If you are living with erectile dysfunction (ED), your insurance might cover medication that can help restore and sustain an erection. Thankfully, there are affordable medications which work just as effectively as the Viagra brand medication - check with your provider or pharmacy.
Medicare and most commercial health insurers publish coverage policies that outline when ED treatment is medically necessary; however, many employer-sponsored health plans still include benefit exclusion language that prevents men from accessing necessary treatment for ED.
Medicare
Medicare is the federal government's health insurance program designed for people 65 or over or younger with disabilities. Medicare typically covers hospital stays, home health care services, hospice services, doctor visits and many other forms of medical assistance.
Medicare Part A covers hospital and nursing home stays; Part B covers outpatient services like doctor's visits, physical therapy, occupational therapy and laboratory testing as well as prescription drug coverage as well as some dental and vision coverage.
Original Medicare does not cover erectile dysfunction (also referred to as impotence), though other conditions which might contribute to it such as diabetes, kidney disease or depression might.
Men with ED often suffer from other related health conditions that can be addressed with medications and other methods, often at an affordable price point. Such therapies can help patients feel better and enjoy more fulfilling relationships.
Viagra is the drug most people think of when discussing "erectile dysfunction". This popular brand-name medication helps improve men's ability to achieve an erection, and can come in both tablet and patch forms for convenience.
Brand-name drugs can be prohibitively costly, while there are generic versions which may be much more affordable. Prescribed by your physician and less likely to interact with other medications in your regimen, generics may provide safer treatment solutions.
If you have a Medicare Part D or Advantage plan, you can purchase Medicare-approved drugs to treat erectile dysfunction at either your local pharmacy or through a separate Medicare prescription drug plan. Before doing so, be sure to review your policy's formulary to see which drugs it covers as well as associated costs.
Private insurers that offer Medicare Part D and Advantage plans often adhere to federal Medicare rules regarding ED drugs; however, this isn't required of them. Some plans may offer more generous coverage; so before making your purchase decision be sure to confirm exactly which provisions your plan offers.
Viagra and other brand-name erectile dysfunction drugs are not covered by Medicare or Medigap insurance plans, making generic ED drugs more cost effective and accessible to seniors without health coverage or limited incomes.
Medicare does not cover injections or male vacuum erection devices - commonly referred to as penis pumps - that treat ED. Although not medically necessary, such devices can be an effective means of treating it when combined with medications or diet changes.
If you suffer from erectile dysfunction and are considering investing in a penis pump, please speak to your physician first before making your decision. Some men find success using combination therapies of drugs and diet while others require surgery as the solution for treating their ED.
Medicare coverage of erectile dysfunction for men may be limited, but it does provide access to treatments that can improve quality of life and lower risk of other medical conditions. Unfortunately, Medicare doesn't cover treatments like ED injections or penis pumps as these medications don't meet medical necessity criteria under its guidelines.
