Is Botox covered by benefits?

Here’s the answer to this week’s reader question.

“A friend told me she gets her Botox covered by her work benefits. Is this possible? How can I get Botox covered with my work benefits?”

—Tania

Is it possible to get Botox covered through my work benefits?

“A friend told me she gets her Botox covered by her work benefits. Is this possible? How can I get Botox covered with my work benefits?”

—Tania

The answer is it depends. If the Botox is for a medical need, it’s very likely going to be covered. However, this depends on which province or territory you live in and your employer’s benefits plan. Start by looking into what’s covered as medically necessary by the government where you reside. You may not even have to touch your workplace benefits. 

If your condition is not covered by your government plan, you can check what coverage is available through your employer. Is it just group benefits? Or do you have an HSA (health spending account)? Most group benefit plans do cover Botox but only for medical reasons, such as bruxism (chronic teeth grinding), hyperhidrosis (excessive sweating), migraines and certain spasmodic conditions. There’s a process required to get this treatment pre-authorized; you can call your provider’s support line for more information.

Beyond your HSA, you may have access to another option, often called a wellness spending account, a flexible spending account or a lifestyle spending account—and this is the option to check if you’re looking to get Botox as a cosmetic treatment. 

Not all employers have a wellness spending account in place, but I’m coming across more and more companies that do. Essentially, this account is an employer-sponsored stipend, which falls under the category of a taxable benefit.

In many cases, a wellness spending account can be used for virtually anything. The employer has full power to say, “Well, we’re allocating it for anything medical, for gym memberships or even for workout apparel.” I know companies where employees take advantage of a wellness spending account to get neuromodulators like Botox, even for cosmetic purposes.

—Olga Radutsky
CEO and founder of Estedica Global Wellness Solutions

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As told to Wing Sze Tang

Wing Sze Tang is an award-winning journalist based in Toronto. She is the founder of Wayword Media Inc.