Botox: FSA Eligibility

What is Botox?

Botox is a drug that is derived from a series of neurotoxins produced by bacterium called botulinum toxin, which has been called "Botox" for short since the drug's inception. Botox is commonly associated with its role in cosmetic medicine, as Botox refers to a series of medications that use various forms of this toxin to paralyze muscle activity to treat specific muscular conditions and cosmetically removing wrinkles and other common signs of aging. Botulinum toxin can only be injected into humans in very small amounts as it is an extremely poisonous substance. In tiny concentrations, this drug works by being injected directly into neuromuscular tissues, where it will take between 24-72 hours for the botulinum toxin to take effect. This will prevent signals from the nerve cells reaching muscles, which effectively paralyzes the underlying tissue to reduce the appearance of wrinkles and fine lines in older adults. This treatment is done solely for cosmetic purposes and therefore would not be eligible for reimbursement with a consumer-directed healthcare account (MedlinePlus).

Are there viable medical uses for Botox?

Aside from its role in cosmetic procedures, researchers have found more than 20 different medical applications for Botox, with many others still being investigated for their medical viability. Botox has been used to treat medical issues including eyelid spasms, severe neck and shoulder muscle spasms, chronic migraines, hyperhidrosis (excessive sweating), overactive bladder/urinary incontinence, crossed eyes/lazy eye (TIME).

Botox injections are primarily linked with cosmetic procedures, and while they do have a number of applicable medical uses, these may require a Letter of Medical Necessity (LMN) and additional documentation to be eligible for reimbursement. Account holders who are considering Botox injections for a legitimate medical condition should speak with their benefits administrators before pursuing treatment to ensure that they have the proper documentation necessary for reimbursement through their accounts.