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was denied.Now what?

We know how frustrating, scary, and confusing this can be, but you’ve come to the right place. First and foremost, it’s important to know that you can appeal. It’s your right!

My claim for

Aimovig

Claimable can help you appeal.  Why was your claim denied?

Learn more about

Aimovig

What is Aimovig used to treat?

Migraines - Aimovig helps mute pain signals in your head and neck that would otherwise be part of a migraine attack

How can Aimovig help me?

Aimovig is used to help people who have frequent migraines and for those whose migraines impact their ability to function. As with any medication, results can vary. In general, people experience anywhere from a 30% to 75% reduction in migraine frequency. In addition to reducing migraine frequency, there are several other goals to consider when starting Aimovig¹: Reducing how painful migraines are when they happen Reducing how often you need to use medications to stop a migraine Improving your ability to function in your daily life and reducing how much migraines impact your daily life Regaining a sense of control and management of your migraines Improving your overall health-related quality of life Reducing the amount of distress and mental strain caused by headaches, which is common when you don’t know and can’t control when your next migraine attack will happen

At least 4 days with migraines per month for the past 3 months
And you cannot have:
Tension headache
Hemiplegic migraine

At least 4 days with migraines per month for the past 3 months
And you cannot have:
Tension headache
Hemiplegic migraine

What do doctors usually try before Aimovig

A trial of at least 2 different preventive medications for migraines, often for anywhere from 2 to 3 months.

Example medications include: Depakote and Depakote ER, Topamax, Neurontin, Elavil, Effexor, verapamil, or beta-blockers (drugs that end in “-olol”)

These medications did not work for you during that trial period

Some insurers will not count medications you got as samples from your doctor or from discount/coupons

A trial of a medication to treat or stop migraines
Example medications are all the drugs where the generic name ends in “Triptan”: Amerge, Axert, Frova, Maxalt, Relpax, Imitrex, Zomig

These medications did not work for you during that trial period, or you were not able to take them for some reason (they were “contraindicated.” If this is the case, make sure your doctor notes it in your records)

For some insurers, they will not count any medications you got from samples from your doctor or from discounts or coupons

Some insurers will also require that you have a trial of Botox for chronic migraine prevention. This can be for 6 months in some cases, and may require a separate prior authorization.

In most cases, you cannot be taking any other similar medication (e.g. Nurtec, Qulipta, Vyepti)

What are the treatment history coverage for Aimovig

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What can you do to help your case?

Make sure your doctor is recording all different types of migraines that you suffer from. For instance, if you have migraines with aura and also have episodes without aura, make sure both are included in your records. Once you get a diagnosis of chronic migraine, however, that difference in coding becomes less important.
Track your migraines. Keep track of how often your headaches happen and their impact on your life (having to miss work or school, skip appointments, avoid driving, etc)
Track the drugs you’ve already tried. This improves your ability to say whether you can skip ahead in the process, especially if your doctor makes note of it.
Note if you have had headaches from your medications, or “medication overuse headaches”. Medications like Aimovig both help reduce headaches and do not cause an overuse headache, meaning they might be the best option for people with medication overuse headache.

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