Botox injections are primarily cosmetic, which makes them ineligible for insurance coverage. Because Botox isn’t approved by the FDA as a TMJ treatment, it is unlikely insurance would cover it. However, if the TMJ is severe enough to cause migraines, insurance may cover Botox as a treatment. Botox is FDA-approved for migraines.
Pierre encourages patients to contact their insurance companies. “Unfortunately, the insurance company is the one who gets to determine medical necessity,” he says, “So there are no guarantees. However, some insurance companies cover Botox for hyperhidrosis so there’s a chance you can get coverage for TMJ.”