Does Medicare Cover Migraine Treatment?

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Does Medicare Cover Migraine Treatment?

Medicare has been our nation’s health insurance program for seniors since 1965. According to the National Committee to Preserve Social Security and Medicare, it covers more than 56 million people in the United States, . This includes some people under 65 who are on Social Security disability income. But does Medicare cover migraine?

Originally, Medicare was created with two parts that provided inpatient and outpatient coverage. Today, it remains much the same as it was at its inception. However, in 2006 a prescription drug program was added to Medicare, and this has been very helpful in providing prescription coverage for migraine medication as well as many other health conditions.

Medicare will cover migraine services that are deemed medically necessary by your doctor for treatment and for symptom relief. There are several different parts of Medicare that cover these treatments.

Doctor in lab coat answers question does Medicare cover migraine

Medicare Part A & Part B

Hospital services are covered under Medicare Part A. This includes inpatient stays, but it also covers skilled nursing facility and hospice care, blood transfusions and even some home healthcare immediately after a hospital stay. If you were to be hospitalized due to a severe migraine, Part A covers the first 60 days in the hospital after you satisfy a $1340 deductible.

Outpatient services are covered by Medicare Part B, and this is where many of the treatments for migraines fall. Part B covers visits to your doctor, lab-work, imaging scans, ambulance, E.R. visits and much more. Injections given in a clinical setting or doctor’s office, such as Botox for migraines, are covered by Part B as well.

When you seek treatment with a physician for migraines, Part B will cover 80% of the cost of both your doctor visit and the treatment provided. You are responsible for an annual deductible of $183 for 2018 under Part B. You will also be responsible to pay the other 20%, which is called your coinsurance.

If you visit with your doctor about migraines, Part B will pay for 80% of the cost of your appointments after once you’ve met your annual Part B deductible. In 2018, that deductible is $183. You are responsible for the other 20%, unless you have a Medigap plan, which is an insurance policy designed to help you pay for the gaps in Medicare.

Medicare’s “New” Drug Program

There are a number of medications that your physician may prescribe for migraine treatment. Prior to 2006, Medicare would have provided coverage for such treatments. However, Medicare Part D now offers voluntary prescription drug coverage for people on Medicare.

Part D plans are private insurance policies that help you to pay for retail outpatient medications. Each company has its own formulary of drugs, and it’s important to review that list before you enroll to make sure that it covers the migraine medications you need.

Most formularies contain a number of options for migraine treatment such as beta blockers, triptans, and glucocorticoids. It is also hoped that Medicare Part D will soon begin to cover newer preventive medications like calcitonin gene-related peptides, such as Aimovig, which was just approved by the FDA.

Danielle Kunkle is the Vice President and Co-Founder of Boomer Benefits, a licensed insurance agency that assists Medicare beneficiaries with their supplemental plan options. You can read more about what Medicare covers on her website:



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11 thoughts on “Does Medicare Cover Migraine Treatment?

  1. Registered Nurse says:

    Aimovig support requires patients to receive a prior arthorization from Medicare Part D, or an application is denied; As Amovig received FDA approval without research on patients over the age of 65 years by allowing a single patient age 65 years into study, Medicare has an obvious reason to exclude Aimovig: Aimovig is effective in fewer than 50% of patients age 18-64 years, effectively raising the $7,000. yearly cost to $14,000. for those who benefit. Aimovig advertises the support program as providing financial assistance for low income, but it appears Aimovig true purpose is to encourage seniors to pressure Medicare, while disguising the fallacy of Aimovig Support- all applications by individuals over age 65 years are denied. If you read the fine print on Achy smile, the Aimovig web site, you discover the site “only represents the views of one individual” and this individual, while accepting responsibility for information is PAID by Aimovig!

    Medicare patients should have the same opportunities for migraine prevention as younger patients. Maybe it is time for Congress to enact laws commonly found in other countries to control costs of medication. Pharmaceutical companies should be required to offer Medicare patients drugs at a fix price, say 10% over manufacturing cost, or generic manufactures of medications should be exempt from the seven year waiting period for sale to Medicare patients: mail order only, part D Medicare coverage the only payment accepted.

    • Lori Glover says:

      We’re too small to have an insurance department, but some insurance will fully or partially reimburse you. Please contact your insurance provider directly for instructions on how to get reimbursed through your plan. You can also use an HSA or FSA to pay for the purchase on our website, if your account has a purchase card.

  2. Emily Sargent says:

    I have been taking migraines for many years with no relief. I was finally diagnosed with small vessel desires of the brain. My doctor has been getting Aimovig samples for 4 months for me I had 2 the first month and none sence this shot has been a God sent to me. But now the samples has stopped coming and Medicare does not pay for the shot so the migraines has started again. Is there not anything that will help us that are in medicare I’ve worked all my life I only ask for one shot a month. I’m disabled at 58 😭

  3. Julia Capps says:

    I have migraines since I was 9-10yrs old to present a nf fact I’m having one now. I have a prescription of Sumatriptin which I have to take every 2hrs. Could you tell me how to have Medicare Medical and Humana Insurance so I can have a medication that will take away my migraines so I may have relief from the pain thank you very much sincerely Julia

    • Lori Glover says:

      I recommend consulting with your medical provider for prescription and Medicare information. We do not have an insurance department. If you have questions about our Axon Optics eye wear, please email [email protected] anytime.

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