to improve the function of a body part.

It is important to discuss Botox with your doctor to find out if it is an effective treatment option for you. Your doctor should also be informed about all of the medications that you are taking, both prescriptions and nonprescription medications.

Your doctor will know what medications cannot be mixed with Botox or may cause serious side effects. Consult your doctor on whether Botox is right for you and if your Medicare coverage will cover the costs.

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