• Most Medicare plans do not cover erectile dysfunction (ED) medications like Viagra, but some Part D and Part C plans may help cover generic versions.
  • Generic ED medications are available and are generally more affordable.
  • ED may be caused by an underlying health condition, so it’s important to talk to your doctor about possible causes and the best treatment for you.

Viagra (sildenafil) is the most recognized brand medication for treating erectile dysfunction (ED), a common condition affecting millions of men. More than 65 million prescriptions for the drug have been filled since it was first introduced in 1998.

Medicare generally does not cover Viagra or other medications for ED treatment. Under Medicare guidelines for coverage, these medications are not considered medically necessary.

However, more generic versions of ED medications have recently become available. The generic versions are much more affordable, even without insurance.

Medicare does cover another brand of sildenafil known as Revatio. Revatio is used to treat pulmonary arterial hypertension (PAH), a condition involving high blood pressure in the arteries in the lungs.

Let’s take a closer look at Medicare plans and how they address Viagra coverage.

Viagra is the most well-known ED medication around the world and is often referred to as “the little blue pill.” Viagra was also the most prescribed medication to treat ED until recently, when new generic versions were introduced.

Viagra works by increasing blood flow to the penis to help get or maintain an erection. It does not affect arousal.

Viagra is available as an oral tablet in doses of 25, 50, and 100 milligrams. If you are 65 years or older, you may be given a lower starting dose to avoid certain side effects. You and your doctor will discuss the right dose based on your overall health and any other medications you may be taking.

Commonside effectsinclude:

  • flushing (redness of face or body)
  • headache
  • body aches
  • nausea
  • upset stomach

Contact your doctor or seek emergency medical care if you have any of the following serious side effects:

  • vision loss in one or both eyes
  • hearing loss or ringing in the ears
  • confusion
  • shortness of breath
  • dizziness, lightheadedness, or fainting
  • priapism (an erection that lasts longer than 4 hours)
  • chest pain

Taking nitrates (such as nitroglycerin) or alpha-blocker medications (such as terazosin) with sildenafil can cause a dangerous drop in blood pressure and should not be taken together.

Medicare has four different parts (A, B, C, and D) and each covers prescription medications differently. Parts A and B are also referred to as original Medicare. Medicare Part A covers costs related to inpatient hospital stays, hospice, skilled nursing, and home healthcare. Part A does not cover Viagra or other ED medications.

Medicare Part B covers outpatient doctor visits, preventive screenings, counseling, and some vaccines and injectable medications given by a healthcare professional. Viagra and other medications for ED are not covered under this plan.

Medicare Part C, or Medicare Advantage, is a private insurance option that offers all the benefits of parts A and B. Medicare Part C also covers prescription drug benefits and other extras like dental, vision, and fitness memberships. There are HMO, PPO, PFFS, and other types of plan options available.

Although Part C plans offer extra benefits, there may be restrictions on in-network doctors and pharmacies.

Typically, Part C plans with prescription drug coverage do not cover Viagra or similar medications for ED. Some plans may cover generic versions. Check your specific plan to see which drugs are covered.

You can also try to appeal a coverage decision. Your doctor would need to write a letter to your insurance company explaining why the medication is medically necessary.

Medicare Part D is also offered by private insurance companies with plans approved by Medicare. You must be enrolled in original Medicare to be eligible to enroll in a Part D plan. Costs and types of coverage vary based on where you live. There are typically hundreds of plans to choose from in any given state.

Choosing a Part D plan

ED medications are not generally covered by Medicare Part D plans, but Revatio (for PAH) is covered by most plans. You can go to Medicare.gov’s Find a Medicare Plan tool to compare rates and drug coverage before choosing a plan.

Each plan has a formulary that lists the specific drugs that it covers. Check to see if Viagra or a generic ED medication is listed as covered. You can also call the plan’s provider and ask if Viagra is covered.

Medigap is an add-on coverage plan to help pay for coinsurance, deductibles, and copayment expenses not covered by original Medicare. There are 10 plans to choose from that offer different levels of coverage.

Medigapplans do not pay for prescription medications. Viagra would not be coveredunder any Medigap plan.

The brand version of Viagra is a fairly expensive medication. The typical cost for one tablet is $30 to $50. You can check for discounts and coupons offered by the manufacturer and other programs to lower the cost.

The good news is that generic versions are now available and are driving down the cost. Generic sildenafil costs a fraction of what the Viagra brand medication does, making it more affordable and accessible for the millions of men with ED.

Even without insurance, the average cost for a 25 mg dose of generic sildenafil costs between $16 to $30 for 30 tablets by using a coupon at retail pharmacies.

You can look for coupons on drug manufacturers’ websites, medication discount websites, or from your preferred pharmacy. Prices can be different at each pharmacy, so check before you go.

Without a coupon or insurance, you could pay as much as $1,200 for 30 tablets.

TipS for saving money on your ED medication
  • Talk with your doctor. Discuss your symptoms with your doctor and ask if generic sildenafil would be right for you.
  • Shop around. Ask for prices at different retail pharmacies to find the best price. Prices can be different at each pharmacy.
  • Check for coupons. You can search for coupons to lower the cost of these medications from the manufacturer, your pharmacy, or a prescription discount website.
  • Look into Viagra discounts. Ask your doctor if there are any manufacturer discounts or patient assistance programs that you may qualify for.

ED is the long-term inability to get or maintain an erection. It is a complex condition that may be a symptom of other underlying physical or psychological conditions.

ED affects about 18 to 47 percent of men in the U.S. and is more likely to occur as you get older. For men older than 75 years, the rate rises to 77 percent.

There are many factors that can cause ED. These causes can be physical, psychological, environmental, or related to certain medications. Some of the common possible causes are listed below.

Physical causes

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Psychological and environmental causes

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Medications

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There are several other treatment options for ED. Other oral medications in the same class as sildenafil include avanafil (Stendra), tadalafil (Cialis and Adcirca), and vardenafil (Levitra and Staxyn).

Other available medical options include:

  • testosterone in injectable, pellet, oral and topical forms
  • vacuum pumps
  • alprostadil urethral suppository (Muse)
  • blood vessel surgery
  • injectable alprostadil (Caverject, Edex, Muse)

You may also consider trying some of the following nonmedical treatment options:

Acupressure and herbal supplements may advertise treatment for ED, but there is no confirmed scientific evidence to prove these claims. Always check with your doctor before taking herbal or natural supplements. They may interact with your medications or cause side effects.

Other treatments that are being studied for possible use in the future include:

ED is a common condition affecting millions of men. Medicare plans generally do not cover Viagra, but there are many generic options available that make medication much more affordable, even without insurance.

It’s important to address the underlying causes of ED. Talk with your doctor about any health concerns possibly related to ED. Consider all treatment options that could be helpful, including healthy lifestyle changes and therapy for psychological or relationship concerns.