Migraine Medication and Health Insurance: Help With Migraines Or More Pain?

By Josh Deither

Everyone is starting to find it harder to buy health insurance coverage for themselves. If you are looking for family coverage (which includes coverage for wife and children), the premiums are so high that you're usually looking at more than a week's worth of pay for their cost. As list of medical conditions that are "not covered/just barely covered" continues to increase, the other side of the list - which is what most of us consider needed health coverage - goes down. When you combine that reality with how many people are unable to pay the overpriced premiums each month, you begin to realize why many could end up being in danger of having a lot of medical conditions that could require treatment.

Migraine headaches are one such condition that have recently fallen victim to insurance constraints. In the past, migraines were not medically understood, and as a result were cared for with a multitude of pain medicine, tranquilizers and relaxants.

Other compounds, developed during the past two decades, were designed for use as migraine medicines. They were administered alone or with other medications for pain or other conditions. Recently, however, a number of compounds approved by the FDA and targeted exclusively to migraine headaches have been marketed and can be purchased by migraine sufferers. Not just in the U.S. Unfortunately, the price of these new medications far exceed the average person's ability to pay for them. Insurance strictly limits the patient's access to these medications by limiting quantity or coverage.

Medications developed specifically for migraines, and meant to be taken with every migraine, are often doled out in amounts of 8 to 12 pills monthly. This leaves the patient with the task of determining which migraines they can medicate and which they must suffer through to conserve medication. Insurance will not pay for early refills and so the patient must pay the lion's share of the exorbitant cost. Even when a patient is up to date on their insurance premium payments, they often can not make use of that insurance to purchase the medications they really need. Migraine headaches can signal other health conditions. They have been linked to stroke. Are there other options for those who cannot afford the cost of medication?

Medicaid can be a viable option for some people, like someone I know, who can't pay for insurance. To apply, you have to complete a multitude of forms and earn only the Medicaid maximum, but if you are able to get Medicaid to accept you, your physician appointments and medications could be covered. But once you get Medicaid, you must stay on top of things or you could be canceled if you don't follow all of their regulations to ensure coverage.

Ironically, at a time when there exist medications that can treat migraines, insurance businesses are basically withholding these remedies by imposing financial or other restrictions upon the patients. Migraine patients could simply be victims of the most recent condition restricted by insurance, but is a solution available to assist them in obtaining the remedy they require? The current presidential administration is taking this and other concerns under consideration. With any luck, some solutions will be forthcoming.

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