CHAMP has created the financial assistance guide below for anyone who has been prescribed Botox by their healthcare provider. Botox is a prescription medicine that is injected to prevent headaches for those living with chronic migraine disease. If you or someone you know requires help with paying for treatment, please review the details provided below to see if you qualify for the manufacturer’s financial assistance program and how best to access Botox.
Please note: This guide has not been produced or approved by the manufacturer of Botox. CHAMP does not endorse the use of any treatment over another, nor promote the use of this treatment for everyone living with migraine disease. Please consult your healthcare providers to determine if Botox is right for you.
Botox is covered by most insurers, but numerous patients still have out-of-pocket costs. If you are prescribed Botox, Allergan is offering financial assistance programs to help cover the costs. Each program is different and various programs exist to support patients with private or public insurance, as well as the uninsured.
I Have Been Prescribed Botox. What Financial Assistance Programs Exist to Help Me?
Find your insurance coverage and see what Financial Assistance Programs exist to help.
I Have a Private/Commercial Insurance Plan
This category includes insurance plans provided through an employer, purchased with subsidy support from the Affordable Care Act (Obamacare) or purchased privately.
Highlights of the BOTOX Savings Program
Most insurance plans cover the majority of Botox costs and on average, you will pay $164 out of pocket per treatment*. Depending on your insurance coverage, eligible insured patients can receive reimbursement to help with remaining costs allowing you to pay $0. The Botox Savings Program covers out-of-pocket costs up to $700 per treatment for up to 5 treatments over a 12-month period. The yearly maximum savings limit is $3500 over a 12-month period. Please note that the Botox Savings Program covers the cost of the product and out-of-pocket costs for the injection but does not cover any associated office visit costs.
*Average cost per treatment based on allerganpricing.com.
Steps to Benefit from the Botox Savings Program
I Have Medicare, Medicaid or other Government Insurance Plan
Currently, Allergan does not have a financial assistance program for patients whose medical insurance is provided by state or federal programs, like Medicare and Medicaid.
I Am Uninsured
The Botox Savings Program is not available to those patients who are uninsured or underinsured.
You may be eligible to receive Botox at no cost from the Allergan Patient Assistance Program if you meet the following requirements:
Where do I turn if I am not eligible for a financial assistance program?
The Patient Advocate Foundation (a CHAMP member organization) can be a helpful resource for patients and caregivers who are experiencing access challenges. PAF provides a suite of expert tips to help navigate insurance denials, appeals and common barriers at: patientadvocate.org/migrainematters.
PAF also offers one-on-one case management assistance through its dedicated Migraine Careline for people living with migraine who experience access challenges. The Migraine Careline provides assistance with navigating eligibility and enrollment in disability benefits and overcoming insurance coverage and financial burdens that impact patient access to care. All services are completely free and provided through phone and/or email communication. Visit migraine.pafcareline.org or call 866-688-3625 to speak with a case manager today.