Posted by: LauraH ®
11/08/2005, 22:51:22
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Hi Alison,Unfortunately the smallest prescription of Botox comes in a 100 unit bottle(my bilateral injection is 2.5 per cord, and I've not heard of anyone receiving more than 6.0 per cord.) A 100 unit bottle costs my insurance roughly $500 US dollars, so it makes it cost prohibitive to buy it only for yourself. Some doctors plan a botox day and share the vial with all of the patients that day(thus distributing the cost.) If yours does not offer this, you may want to look around for another MD. Ceratinly you DON'T want your doctor to charge you for a whole vial, when you'll only be receiving such a small portion, b/c there is a limited shelf life. I like to refer to this practice
as the "botox time-share." Hope this helps! Laura/AD/PA
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Posted by: Renee ®
11/08/2005, 23:22:32
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A botox SHOT without any insurance would run me about $1,200. WITH insurance a botox shot costs me $25.00. For me this is a no-brainer. I would just wait for the insurance to pay...Renee ADSD/ Austin, TEXAS
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Posted by: Will Blum ®
11/09/2005, 00:39:43
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Go to this link,http://www.dysphonia.org/treatment/reimburse.asp, on NSDA website to find information on have to handle problem with your insurance company.
You will find a BOTOX® Reimbursement Hotline number to call to help you in dealing with your insurance company.
Related link: Reimbursement for Botox
Modified by Will Blum at Wed, Nov 09, 2005, 00:41:42
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Posted by: mdubovick ®
11/09/2005, 07:39:08
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I would certainly put pressure on the insurance company to pay. However, you could help them and yourself by sending them some documentation about Spasmodic Dysphonia. Go to the NSDA web site, http://www.dysphonia.org/ and print out a few pages.
Under the heading tab, 'Spasmodic Dysphonia', print the page, What is Spasmodic Dysphonia? Under the heading tab, 'Treatment', print out the first page where it mentions Botox shots. And lastly, if it can be done quickly, get a letter from your Otolaryngologist or ENT that you were diagnosed with Spasmodic Dysphonia. These steps should be sufficient for your insurance company to step up to their obligation.As far as the cost of Botox, the advice you've received about not paying for an entire bottle should be well heeded. As to how much doctor's charge, I've been to Botox clinics, i.e. usually hospital settings where there is usually one or a few days a month set aside for Botox injections - the cost has varied from state to state, being as high as $1,200. to as low as $600. The provisions of MY insurance is that I have a 20% co-payment. Each health insurance policy can be different, depending on the company, whether you have a PPO, HMO, etc.
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Posted by: Samietooo ®
11/09/2005, 14:36:51
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Hi Alison. I definitely understand what you're going through! My insurance changed and because of that, I had to start seeing another doctor. After having many successful injections (by my original doctor), the new doctor didn't have any success! In order for me to see my original doctor, I had to pay out of pocket. Now I'm trying to see what the insurance company will do for me, so I can return to my first doctor. I did get a discount rate, but if this doctor was performing the injections in a hospital or clinic (which he originally was), I would have had to pay for the hospital or clinic too! I have found that unless a doctor gives botox injections in his own office, there are many other expenses, so be careful if you decide to pay on your own, and get the TOTAL cost!! Your doctor should have scheduled appointments for botox, and you shouldn't have to pay for a whole vial on your own. Some doctors even give injections during unscheduled times if there are others who also want/need botox.Hopefully some of the other responses will help you, so you don't have to do this on your own!! Good luck! Carol
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Posted by: kim ®
11/09/2005, 20:44:48
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Hi Allison. I was thinking that maybe you could ask your doctor if there are special rates available for a cash pay patient? It might help some.I know with my insurance I have to meet a $3000.00 ded., then I'm responsible for 30%. It's expensive for me to have any medical treatment. Some doctors will work with you on this. Also maybe the insurance specialists who work for your doctor could help to get the authorization for your injections. I hope everthing works out for you. Best wishes. Kim
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Posted by: Alison ®
11/09/2005, 21:48:04
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Thanks to all of you for the input. I had NO idea it was this expensive. I was aware of the NSDA site information about reimbursement so will study that some more.
Would anyone believe I work for the insurance company, and have for 10 years ? Goes to show you employees don't get any breaks. The whole thing is very frustrating. I was lucky enough to get a pretty quick diagnosis. Now the hoops to go through to confirm the dx and treat.
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Posted by: kim ®
11/10/2005, 17:58:02
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Hi again Allison,I did not know botox costs so much either. But, I wonder why? Does anyone know why its so expensive? Thanks, Kim
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Posted by: Lynne ®
11/09/2005, 22:11:42
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Good information to Alison's post, Carol. Sorry this has happened to you. What a run-around. I'm glad Alison asked this question also. Always good to keep the subject of "insurance for SD treatment" at the top of discussion. It's so sad that many of us have to make major health decisions (or suffer long-term) due to insurance anomalies. Non-insurance. Wrong insurance. Odd insurance. Run-around from insurance companies (when our voices don't work in the first place and it's all hard to explain), etc. Back in the old days (well over 10 years ago) when no doctor or speech pathologist could diagnose my severe case and before the Internet had so much information on SD, I was left with two options (from my insurance company), after not being able to work for years, and being left with the impression that nobody had SD but me. Two options: Surgery or Botox. My doctor recommended surgery. Said Botox wouldn't work with such a severe case. With my insurance company, surgery was free. No $$. My doctor (an expert on SD) told me Botox would never work with my severe case and it would cost $1500 per injection, four times a year and would make him a rich man. Yes, my insurance company would have charged me a large co-pay for Botox. Not $1500, but a substantial part of that. Based on alot of research and information at hand, I went with surgery. Fortunately things have improved with so much information available on the Internet now. More options. The Allergan Hotline 800# resource (to my knowledge) pays for the serum to people without insurance or limited insurance who neet certain financial requirements, but not the doctor who injects it. That would be helpful but not take care of the entire issue of insurance companies who aren't yet up-to-speed on the medical use of Botox for certain disorders. Anyone who has insurance is entitled to be reimbursed for the cost of Botox treatments (similar to what Mel D. described above) based on an established/documented case. Hopefully our medical insurance covers more than the Allergan resource would. If anyone knows about this, hopefully they will report back. This is a good forum to discuss this important issue of insurance, which has affected so many of us SD'ers over the years. It's a shame we have to make medical decisions based on what is/isn't covered by our insurance companies. Good luck to Alison. I hope you can gather alot of information and pursue the issue with your insurance provider so that they acknowledge their contract with you, and pay their share of your Botox. It's frustrating for us and/or our employers to pay those premiums, and then be left hanging when we need the services we thought we were paying for. --Lynne (AD-SD; RLN surgery; PVFM; Northern California)
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Posted by: Barbara S. White ®
01/29/2006, 03:03:37
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It has never cost me anything. My insurance Blue Cross pray for it all. I have seen invoices for as much as $2000 though but Thank GOd I didn't have to pay for them.
Barbara / god4me@comcast.net
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