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What Erectile Dysfunction Drugs are Covered by Medicare


Medicare coverage for erectile dysfunction prescriptions may have coverage under Part D. Most brand name medications for erectile dysfunction, such as Viagra, Cialis, and Levitra, are not covered under Part D. However, the generic versions have some coverage. Some Medicare Advantage plans that include prescription drug coverage cover the brand name medications for erectile dysfunction. We’ll cover this in detail below.

Does Medicare Cover Viagra?

The retail cost of Viagra can be very expensive. Part D plans do not cover Viagra. However, Part D does cover some generic versions, such as Sildenafil.

You’ll need to take a close look at your plans’ drug formulary to see if the generic version is included and how much it will cost out of pocket. Some MAPD plans cover both Viagra and the generic versions. The drug class is a PDE-5 inhibitor.

Does Medicare Cover Cialis?

Part D plans also do not cover Cialis. However, there are some generic versions that may have coverage under either Part D or an MAPD. The drug class is also a PDE-5 inhibitor.

Does Medicare Cover Levitra?

Levitra is not covered under Part D. There are a few generic versions that do have coverage.

Some MAPDs cover Levitra, as well as the generic version. However, you’ll have less out of pocket costs if you go with the generic version. Again, the drug class is a PDE-5 inhibitor.

How Much Do Erectile Dysfunction Drugs Cost with Medicare?

When choosing which medication is right for you, the price can play a significant role. Not all erectile dysfunction drugs are the same. Ideally, you want a medication that works right for your body; what works for one person may not work for another.

Unfortunately, health insurance restrictions are usually the final determining factor. Many insurance plans place restrictions on the number of pills a patient may receive each month. After reaching the limit amount, out-of-pocket costs for one tablet can be $20-$50.

Erectile dysfunction drug costs depend on the co-payment amount, health insurance coverage, plan type, and the pharmacy price. The national out-of-pocket cost per pill is generally $15-$20.

Does Medicare Cover Penile Implant Surgery?

Yes, Medicare covers penile implant surgeries. If it’s medically necessary, coverage includes all other Coloplast devices. Unless supplement insurance is in place, patients can expect to make payments of $2,500 – $3,000 for the procedure.

Generally, this is an outpatient service, so Part B covers 80% of the allowable costs. The beneficiary is responsible for the remaining 20%. Part B also includes penile pumps and other devices like it.

Get Help with Medicare Coverage for Erectile Dysfunction (ED)

Medicare Supplements may help cover some of the out-of-pocket expenses for sexual health/dysfunction treatments. Starting with erectile dysfunction consultations to diagnose and adequately treat the individual.

If you’re looking for ways to help cover your out of pocket costs with Medicare, we can help. Our team of licensed agents specializes in all things Medicare. We’re happy to compare rates and answer any questions you may have about coverage – free of charge. Can’t call today? Fill out an online rate form and get the process started.

Jagger Esch

Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and MedicareFAQ.com. Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

4 thoughts on “What Erectile Dysfunction Drugs are Covered by Medicare

  1. Hi Lindsay, I was told that my Medicare plan does not cover Tadalafil, even though it was paid for last August when my Urologist first prescribed it. I don’t understand why this time it is being rejected by my pharmacy.
    Thank you.

    1. Hi Cris! Part D plans do not cover Tadalafil. If it happened to be covered for you in August, I would as your doctor or pharmacist how they billed Medicare. Now, Part D plans do change their drug formulary yearly. It could be that the plan did cover it last year but the plan updated in the new year and no longer covered it. However, according to my research Part D plans do not usually cover it, so I’m thinking something else has changed.

  2. Hello..I’m currently on Blue/Blue Shield till Dec.31. Then will be switching to either Medigap or Medicare Advantage. My urologist has prescribed both generic viagra and cialis also muse 1000mg. I do have high blood pressure and I’m on medication for that and also have enlarged prostrate and on medication for that also. My question is will theses meds be covered by unitedhealthcare plan f or a medicare advantage plan.

    1. Hi Randy! Medigap Plans do not cover any prescription drugs. You would either need to get an Advantage plan or Medigap Plan + Part D plan. You can use the Medicare plan finder tool to type in your medications and see what Advantage & Part D Plans will cover them in your area.

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