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Picture of onpointgun
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Ok here is my situation. My Doctor wants to give me an injection of Botox for a off label diagnosis. He would be treating chronic pain in my piriformis muscle. I have had this pain for over 10 years that it wasn't diagnosed. Recently the Doctor gave me a steroid and numbing medicine and it was the first time in years that I didn't have any pain. But it only lasted about 24 hours. Unfortunately since it's off label I have to pay 100% out of pocket I contacted Botox for assistance and since its off label they don't have a program to help. The other programs that I have found are income based and I make just over the amounts that the programs allow. What I am looking for are any other ideas on how to cut some of the costs so I can at least get the first injection to see if its even going to work.


I will be swift in my attack. My venom is packed with enough pride and gun powder to take down
any adversary that attempts to tread on my freedom. You've been warned, but if you
still want to test me, take a step forward.
 
Posts: 2036 | Location: ON THE YELLOW BRICK ROAD | Registered: February 11, 2009Reply With QuoteReport This Post
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How much is it ?
Botox is not that expensive, is it ?


"Crom is strong! If I die, I have to go before him, and he will ask me, 'What is the riddle of steel?' If I don't know it, he will cast me out of Valhalla and laugh at me."
 
Posts: 6641 | Registered: September 10, 2007Reply With QuoteReport This Post
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Picture of onpointgun
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100 units is about $600


I will be swift in my attack. My venom is packed with enough pride and gun powder to take down
any adversary that attempts to tread on my freedom. You've been warned, but if you
still want to test me, take a step forward.
 
Posts: 2036 | Location: ON THE YELLOW BRICK ROAD | Registered: February 11, 2009Reply With QuoteReport This Post
Lost Allman Brother
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Xeomin is another brand of injectable botulinum toxin that might be a bit less expensive than Botox. GoodRx shows that it's usually about $100 less than Botox. Doc may prefer Botox for some reason, but worth asking about.

Edited to add: The manufacturer of Xeomin has a savings program that doesn't seem to be quite as restrictive as the Botox savings card. While the Botox card requires you to select from a list of approved conditions, the Xeomin site says that you're eligible for reimbursement if "appropriate for XEOMIN treatment, as determined by your doctor."


_________________________
Their system of ethics, which regards treachery and violence as virtues rather than vices, has produced a code of honour so strange and inconsistent, that it is incomprehensible to a logical mind.

-Winston Churchill, writing of the Pashtun
 
Posts: 3989 | Location: Holly Springs/Canton, GA | Registered: November 02, 2004Reply With QuoteReport This Post
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Is this an insurance issue? If so, these things can be appealed.
 
Posts: 17643 | Location: Stuck at home | Registered: January 02, 2015Reply With QuoteReport This Post
Lost
Picture of kkina
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I just pulled up Botox on Blink.com. Yep, $633.85 per 100 units.

Xeomin: $509.58 per 100 units.



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Posts: 17124 | Location: SF Bay Area | Registered: December 11, 2003Reply With QuoteReport This Post
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Picture of onpointgun
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quote:
Originally posted by ZSMICHAEL:
Is this an insurance issue? If so, these things can be appealed.


I have appealed it twice with the help of my doctor. I guess I will just have to pony up and pay for the botox once and see if it works. I have good insurance I work for the federal govt and I will switch to a different policy next year and they might cover it.


I will be swift in my attack. My venom is packed with enough pride and gun powder to take down
any adversary that attempts to tread on my freedom. You've been warned, but if you
still want to test me, take a step forward.
 
Posts: 2036 | Location: ON THE YELLOW BRICK ROAD | Registered: February 11, 2009Reply With QuoteReport This Post
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quote:
I have appealed it twice with the help of my doctor. I guess I will just have to pony up and pay for the botox once and see if it works. I have good insurance I work for the federal govt and I will switch to a different policy next year and they might cover it.


Blue Cross Blue Shield Federal plans are usually the best in FEHB. Using botox is pretty standard for migraine headache, so am somewhat confused. The fact that it is for a different muscle seems irrelevant. I guess they put it in the category of experimental, meaning no payment. It is clearly not for cosmetic purposes. It is a hassle for the doctor they get tired of this stuff and just give in to the insurance bureaucrats. Your doctor should know if the botox is covered under other health plans. I have successfully battled these things as a patient and have been successful.
 
Posts: 17643 | Location: Stuck at home | Registered: January 02, 2015Reply With QuoteReport This Post
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With Botox, it is normally administered in the office so it is doubtful the doc will switch brands for the cost savings. If you pony up for the 1st administration and it works, you may have *some* better success with the appeal. Getting coverage for an off label use is very difficult in the case of relatively expensive drugs.

The doc may be able to ask his botox rep if they will provide some as a sample for this trial treatment.


Disappointing women since the 1970's
 
Posts: 1120 | Location: SC | Registered: October 24, 2010Reply With QuoteReport This Post
His Royal Hiney
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quote:
Originally posted by NateSC:

The doc may be able to ask his botox rep if they will provide some as a sample for this trial treatment.


That's about the best hope. And if it works for you, it's to the benefit of the drug company as they can start explore new uses for their drugs.



"It did not really matter what we expected from life, but rather what life expected from us. We needed to stop asking about the meaning of life, and instead to think of ourselves as those who were being questioned by life – daily and hourly. Our answer must consist not in talk and meditation, but in right action and in right conduct. Life ultimately means taking the responsibility to find the right answer to its problems and to fulfill the tasks which it constantly sets for each individual." Viktor Frankl, Man's Search for Meaning, 1946.
 
Posts: 20193 | Location: The Free State of Arizona - Ditat Deus | Registered: March 24, 2011Reply With QuoteReport This Post
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I guess that I would like to know if the doc plans to give to whole 100 units.....

I've heard ( but don't actually know) of cosmetic docs finding a couple of potential botox patients and having them share the cost of one vial.....( for treatment of wrinkles)

Just a thought....mike
 
Posts: 1303 | Location: Idaho | Registered: October 21, 2007Reply With QuoteReport This Post
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I would keep after your insurance company just be a big pain in the ass the squeaky Wheel gets the oil.


"They that can give up essential liberty to purchase a little temporary safety, deserve neither liberty nor safety."
--Benjamin Franklin, 1759--


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Posts: 1245 | Location: New Hampshire "Live Free or Die"  | Registered: September 02, 2006Reply With QuoteReport This Post
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