Do Most Health Insurance Plans Cover Viagra

Viagra, a brand name drug to address erectile dysfunction, is an expensive drug that many Medicare-eligible men consider using. Does Medicare cover the cost of Viagra or related drugs like Cialis? The answer is somewhat complicated but we try to make sense of it below:
Does Medicare Cover Viagra?
Original Medicare (Part A and Part B) does not cover prescription drugs, so it does not cover Viagra. Medicare Part B currently covers pumps for erectile dysfunction under Durable Medical Equipment. This would leave a 20% cost for you, unless you have a Medigap plan that covers Part B’s costs. But again, Part B does not cover Viagra.
Do Medicare Part D Drug Plans Cover Viagra?
Medicare Part D is additional coverage that you can purchase to pay for prescription drug coverage. Currently we do not know of any Medicare Part D plans that cover Viagra . Remember to check back during Medicare’s Annual Election Period (Oct 7-Dec 15), to see if any new Medicare drug plans will include Viagra on their formulary (list of covered drugs) next year.
Do Medicare Drug Plans Cover GENERIC Viagra?
Currently there is not a generic Viagra available anywhere but the active ingredient in Viagra is Sildenafil. Sildenafil is covered by some Medicare Part D providers. If you doctor prescribes you Sildenafil, give us a call and we can tell you which drug plans cover that (and all your other prescriptions).
While brand-named Viagra is usually not covered, some Medicare Part D plans cover Cialis depending on the dose. . Check out our article called “Does Medicare cover Cialis?”
Viagra Generic Available December 2017.
As of December 2017, a generic Viagra will become available. Make sure to check your formulary to see if you plan covers the generic version, as well as, check to see if any plan your switching to has the generic on its formulary.
Does Medigap Cover Viagra?
Medigap does not cover Viagra. While this supplemental insurance does cover a lot, it does not cover any prescription drug. It can cover all your out of pocket cost for the pump mentioned above.
Does Medicare Advantage Plans Cover Viagra?
Medicare Advantage (MA) plans can cover viagra. Don’t jump up and down just yet. The few plans that do cover Viagra require you to pay a high percentage of the cost that is often prohibitive.
IMPORTANT TIP: When selecting a Medicare Part D plan, you want to consider all of your drugs (not just Viagra). We can run a free comparison of all you drugs to see which part D companies have the best plan for you. All you will need the name of all your drugs, the dosage and how often you take them. Give us a call at the number in the upper right hand corner of this page.
Already have a part D plan but want to switch? You must change plans during the Annual Election Period of Oct. 15- Dec 7. Call one of our Senior65 licensed independent insurance agents at 800-930-7956 for help .
Reader Comments and Questions.
By William on May 28, 2017.
What skin conditions are covered by Medicare D for Tretinoin .1%
Thank you for your question. Each Medicare Part D plan has its own formulary (list of drugs) and has specific rules that apply to how a drug is covered. Therefore, we would not be able to answer this question for you. If you’re interested in comparing and enrolling in a Part D plans that cover Tretinoin, call one of our Senior65 licensed independent insurance agents at 800-930-7956.
By Dennis on May 09, 2017.
Since my Medicare Part D Plan doesn’t cover Cialis, why won’t they let me use the $200 manufacturer’s discount coupon? It specifically says that if you have Medicare, you are not eligible for the coupon. I even called to clarify to say yes, I have Medicare but I am not getting any reimbursement for this drug. They still said I will not qualify for the coupon. Is there a way around this? What if I went into a pharmacy and just wanted to pay cash and use the coupon, and not even present my Medicare Part D card, would that work? It seems so nonsensical to me since a large percentage of the men that this drug is created for are going to be over 65 but no Medicare reimbursement and no Lilly coupon eligibility. If you have any suggestions, please share. Thanks!
We totally understand your frustration with this situation! Believe us, we get calls all day long from men over 65 looking for drug coverage for Viagra and Cialis, and we are not able to help enroll them, in most areas. We agree this doesn’t seem fair, but according to Cialis they do not offer the $200 discount to people covered by government programs (ie. Medicaid, Medicare, VA). Our suggestion is to call Cialis directly to see if they can make an exception for you.
By Barry on April 25, 2017.
I have SilverScript for my Part D provider. They cover Sildenafil Citrate (20 mg), which is for ED, BUT THEY ONLY COVER IT for pulminary atrial hypertension, which it is also indicated for. I don’t even want my physician to “fib” about that one because I wouldn’t want PAH listed in my medical records. As a result I have been denied Sildenafil for my ED both on prior authorization as well as on appeal. This is insane! Truly a medical and psychological issue (regardless of what Marge says on 09/06/2016) and we have no recourse.
By ROSENDO GUZMAN on October 24, 2016.
Pls. inform me for any Medicare insurance that covers free viagara prescription. Thx.
Unfortunately, there are no insurance providers that offer free Viagra. Not only that, most insurance companies don’t offer any coverage. You may want to check with your doctor to see if they have any free samples.
By Marge on September 05, 2016.
I am glad Medicare doesn’t cover Viarga or Cialis . Medicare doesn’t covered the necessary items of hearing aids, eyeglasses, or dental. So why should they cover something that is not that necessary to a fulling life. Women over a certain age do not need birth control pills useless there is a medical serious medical need. All those guy whiney about it need to fine something else to fill their time.
By jack on August 24, 2016.
rather than viagra or cialis i opted to have implants best choice i ever had.
By william howard on July 06, 2016.
i’am 75yrs of age and have diabetes,is there any help for men like me, my wife of many years left me because of my problem,ED.what are we supposed to do.life has no meaning anymore.will medicare cover any of this care,or are we left to demise ? I don’t know how to handle this,a fish out of water effect.
There are a small handful of Medicare Advantage plans that cover Viagra, and some Part D drug plans that cover Cialis. If you need help finding a plan in your area, call one of our Senior65 licensed independent insurance agents at 800-930-7956.
By John on June 01, 2016.
Does Medicare cover Cialis or Viagra in North Carolina, zip ? I have the enhanced prescription (Blue Medicare Rx (PDP))
Since you’re already enrolled in a plan, you’ll want to check on other Part D plans closer to Medicare’s Annual Election period. At that time, you’ll be able to see if plans are newly offering coverage for Viagra or Cialis. In the meantime, you can contact the number on the back of your card to see if your current plan offers any coverage for either drug.
By Melvin E. Jones on May 31, 2016.
My area code is 30088. Are there any Medicare Advantage Plans, or supplement plans, in my area that covers prescriptions for Viagra or Cialis?
At this time, there are no Medicare Advantage plans in your area that cover Viagra. There are three that cover Cialis. To learn which plans cover Cialis, as well as, to let us know your entire list of drugs and dosages, please call one of our Senior65 licensed independent insurance agents at 800-930-7956.
By Jose Duque on May 31, 2016.
I live in Texas zip code 78572. I am enrolled with Cignahealthspring. Do you know if they cover Cialis or Viagra.
You will want to contact the number on the back of your card to confirm benefits. If you are looking to switch your Medicare Advantage during Open Enrollment, please call one of our Senior65 licensed independent insurance agents at 800-930-7956.
By Linda Cohen on May 09, 2016.
Woman can get birth control pill to women at any age if needed. Why isn’t Ed medical medication not allowed on Medicare. This is form of dicrimenation. It is cover on insurance for those until 65, this is also age discrimation as well. This also effects the mental health of both men and woman over 65. Maybe the new president can afford anything they need for wellness. Everyday people are being left without a real choice. Mrs Clinton simple things that should be included it Omama care are not included in any affordable Medicare formularies.
We agree that Viagra and Cialis should be covered by more Medicare Advantage and Medicare Part D plans. Hopefully, in 2017, more companies will chose to cover these important drugs. If you would like help finding a plan in your area that covers one of these drugs, please call one of our Senior65 licensed independent insurance agents at 800-930-7956.
By David on April 18, 2016.
Are penile implants covered by Medicare?
Medicare will cover a penile implant if it is considered medically necessary. If you have a Medicare Supplement plan, it can cover the out of pocket costs left over. To learn more about Medicare Supplement plans call one of our licensed independent agents at 800-930-7956.
By Don on February 16, 2016.
My script for 5mg Cialis says it is for BPH, not ED. Does that make a difference for coverage among the Medicare B pharmacy supplement plans (not Advantage).
There isn’t a distinction made when we look up Cialis for our clients. However, sometimes your doctor may be able to request an exception for a brand name drug, if your Part D coverage doesn’t allow it.
By Mike on January 18, 2016.
Please send me any information you have or will in the future, regarding part D or MA plans that cover ED drugs like Cialis and Viagra. Much appriciated, Mike.
Currently there are some Medicare Advantage and Part D plans that cover Cialis, and very few MA plans that cover Viagra (haven’t seen any Part D plans that do). However, you also need to consider your other prescription drugs to know the true cost of the plan. Please let us know if you need any help by calling 800-930-7956.
By ron on December 16, 2015.
The GOVT. pays for contraceptive coverage and even forces all insurance to cover it under ,,Obama care, but no forcing of E.D. drugs coverage . which is a true medical condition. Where as contraceptive pills..is NOT. a medical condition. I thought. it is illegal to promote gender in equality and discrimination.
By Bill Sizer on December 05, 2015.
Is there a Medicare advantage or supplement plan that will cover Viagra or Cialis in 2016? I’m at 37221 in Davidson County, TN. Thank you.
There might be a Medicare Advantage (MA) or Prescription Drug plan that covers Cialis, and there might be an MA plan that covers Viagra in your area of TN. Unfortunately, at this time we are not appointed in TN, and could not give you detailed information.
By Jake on November 18, 2015.
2016 plans in nc with cialis.
Happy to help! We’d need your zip code and county to find plans in your area. As well as, if you are looking for Medicare Advantage plans or Part D plans that cover Cialis. Once we get this information we will let you know.
By J Badon on November 12, 2015.
Have you found what plan will cover Viagra ?
We’d be happy to locate a Medicare Advantage plan in your area that covers Viagra (if available), as of now, Part D plans are not covering Viagra. All we need is your zip code and county and we’d be good to go!
By Rani on November 07, 2015.
I hate my current plan, so I’m comparing Medicare Advantage Plans for 2016. So far, I’ve seen Viagra in several formularies, but it’s always Tier 4 or even Tier 5, which means you pay a percentage of the retail cost, which may be 40-50-60 %, depending on the plan.
By Linda Savage on October 17, 2015.
How can we know which plans will cover Viagra /Cialis?
We haven’t seen any Part D plans that are covering Viagra. To see which Medicare Advantage plans cover Viagra, and which Medicare Advantage and Part D plans cover Cialis, you’ll want to call us at 800-930-7956 with your zip code and we can locate the available plans in your area.
By Steve on October 10, 2015.
Is there someone or an agency we can contact who we could encourage the change on ED medications? My previous insurance covered Viagra, Cialis, etc., but Medicare changed all of that. Thank you.
Good news! A few stand-alone Medicare prescription drug plans and Medicare Advantage plans w/ drug coverage are covering Cialis, and a few Medicare Advantage plans w/ drug coverage are covering Viagra for 2016. Unfortunately, as of now, we’re not seeing any stand-alone drug plans covering Viagra. Hope this helps!
By Gary on September 16, 2015.
you mention some companies WILL cover viagra in 2016. can you tell us which ones will so I can make my decision to switch during the open window? thank you.
As of now, Viagra is not showing up on the formularies. It was proposed, but not confirmed that some plans may start covering the enhancement drug as of 2016. We are keeping a watch on the drug plans and will update the article as new information becomes available.
By Martin on August 10, 2015.
Does any plan in Medicare Part D cover the drug Viagra when prescribed for non-sexual reasons?
As far as we know, Viagra is not covered at all by Part D, regardless of it’s medical purpose. Sorry we don’t have better news.
By Timothy West on July 16, 2015.
I know that there are no Part D plans that cover this right now, but do any give a discount on the drug? You know how vision plans can give a discount on LASIK..
As of now, we don’t know of any companies that offer discounts, but we will update the article if we learn anything new.
By Henry Klein on July 02, 2015.
Is there a generic version of Viagra? Cause it’s so expensive.
We hear you! Unfortunately, there will not be a generic version of Viagra available in the states for awhile. Conflicting reports say 2017 and 2020.
By Lawrence on June 23, 2015.
This is good news. Do you know if all Medicare drug plans will have to cover Viagra?
At this point, we don’t know how many plans will cover Viagra. Once Open Enrollment rolls on by we’ll have a clearer picture on how the drug is covered by Medicare Advantage and Part D.