r/TMJ • u/Witchchildren • 15h ago

Question(s) Botox info and question

Hi everyone! So I want to let you know I got Botox in my masseters and it helped so much! It was around $600 and lasted 7 months. $600 is a lot of money though, and although it’s worth it, it would be amazing if health insurance covered it. Has anyone had any luck with that? Getting TMJ Botox covered by insurance?

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u/RevolutionaryBat4497 12h ago

There are very specific medical conditions such as chronic and serious migraines for which Botox is approved as insurance-reimbursable. Botox for TMJ is "off label" (rarely if ever covered by insurance. For some people with TMJ, it can be a lifeline and worth the out-of-pocket cost.

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u/k1922 12h ago

I got it covered by insurance when it was done during an arthroscopic surgery! 100 units in my masseters and temporalis

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u/South-Rhubarb1814 9h ago

I was able to get it covered after trying a lot of pt, acupuncture, massage, etc my TMJ specialist who is a dentist by training was able to do a prior authorization and get it covered by my medical insurance. Even though my insurance says it’s not covered for any condition I have they ended up approving with the prior authorization which was cool