The short answer is no – yet, truth be told, it is a little more complicated than it seems. As of now, 15-25% of men 65 years and older currently struggle with symptoms of erectile dysfunction. Unfortunately, Original Medicare coverage does not include prescription drug coverage.

But that’s just for Original Medicare (Medicare Parts A and B). If you sign up for prescription drug coverage with Medicare Part D, you’ll have the opportunity to purchase additional coverage that could provide you with coverage for your ED medication. But that may depend on a variety of factors.

Medicare Part D

Medicare Part D is tasked with providing discounted, affordable prescription drug coverage for seniors enrolled in Medicare Parts A and B. In Part D, the federal government funds private insurance companies that provide prescription drug coverage. As of right now, this program only covers a narrow range of prescription drugs, and coverage will be given to the following:

  • Original Medicare
  • Certain Medicare Cost Plans
  • Medicare Medical Savings Account Plans
  • Medicare Private-Fee-for-Service Plans

Given the long research and certification process required for most prescription drugs, the process to certify prescription medication covered under Medicare Part D means options are limited. Moreover, experimental medication will almost always be excluded from coverage.

With this in mind, the patient should understand that insurance plans will vary between carriers. This makes estimating exact prices difficult. In the present moment, the monthly average for premium prices is estimated to be $33.19. But that will vary based on variables like your age, your location, and which company is supplying you with your coverage.

In addition to this premium charge, some insurance providers will enforce a separate prescription deductible that doesn’t contribute towards the payment of prescription. You’ll have to pay that deductible first before your medical benefits will kick in and reduce your out-of-pocket costs.

These prescription drugs will be arranged into a tier system based where premiums and copayments will vary depending upon the medication you need. As a result, the more specific the medication, the higher your costs will be.

Overall, in contrast to other insurance plans under the Medicare system, Medicare Part D offers an opportunity for patients suffering from erectile dysfunction to receive a form of treatment coverage.

Medicare Part D and Erectile Dysfunction

Before considering and choosing an insurance plan, it is important to understand what the potential causes of erectile dysfunction are. Numerous health issues can contribute to ED, and it’s just as important to treat the root cause as it is to manage the day-to-day symptoms. The following conditions have been closely associated with ED symptoms:

  • Diabetes
  • Obesity
  • Cardiovascular issues
  • Smoking
  • Alcoholism

With the proper medical treatment of these conditions, symptoms of erectile dysfunction are lessened drastically. You may be able to alleviate symptoms by focusing on lifestyle changes that emphasize exercising regularly, dieting, and even smoking cessation. While Medicare may not cover ED medication directly, it is important to note that Medicare does cover treatment for health conditions that are associated with ED – and getting that treatment can help alleviate your worst symptoms.

Viagra Coverage and Medicare Part D

Viagra is a crucial medication often used to treat individuals that suffer from erectile dysfunction. This medication’s usefulness is unparalleled for a lot of patients seeking treatment. Despite all of this, it is difficult to find a plan under Medicare Part D that offers coverage of Viagra.

Treatment Examples Covered?
Medication – Phosphodiesterase type 5 (PDE5) inhibitor pills Viagra (sildenafil), Cialis (tadalafil), Levitra (vardenafil), Stendra (avanafil) If prescribed for ED: No If prescribed for another condition: Maybe
Medication – self-injections Caverject, Edex (papaverine, phentolamine and/or alprostadil) No
Medication – urethral suppositories MUSE (alprostadil) No
Vacuum erection devices No
Penile implant (prosthesis) Under certain circumstances. See below.

Nevertheless, generic versions of the drug that contains Viagra’s active component, sildenafil, may be covered by some Part D insurance plans. This also applies for drugs similar to Viagra like Cialis and Levitra, where their own corresponding generic versions (Vardenafil, Tadalafil).

Another option outside of Medicare Part D is Medicare Advantage. Medicare Advantage is a health insurance plan offered by a private company that maintains coverage for:

  1. Medicare Part A and B benefits
  2. Limited prescription drug coverage from Part D.

Fortunately, with Medicare Advantage, a few plans do cover Viagra and depending on the plan itself, the individual could pay little to no money. Otherwise, when crafting and selecting a Medicare insurance plan, one should take note of all available plans in order to decide which insurance company offers the most ideal deal options for you.

Are There Other Potential Options Beyond Medicare?

In the case that an individual isn’t able to afford or have their Viagra supplements covered due to expenses, there are alternative ways of mitigating the issue. For instance, options such as:

  1. Lifestyle Changes – any lifestyle changes you can make that promote better health (such as getting better sleep, losing weight, or quitting smoking) could alleviate your symptoms so that you don’t need Viagra anymore.
  2. Treatment for Underlying Conditions – If you suffer from health conditions that are known to contribute to erectile dysfunction (Diabetes, Heart Disease, Alcoholism, etc.), touch base with your doctor and come up with a comprehensive treatment plan to alleviate symptoms for better health.
  3. Coupons & Discounts – Depending on the drug manufacturer, certain companies like Pfizer offer discounts on as many as 12 of their Viagra supplements per year. Besides this, Pfizer also provides an assistance program for certain drug purchases.
  4. State Pharmaceutical Assistance Program – Throughout the United States, some state programs offer assistance to their residents by paying for their medications.

What Should You Do If Viagra Is Not An Option?

If you can’t afford a Viagra prescription, or if you can’t get it filled at your local pharmacy for whatever reason, then it’s important to consider your alternatives. For instance, penile implant surgery is a safe form of treatment given that Medicare and Medicare Advantage offer coverage for the procedure.

Furthermore, Part B of Medicare will cover 80% of the cost, while allowing the patient to pay the remaining 20% of the procedure. In the event the patient isn’t open to penile implant surgery, Medicare Part B offers plans that include pumps.

On the other hand, a disorder such as anxiety can produce symptoms similar to erectile dysfunction, which wouldn’t require the use of Viagra or penile implants. If anxiety is the main cause, then cognitive-behavioral therapy (CBT) and/or certain antidepressants can help alleviate the condition. You may also want to try CBD or cannabidiol supplements. These drugs drastically reduce anxiety levels in many of the patients who try them. Not only does CBD tackle ED symptoms by lessening anxiety, it also gives men a different option outside of prescription medications. Under those circumstances, CBD serves as a short-term solution that gives fascinating results.

All things considered, if you suspect that you’re suffering from symptoms that are reminiscent of erectile dysfunction, then you should consult with a doctor immediately. In any event, you’ll be more likely to discover the root cause of your problem and tend to it with the most optimal solution.