coverage for pelvic injections

[anniepie1976]

ok, So I'm wondering if there is anyone on here who's insurance has covered botox injections? I got turned down by blue cross/blue shield and just found out today after waiting almost a year to find out that they have also been turned down for a grant for botox samples they could have used on me. They told me that Univera or Independent Health usually covers this but I'm not sure if it does for pelvic muscles. I know that there are many on here that have paid out of pocket and I'm not sure I have seen anybody who has had it covered for this type of problem. Does anybody know if either of those insurances really do cover it? ~Ann

[Sheryle]

I'm trying to answer two questions here at once. I would never have Botox without being under anesthesia; I had approximately 30 injections. The pain was so intense when I woke up from the anesthesia that I was kept on the IV for 22 hours afterward in order to have pain meds administered. Maybe I'm just a sissy, but I wouldn't think of having it any other way. As far as insurance: Ask your Doctor if he/she can do the hydrodistention with instill and while he's doing that (which insurance covers) if he could inject the botox. I have to pay out of my own pocket for the medication (botox) but it is well worth it. Hope this helps those of you who sent me questions! Have a great day!

[catlover2]

If you have BCBS FEP, Botox is a covered medical benefit. If you try to get a prior approval for the Botox, you will receive a denial letter because the FDA has listed Botox as a experimental treatment for IC. However, if your doctor bills for the Botox along with the other charges for the cysto, BCBS will cover the Botox.

[Sheryle]

I do have BXBS but we are HMO and they flatly denied payment. I appealed and they denied again. I appealed the second time and they turned me down the third time so I had to pay out of pocket.

[Sheryle]

My insurance does pay for botox for migraines, but not for IC - they consider it experimental. We need to put together a petition and try and get that changed, huh?

[Bessie]

I had the botox injections done along with a hydrodistention and my insurance paid for it. I did have to pay the urologist a deposit of $500.00 and I did not get any of it back. I had injections and hydro done in the hospital in the outpatient department. My insurance paid 100% of the hospital expenses which were $16,000.00. I did not have good results with the botox injections and my pain levels were so intense. It took me 3 weeks to recover, I had to take Predinsone afterwards, there were days that I don't even remember, and it made it hard to urinate. I would never do it again, but I know others have had good results. We are all so different and what works for some does not work for others. I hope if you do get to have them they work well for you. Good Luck!!