Insurance Coverage

Many chronic migraine sufferers approach Migraine Treatment Centers of America with a common concern: a long-term, affordable treatment for their migraine pain.

NOT TREATING A MIGRAINE CAN BE EXPENSIVE

A July 2011 medical study concluded that Americans with chronic migraine have an average medical cost of $1,036 over three months, totaling $4,144 per year – and potentially reaching up to $9,480 per year.  Since one-quarter of chronic migraine sufferers have visited a primary care physician in the last three months (some even go to the emergency department for their pain), and medications like Treximet cost around $24 per pill, it is easy to see how the bills can add up.

NAVIGATING INSURANCE OPTIONS CAN BE A HEADACHE FOR MIGRAINE SUFFERERS

For good reason, insurance companies and health care providers are wary about who is asking for migraine treatment: some people may want to get the benefits of a migraine treatment, such as Botox injections, pain medication, or a medical procedures that might “turn off headaches” – without truly understanding whether their medical condition warrants the treatment.   A migraine is not easy to diagnose, like an infection or broken bone may be.  The specialists at Migraine Treatment Centers of America are especially adamant that patients follow the Migraine Continuum of Care –  giving the old college try to conservative treatments such as lifestyle changes, trigger avoidance, therapy and preventive medications – before trying more invasive procedures.

For chronic migraine sufferers who have qualified for a medical procedure such as the Omega migraine procedure or Botox injections for migraine treatment, Migraine Treatment Centers of America provides a team of insurance specialists dedicated to navigating the insurance approval process.

THE SHORT ANSWER: YES, MIGRAINE TREATMENTS ARE COVERED

The short answer is that yes, migraine procedures like the Omega migraine procedure and Botox injections for migraine treatment are covered by some major insurance carriers, if the carrier has determined that the procedure is a medical necessity for the situation in question.   Your coverage for a given treatment will be determined by your specific benefits and medical history. We are happy to work with your insurance provider to help you receive the best possible medical care.

MIGRAINE PROCEDURE INSURANCE APPROVAL PROCESS

As with most medical treatments, some treatments offered by Migraine Treatment Centers of America will require pre-authorization from your insurance carrier. This is often referred to as pre-certification or pre-determination process. This process—which generally takes two to four weeks—will involve a review of your medical and treatment histories, along with a psychological evaluation. Our staff is happy to work with you to help you complete the pre-authorization process as quickly as possible.

If you have received pre-authorization for the Omega migraine procedure, your dedicated Patient Care Manager will work to schedule your trial procedure as soon as possible.  The trial procedure has been shown to be successful in 80% of qualified patients (in other words, those who respond to neurostimulation).  If the trial has been a success, we will need to get an additional pre-authorization for the permanent procedure.   This step could take an additional two to four weeks.  If the permanent procedure receives pre-authorization, we will work to schedule your procedure as quickly as possible – so you can get back to enjoying your life without chronic migraine pain.