Survey on cost of Botox


Posted by Shanasy in IL , Jun 06,2001,08:51   Archive
Hi everybody! I am currently in dispute with my dr/insurance co. regarding how much my botox is costing me. My dr. billed me $1,104 for 33 units of botox ($198 for botox serum PLUS $604 to do inject right eye (took less than 5 minutes) PLUS $302 to do left eye). Both eyes got equal amounts. Looks like she is charging $906 for her 5 minute labor! IS THIS OUTRAGEOUS OR WHAT!!???? My insurance is willing to pay $802 but NO MORE (can't blame them for that!). I chose this dr. because she is on my insurance plan and I should only be paying a $10 co-pay. She is saying I owe $300+ on top of what my insurance pays. I cannot afford botox at this outrageous price.

I would like to know what other drs charge for giving botox, what other insurance co.s pay for it, and how many units it covers. Maybe this might give me amunition to confront my dr. with. Am also curious to know if myoblock costs more, the same or less than the original botox. Also am curious as to the breakdown of charges and how it differs from mine as listed above. Thanks so much for all replies!!!!!

--modified by Shanasy in IL at Wed, Jun 06, 2001, 08:53:08




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Re: Survey on cost of Botox

Re : Survey on cost of Botox --- Shanasy in IL
Posted by Virginia , Jun 06,2001,12:14 Top of Thread Archive
First of all, if your doctor is on your plan, she has already agreed to take what the insurance company pays and "can't" bill you for anything other than the co-pay (or predetermined patient cost) as long as the charge is for a covered item (treatment, drugs, whatever). When I had a problem with payment on one occasion, the insurance company offered to set up a three-way call to resolve the problem. When I called to set it up, the insurance company and billing office managed to resolve it without me. I was thrilled, as this had been going on for over a year.

It was an interesting exercise to go through my records and compare charges and payments for botox from different doctors and different insurance companies. All I can say is it doesn't make much sense to me and is always expensive - thank goodness for the insurance, even if it is a hassle. The last two times I was charged for a full vial of Botox (I get over half the vial anyway, but the charge is exorbitant). One time the ins. paid it all, the next they decreased it. The other doctor charged much less, the ins. decreased it even more - go figure. Payments for Botox ranged from $60 to $663. (Billed amounts from $200 to $663.)

On the injections - that also varied a lot. One doctor charged 4 times as much as the other. Insurance payments were inconsistent, even for the same doctor. Payments for injections ranged from $141 to $658 (billed amounts ranged from $245 to $1400). I've never had to pay more than my co-pay for any visit and with the current insurance, I don't pay anything. The charge was always the same for each eye.

When my husband's company changed insurance companies, it took them 4 months to pay for the first botox. I had to go back for a second set of injections not knowing what would be paid or even if it would be paid for. Thank goodness it all worked out okay.

Sorry this is so long -
Virginia in AL - doctors in two states




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Re: Survey on cost of Botox

Re : Survey on cost of Botox --- Shanasy in IL
Posted by sylvia lew (Sylvia lew,sylvia lew), Jun 06,2001,12:22 Top of Thread Archive
Hi Shanasy,

I belong to Kaiser Permanente and I only pay $10 per visit for my botox, nothing else. They told me on the side that each bottle (100 Units) costs them $450.00. I got between 35-50 units. Sorry to hear that they are giving you so much grief. They should have given you the cost before the botox was given. Next time, if you go to a different doctor, make sure you know up front how much your insurance will pay and how much they charge for botox shots. Good luck. $906.00 does seem outrageous!

Sylvia




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Re: Survey on cost of Botox

Re : Survey on cost of Botox --- Shanasy in IL
Posted by Shirley-Arkansas-USA , Jun 06,2001,16:05 Top of Thread Archive
Hi Shanasy, Long time no hear from. You must check in more often.

My first botox doctor was in-network for our insurance plan and all I paid was a $15 co-pay. He gave "everyone" 50 units and just charged the patient or the insurance company the $450.00 per vial that he had to pay for it. The cost for the vial was split between the two patients with my insurance being billed $225.00 for the botox and whatever his charge for the office visit was, which I never found out as I never got a bill from him or "Explanation of benefits" from the insurance co. since it was in-network. Cheapest but worst doctor and it got to the point where they couldn't have paid "me" enough to deal with this man. I have other names for him but won't go into that.

2nd botox doctor was in-network also so just paid a co-pay and don't know what his charges were. Nice but unfamiliar with BEB and he didn't think that he could help me. Only injected me one time-40 units.

3rd botox doctor and present one charged $511.00 for the botox and $400.00 to inject me and $250.00 for new patient visit. He was out of network and I had to meet a $410.00 deductible and I wound up with a bill of $560.20. 2nd visit was fifty dollar office visit, $511.00 for botox and $400.00 to give the injections. I paid $192.00 and my insurance paid $768.80. I also had food, gas and motel bills as it is a 7 hour trip. Since those two visits, I talked with his scheduler(very nice person) and asked if he would except in-network benefits. She said that she would do some checking and get back to me. It was a done deal after a letter from my PCP here that I had to go out of state for treatment. So just made a 15 dollar co-pay after that. Insurance changed and this doctor happened to be in the plan so it is still just a $15.00 co-pay. I still have the motel bill for the overnight stay but this guy is worth it. It was also every 8 weeks and my husband had to take off work for 2 days. I started out getting 65units and then went to 100 units.

Since my surgery, he is going to try to find me someone hear locally that he trusts, at my request. Since I will only need the injections in my lower lids, the job won't be quite so difficult. If on his visit to AR., he is not pleased or can't find someone, I will continue to see him as long as I can or as long as my husband can take off the 2 days.

Virginia is right. If you have an HMO and the doctor is in network, you just pay the co-pay. Nothing more.

As you can see, there are a wide range of prices.

Shirley in AR. How much Ativan did you take the last time you got injections?




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long distance botox

Re : Re: Survey on cost of Botox --- Shirley-Arkansas-USA
Posted by Virginia , Jun 06,2001,16:56 Top of Thread Archive
Shirley,
We do the overnight thing, too, but I can schedule a Monday morning appointment - that lets us drive down on Sunday and back Monday after the appointment. Carl can take sick leave for driving me to the doctor (and he never gets sick, so he has plenty), so it hasn't been a problem for him - and I've been able to stretch it out to 12 weeks between appointments since the myectomy, so it isn't too often. Can Roy take sick leave to drive you to St. Louis?

I'm hoping the MDS in Birmingham works out - it's an easy day trip (only 100 miles) and my daughter lives there, so we can meet for lunch.

Virginia in hot, humid AL

(Couldn't resist the Piggly-Wiggly link - people out of the country shouldn't miss an important piece of Americana like that.)




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Re: long distance botox

Re : long distance botox --- Virginia
Posted by Shirley-Arkansas-USA , Jun 06,2001,17:42 Top of Thread Archive
Perlmutter only does a Wednesday Botox Clinic. So it hits right in the middle of the week. Right now, it isn't a problem for Roy and hasn't been as he just takes vacation time which he has plenty of but he has taken an early buyout on his retirement and we don't exactly know how much longer he will be with his present company. We made the decision last November and then they asked him to stay one additional year. He has already trained his replacement, though, at this point and he feels that they will be letting him go at any time and probably before November. He plans on taking some time off but then intends to find another job. We may relocate, depending on my parents health and also my youngest son just received a full scholarship to the local university and wants us to stay here, now. He didn't a year ago. Anyway, Roy will probably be getting a new job and then it won't be quite so convenient to just take off like he has been able to do.

I truly wasn't expecting Dr. Perlmutter's reaction to my decision to try someone closer now that I had had the surgery and didn't have to worry about getting a ptosis and such but he really just stated very matter of factly that I was not to see someone that didn't know what they were doing. He said that he was planning a trip to AR in a couple of months and he would do some checking for me. It really made me feel like he was truly looking out for my best interests which I have felt all along with him. It wasn't like he was mad that I didn't want to continue seeing him-he just wanted me to see someone good. It was a really nice feeling.


I did enjoy the Piggly Wiggly link. My whole family has seen it now.
It is an important part of American History.

Shirley in AR. Proud to know Virginia/queen of the links.




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Re: Survey on cost of Botox

Re : Survey on cost of Botox --- Shanasy in IL
Posted by Sally - in - Idaho , Jun 06,2001,20:18 Top of Thread Archive
Hi Shanasy ... I've missed you!

My payments/charges are a bit different since I am on Medicare as well as with an HMO. I pay a $10 co-payment for the HMO and Medicare has been sending me the billing so I do know how much it costs, but I think I threw the last one away. It is something like $863, and Medicare only allows x # of $ for that procedure and the doctor has agreed to accept that. So Medicare pays 80% of what they allow and the HMO pays the other 20% for a total of approximately $600+. The billing is listed as so much for the Botox, office visit, and for "destroying nerve." But I can't remember how much each one is. I'll look next time. I am at the full 100 units now.

Sally in North Idaho where the sun has come out today.




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Re: Survey on cost of Botox

Re : Survey on cost of Botox --- Shanasy in IL
Posted by Delaine Inman , Jun 06,2001,20:27 Top of Thread Archive
I have had Botox from 3 different doctors and the charges were all different. All three charged per eye for injections and I got it along my nose last time but fewer total injections and there was a separate charge for that....a total of $1035.00. Then my insurance sent me statement saying they were paying for only 176.00. I called insurance company and then the doctors office and they worked it out. It had been coded wrong by insurance co. Now insurance is paying for everything.



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Re: Survey on cost of Botox

Re : Survey on cost of Botox --- Shanasy in IL
Posted by Lyn Patterson , Jun 07,2001,01:43 Top of Thread Archive
Hi Shanasy and everybody -

Am HORRIFIED at the cost of your treatment. I'm glad so many of you are on insurance of one sort or another. Of course I do not know the situation re disability in Australia as I don't know how many people have BEB but I would be VERY SURPRISED if anybody got worker's compensation or an invalid pension. Here, for general medical purposes, people can take out private health insurance but this is quite expensive and doesn't cover all the costs - there is usually a gap to pay. More and more people just use the Government Medicare programme. For example, for aged pensioners, (my husband is one as he is 73 - and I therefore have a wife's pension automatically even though I am only 55)it costs nothing to go to the General Practitioner (family doctor) and often the same to a Specialist if he will accept the Government scheduled fee for whatever the service is. Sometimes there is a small amount to pay for going to a specialist.
To go to a public hospital for an operation under Medicare costs nothing. For example, my husband had another angioplasty last week and it cost nothing. This set-up applies to people on widow's pensions, unemployed, invalid pensioners and so on. There is a levy on tax for employed people to pay for medicare.

Just so you get the picture.

For my Botox, when I first started it was experimental and therefore not subsidized and I had to pay just over $100 Australian - I seem to remember about $125, of which I got back the portion that pertained to the consultation and had to pay for the Botox myself. A few years ago the Government decided to subsidize it and now the bill comes to $110.50 , $57.55 is paid by the Government and I pay $52.95. I believe he charges the same amount for everyone regardless of how much toxin is used because I know I take about an entire vial. So it actually costs me, out of my own pocket, $52.95 for four injections around each eye and two in the forehead - 10 in all. For all you mathematicians out there, the exchange rate is about $1 Australian = 51 US cents. I think that makes my costs $US26.

Now don't all try to emigrate at once ......

It will be interesting to find out what other ophthalmologists charge when I eventually go to see the new one. I am going up to Perth next Thursday for my Botox so will get that out of the way first.
Lyn




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Re: Survey on cost of Botox

Re : Survey on cost of Botox --- Shanasy in IL
Posted by Shanasy in IL , Jun 07,2001,09:39 Top of Thread Archive
Thank you so much for all your kind replies, especially the long, detailed ones. It was ALL good info and will help me in talking to dr.

Sorry I haven't been posting. My eyes have just been too tired from the strain of all this.

Interesting how the charge (from what I've read and seen on TV) for botox is about a third of the price if you are getting it for cosmetic reasons!!!!

Wishing you all blink-free days (or at least minutes?)

Shanasy




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Re: Survey on cost of Botox / Drug Plan

Re : Re: Survey on cost of Botox --- Shanasy in IL
Posted by Mindy , Jun 07,2001,20:08 Top of Thread Archive
Any prescription medication that I need on a continuing basis, I can
mail away to my drug plan, at no cost to me.
They considered my Botox as such.
If I remember correctly previous to that I was able to bring
my prescription to the drug store / pharmacy and pay the
amount indicated on my card for non-generic drugs, for me $7.00
If you have any kind of drug plan, call them to inquire.
I believe there is also some type of Botox reimbursement plan, either
in our Main page or the Dystonia Main page.
Mindy in NY



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Re: Survey on cost of Botox

Re : Survey on cost of Botox --- Shanasy in IL
Posted by Kelly Saffell , Jun 07,2001,12:38 Top of Thread Archive
My doctor does have two separate charges for the botox and the giving the injections but I receive a total of 100 units and about 16-20 injections for a total cost of $800. I pay a co-pay of $15 and my insurance pays for the rest.



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Re: # of injections

Re : Re: Survey on cost of Botox --- Kelly Saffell
Posted by Shanasy in IL , Jun 07,2001,15:42 Top of Thread Archive
You get 16-20 injections? How does one live through that????????? I thought 10 was bad!!!! It would be interesting to see who gets the MOST injections at one time. Does anyone get more than 20 at a time? If not, I think we all owe Kelly the "Badge of Courage" (or would it be the "Badge of Insanity"? lol!!!!



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Re: # of injections

Re : Re: # of injections --- Shanasy in IL
Posted by colleen , Jun 07,2001,19:09 Top of Thread Archive
I get 17 injections.My doctor charges 400 for each eye 1022.00for the
botex.I have medicare & blue cross blue shield so i pay nothing except my ins. coverage.
Colleen in IL



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Re: # of injections

Re : Re: # of injections --- colleen
Posted by Shelley Chambers , Jun 07,2001,22:21 Top of Thread Archive
I get sixteen injections. I also just pay a co-pay, like $10-$15. But I have absolutely NO threshold of pain, so I think I should get the award!!! Once, I got terribly ill afterward. We were driving down the freeway (also had our son with us) and I was bent over, sick as a dog, moaning and groaning, begging my husband to find a bathroom. All we could find was a bowling alley - so I lurching in, found a stall and got sick. I didn't come out for a long time and I could hear my husband and son outside calling me but I couldn't get up. I had started undressing because I was so hot. So they started asking anyuone who came in to look for me. It was senior citizen day, and these ladies were scared! They were inching along the wall, calling my name. And I could hear my son saying "She's wearing a blue sweat shirt that says "So Many Books, So Little Time"!!! It is funny in retrospect, but it certainly wasn't at the time!
Shelley



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Re: Survey on cost of Botox

Re : Survey on cost of Botox --- Shanasy in IL
Posted by coleen dennis , Jun 07,2001,20:36 Top of Thread Archive
Well I guess I can top you all!

For my first set of injections in April, the neuro-ophtalmologist's office told me the total charge for that day was $3,300! Yes, you read it correctly. Over 3,000 dollars! That was for 8 injections in each eye with 25 units per eye.

After reading all of your responses, I am at a loss for words. Does it depend on the type of doctor that does the injections. Is it the location of the doctor, I am in central PA.

I have an HMO and was informed that they consider this surgery and pay at 100%. At 4 times a year that would run about $12,000. Each time I go they check my vision and then I see the doctor. Is this what happens with everyone. I will respond to the bio also after I finish this and then I may check to see what types of doctors you have from your bios to compare doctors to prices.

Got to go and do the bio now. My Fibromyalgia is flaring up and my right shoulder is really bothering me today. Can't do the computer much longer....Coleen




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Re: Getting vision checked

Re : Re: Survey on cost of Botox --- coleen dennis
Posted by Shirley-Arkansas-USA , Jun 07,2001,21:14 Top of Thread Archive
Coleen,
The only times that I have gotten my vision checked when I went in for botox was when I was seeing my first doctor who was an opthalmologist that was an oculo-plastic surgeon. They always checked my vision before I saw the doctor. The neurologists that I have seen do not do this. It is probably just an eye doctor thing.

Sorry about your Fibromyalgia. Hope you get to feeling better soon.

Shirley in AR.




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