Does Medicare cover Viagra?

If you’re experiencing sexual dysfunction, you might be wondering if the United States federal government’s Medicare program covers drugs like Viagra. The pills are incredibly expensive. The national averages indicate that a 10-pill supply will cost you upwards of $200 per month. As to whether Medicare can help you cut some of this cost, the short answer is “no,” even though Original Medicare Part A and Part B do offer limited prescription drug cost assistance. In most cases, Part A covers prescription drugs that are given to you at a hospital as part of your inpatient treatment. Part B, on the other hand, covers drugs that are typically found in an outpatient setting.

If you are already enrolled in Medicare, your best course of action, is to explore either a Medicare Advantage plan or a Medicare Part D plan. Medicare Advantage plans, sometimes called Medicare Part C plans, are sold and serviced by third-party health insurance providers under the supervision of the federal government. Advantage plans are required to provide the same benefits as Original Medicare Part A and Part B. However, they also typically provide extras, such as prescription drug coverage. Some Medicare Advantage plans might cover Viagra. Advantage plans vary in terms of cost and availability based on your location. They also have different formularies. You’ll need to contact local providers or ask your doctor to find a plan that meets your needs with regard to Viagra.

Part D plans may help

If you’d rather stay with your Original Medicare Part and Part plan for your overall health insurance, you should consider adding a Part D plan. Part D was specifically designed to provide assistance with prescription costs. Each state has different plans, so you’d want to speak with an insurance representative to find out which local plans are best fit for your individual needs. As of press time, Medicare Part D plan drug lists do not include Viagra. You should check with Medicare again during it’s Annual Election Period (sometimes called Open Enrollment), because it is possible that the federal government could add Viagra or similar drugs to one or more of its Part D plan formularies.

It’s worth noting that Medicare coverage for drugs like Viagra is unlikely. However, it cannot be ruled out due to the vast number of Medicare Advantage and Medicare Part D plans available across the country. Medicare generally provides coverage only for services that it deems “medically necessary,” and drugs designed to assist with sexual dysfunction (as well as fertility, weight management, or cosmetic concerns) are usually not covered.

If you’d like help learning about Medicare Advantage and Part D prescription drug plans in your area, you can click here to be connected to one of our insurance representatives. You can also call directly at 1-(855)-MEDIGAP.

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