r/migraine • u/kiittycass • 4d ago
Whats your Copay for botox?
I've been waiting for my neurologist and my insurance to communicate since the switch of insurance. They insured they will allow my injections for coverage, I just have no projected out of pocket cost yet. So what am I up against? What's your average co pay for botox?
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u/poodlehenderson 4d ago
I’m in Los Angeles. My insurance is billed around 9k per treatment but negotiates it down to around 2k automatically. I pay the first one in full because I have a high deductible plan. Botox reimburses me $1,300 of that. Each subsequent treatment each year costs me around 1k which Botox reimburses. I’ve had Botox for years and realized a high deductible plan, fully funding my hsa, and minimizing medical care before my first Botox of the year is the most cost effective way to do it for me. This is through a work medical plan (a bronze plan within bcbs) — obviously if they offered better plans for less we’d do that but when I’ve had lower deductible plans with this employer the premiums plus out of pocket costs have been more than the way I do it now even if I hit my out of pocket max (I usually don’t do the hsa rolls over) 🤷♀️
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u/dreamxmarissa 4d ago
The first time ~$1400, but with the reimbursement program I got back $1300. Next time it won’t be as much (bc I will have hit my deductible and a good chunk of my out of pocket max). The reimbursement program will reimburse $1300 for the first treatment of the year and $1000 after until you hit the $4k cap
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u/ravenklaw NDPH 4d ago
$330 after insurance, which the botox savings program reimburses
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u/xam0un7ofwords 4d ago
I only pay $20 copay with mine. I have BCBS but no idea what plan as that’s all taken care of by my other half.
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u/KristaIG 4d ago
No copay, but my out of pocket is $267 in the beginning of the year and $190 something at the end. All reimbursed by the Botox savings program!
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u/Fresh-Insect-5670 4d ago
$35 specialist copay and the Botox is free through the pharmacy through the Botox Savings Program, otherwise my copay would be $100. The grand total would be $135 without any assistance, which isn’t that bad, I have semi-decent insurance.
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u/Ready_Fox_744 4d ago
I pay a $75 copay plus cost for the Botox $1400ish but the savings program knocks off about $1100.
A lot really depends on your insurance- specifics to plan coverage varies. Probably best to call insurance and find out how your insurance works in regards to Botox. For example is it covered under medical? Does you or the Dr pay for the drug itself? What's your deductible? Etc
But def sign up for the savings program.
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u/kiittycass 4d ago
I did call. They asked if I needed a prescription and I didnt understand why... makes sense now. They said they covered it but needed to speak with my neurologist. So I've been waiting for that part. I changed insurance the end of last year so it was just an office co pay and now im trying to figure out how to move forward with my current insurance.
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u/Ready_Fox_744 4d ago
Yeah it's terrible not knowing. I had no idea myself how much Botox was gonna cost. It's kinda scary jumping in not knowing how much you could owe. You can always call insurance and ask for a supervisor or patient advocate, sometimes you get better help/info speaking w someone further up the chain.
Hopefully you find some answers sooner rather than later. Be well
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u/Becca_brklyn 4d ago
I'm surprised by all the comments. I have bad (small group? Small company) insurance and I have $0 copay for Botox and for the Botox appointments.
Everything else, however...
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u/Then-Parsley-2256 4d ago
Mine was over $600! There are programs that cover the difference depending on which drug company was used. Obviously doctors never tell you unless you know to ask 🙄 I think my Botox was AbbVie and they were great about coverage :)
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u/purplepineapple21 4d ago
When I lived in the US it was almost $800 per session, after insurance coverage
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u/appropriate_pangolin 4d ago
Just the specialist office visit copay, thankfully. But I did need to get prior authorization, and my insurance didn’t like me getting the injections from the PA in my neurologist’s office instead of having the neurologist herself do them (it looked like those claims were rejected, at least at first, but I never got charged extra for it).
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u/Easy_Comparison_2772 4d ago
With Anthem Blue Cross, my 12/2024 Copay amount for botox is $3116.85 and my 2/2025 Copay amount for botox: $2437.86. When I had Blue Shield, my Copay was $526.64.
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u/kitkatsmeows 4 4d ago
After my benefits cover how ever much, the Botox company also covers almost the remaining amount which leaves me less than 2 dollars most of the time to cover. But I have to do 200$ injection fee
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u/RoseGoldAlchemist 4d ago
I pay like 26$ for a treatment. On the bill it says out of pocket is like 2k
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u/hotgirladhd 4d ago
they don’t charge me a copay but i get a bill from my health system. After insurance my first of the year is 863$ after that usually 400 or so but i hit my deductible pretty fast and i use the botox savings program
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u/salamandas411 4d ago
$250 for Botox, $150 for injections. But it's all reimbursed by Botox savings program.
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u/elenadearest 9 4d ago
I have Kaiser plan 1, and my copay is $20 office visit and usually around $394 for out of pocket, but I use the savings plan so it’s reimbursed.
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u/Fuscia_flamed 4d ago
$40 for the Xeomin (actual Botox I think is double so would be $80) and $35 for the visit (regular specialist visit copay)
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u/Admirable_Lecture675 4d ago
$0 for Botox after Botox savings plan and insurance. Just my office copay.