Should Insurance Cover Viagra

June 19, 2000 — A dollar spent on Viagra is spent just as efficiently as a dollar spent on kidney dialysis, a new study shows. Experts agree that the math is right, but whether it justifies insurance coverage for the male potency drug is a bone of contention.

“There is a significant loss of quality of life that comes from erectile dysfunction,” the lead researcher of the study, Kenneth J. Smith, MD, tells WebMD. “One thing that motivated me to look at this is that I am a primary care doctor. I am seeing men with erectile dysfunction having to fill out insurance forms to justify Viagra treatment. What prompted the insurance carriers to set up so many barriers for some men to get Viagra who would clearly benefit from it? I see Viagra use more as a health issue and a quality-of-life issue than as a lifestyle issue.”

Smith, who is associate director of the internal medicine residency program at Mercy Hospital of Pittsburgh, based his calculations on several key assumptions, such as the average age of the Viagra user and the average number of times he would use it per month.

Researchers also took into account that this medication would not work for some men and that some men would have side effects. In every case, they chose figures that would make it harder to show a cost benefit for the drug. Even so, Viagra was a good deal when measured in quality years of life gained.

How Can I Save Money On My Prescription

With or without insurance, there are many different ways to save money on your Viagra prescription. The release of the generic version of the drug in December 2017 resulted in a major drop in price for both the brand-name drug and generic Viagra. When only the brand name version of Viagra was available, the cost per pill was approximately 60 dollars, putting it out of the reach of many men who needed it. The launch of sildenafil immediately cut the price of the drug in half, and as more manufacturers have begun producing sildenafil, prices have dropped as low as four dollars per pill. Purchasing the generic form of Viagra can save you about 90 percent of the cost of your medication on most drug plans. Prices are subject to fluctuation based on supply and demand and occasional stock shortages. The table reflects cash prices, which are not valid when combined with coinsurance. Additional discounts may be offered for ED drugs purchased as a 90-day supply however, this option is not available for all medication dosages.

How Should I Take Oral Sildenafil

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Revatio is usually taken three times each day, about 4 to 6 hours apart.

Viagra is usually taken only when needed, 30 minutes to 1 hour before sexual activity. You may take it up to 4 hours before sexual activity. Do not take Viagra more than once per day.

Shake the oral suspension before you measure a dose. Use the dosing syringe provided, or use a medicine dose-measuring device .

Viagra can help you have an erection when sexual stimulation occurs. An erection will not occur just by taking a pill. Follow your doctor’s instructions.

During sexual activity, if you become dizzy or nauseated, or have pain, numbness, or tingling in your chest, arms, neck, or jaw, stop and call your doctor right away. You could be having a serious side effect of sildenafil.

Store at room temperature away from moisture and heat.

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What Erectile Dysfunction Drugs Are Covered By Medicare

Home / FAQs / Medicare Coverage / What Erectile Dysfunction Drugs are Covered by Medicare

Medicare coverage for erectile dysfunction prescriptions may have coverage under Part D. Most brand name medications for erectile dysfunction, such as Viagra, Cialis, and Levitra, are not covered under Part D. However, the generic versions have some coverage. Some Medicare Advantage plans that include prescription drug coverage cover the brand name medications for erectile dysfunction. Well cover this in detail below.

How Much Does Cialis Cost In Canada

Newcomers to Rx Connected may be surprised to learn that Cialis or generic Cialis from Canada on our website is so cheap. This is because drug prices in Canada are kept in check by the government. So our prices are on par with Canadian prices in general.

Using Pharmacy Compass, a Canadian price comparison tool, 5 mg generic and brand name Cialis cost between $2 and $6 per pill, plus a flat dispensing fee of $10.

At Rx Connected, we offer brand-name 5 mg Cialis for $3 to $8 per pill. Generic 5 mg Cialis at Rx Connected costs between $1 and $3 per pill.

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What Are The Side Effects Of Viagra

While Viagra is known to be highly effective in treating ED, it may also come with possible side effects that include:

• Nausea or headaches
• Body aches
• Redness or flushing of the face or body

More serious side effects may include vision or hearing loss, confusion, shortness of breath, fainting or chest pain. Call a doctor if you experience any such symptoms.

Ask Your Doctor For A Larger Quantity

Theres a reason that companies like Costco can offer such great deals. Buying in bulk almost always lowers the cost per unit, and this applies to drug costs, too. Purchasing 10 pills at once will likely yield a lower price per pill than buying one at a time. Even if insurance or Medicare Part D does cover your medications, bigger prescriptions can still save you money. Each time you fill a script, you owe a copay. Your deductible and prescribed dosage determines your copay. If you dont need to refill quite as often, youll end up having fewer copays. Consult your doctor about changing your current prescription.

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Find A Medicare Advantage Plan That Covers Prescription Drugs

Are you eligible to enroll in Medicare? You can compare Part D prescription drug plans available where you live and enroll in a Medicare prescription drug plan online when you visit MyRxPlans.com.

You can also give one of our licensed insurance agents a call to learn more about Medicare Advantage plans available in your area.

You may be able to enroll in a Medicare Advantage plan that includes prescription drug coverage.

• Medicare Enrollment Guide

1 The Formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.

2 Mayo Clinic. Erectile dysfunction. . Retrieved from www.mayoclinic.org/diseases-conditions/erectile-dysfunction/symptoms-causes/syc-20355776.

3 Span, Paula. ‘Sex Never Dies, but a Medicare Option for Older Men Does. . The New York Times. Retrieved from www.nytimes.com/2015/08/04/health/sex-never-dies-but-a-medicare-option-for-older-men-does.html.

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts enrollment in any plan depends upon contract renewal.

Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE , 24 hours a day/7 days a week or consult www.medicare.gov.

Medicare has neither reviewed nor endorsed this information.

View General Prescription Drug Lists

View the lists below to find general pharmacy benefits information for UnitedHealthcare plans, including certain PDLs. Remember, this is only general information. Sign in on myuhc.com or call the number on your health plan ID card to see your PDL and get specific information about your pharmacy benefits.

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Cheaper Alternatives To Viagra

There are two cheaper versions of sildenafil citrate available: generic Viagra and generic Revatio.

Generic Viagra is similar to Viagra and comes in the same doses.

Revatio is a medication thats FDA-approved for treating a specific type of high blood pressure in the lungs .

It may seem confusing, but Revatio has the same active ingredient as Viagra. The difference is that it comes in different strengths. While Viagra comes in 25 mg, 50 mg, and 100 mg tablets, Revatio comes in 20 mg tablets. Some healthcare providers prescribe generic Revatio at doses of 20 mg, 40 mg, 60 mg, 80 mg, or 100 mg to treat ED. However, this is considered off-label prescribing since Revatio, and its generic form are not specifically FDA-approved for ED.

Generic Revatio is a much more affordable alternative to Viagra, available for as low as $10 for 30 doses of 100 mg .

Coverage Of The Treatment

Many insurance companies list the drug as a non-essential medication. Although, you can find HMO plans partially cover the cost of the medicine. The only downside is that youll typically experience a high co-pay. In certain situations, Viagra can be covered entirely by your insurance if your doctor can prove its medically necessary.

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Does Original Medicare Cover Viagra

Medicare has four different parts 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.

The Good News You’re Already Saving Big Bucks With Sildenafil

Don’t want to buy in bulk? The good news is that no matter how you purchase it, you’re already saving a ton of money by opting for Sildenafil over name brand drugs.

Sildenafil is simply the generic version of Viagra. Both medications contain the exact same ingredients and do the same thing in your body. The only difference comes down to the name and price.

With Sildenafil, you can save 50 percent compared to name brand. Consult with your doctor today to see how Sildenafil can help you.

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Why Is This Practice Important

Drug-shop and pharmacy staff already advise patients and treat a variety of ailments in many countries, providing an opportunity to reach existing and potential family planning clients.

For decades, people have routinely used drug shops and pharmacies for treatment of common ailments. Studies in Thailand , Nigeria , Indonesia , and Uganda confirm that pharmacies are primary sources when people are ill and need outpatient treatment or drugs. In some countries, drug shops are just as important, if not more so . Both venues are particularly important in countries where health system infrastructure is weak, over-burdened, or poorly distributed. Training, support, and regulation for pharmacy and drug-shop staff can be thought of as a âharm-reductionâ strategy because, in some countries, they routinely provide services that may not be legal and have the potential to cause harm through incorrect use or unsafe practices.

Drug-shop and pharmacy staff can safely provide a wide range of methods.

What Is Erectile Dysfunction And What Causes It

There are many misconceptions about erectile dysfunction, and the shame associated with the condition often prevents men and women from learning more about what causes it. Erectile dysfunction, or male impotence, is a form of sexual dysfunction associated with difficulty getting and/or keeping an erection in the penis due to limited blood flow and low blood pressure to the penis and decreased sexual stimulation or sexual activity. Researchers recognize that the body needs three things to have an erection: good blood flow, a functioning brain, and adequate hormone levels. That means that there can be many different causes of erectile dysfunction, including physical causes, lifestyle causes, psychological causes, or a combination of all of the above, which is one of the reasons that erectile dysfunction is so difficult to treat.

The most common physical causes of erectile dysfunction are atherosclerosis , diabetes, high blood pressure, high cholesterol, and obesity. Alcohol abuse, illegal drug use, smoking, common side effects of other prescription medications , and side effects of over-the-counter medications such as antihistamines and Sudafed are the most common lifestyle causes of erectile dysfunction. Psychological causes of erectile dysfunction include depression, stress, and anxiety.

Fortunately, there is a lot that men can do to help prevent or reverse erectile dysfunction. Simple lifestyle issues can be changed to improve your health, for example:

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Medicare Coverage For Sexual Dysfunction Treatments

Though Medicare Part A and Part B dont cover medications like Viagra, they may help provide coverage for other erectile dysfunction treatments.

The same is true for Medicare Advantage plans. ED can be caused by a number of other health issues, including, but not limited to:2

• Obesity
• Certain prescription medications
• Diabetes

Management and treatment of these conditions are usually considered medically necessary and are typically covered by Medicare Part A and Medicare Part B. Treating the root cause of your erectile dysfunction could help alleviate it.

If you receive treatment under Medicare Part B, you typically pay 20% of the cost of services after you meet your Medicare Part B deductible .

While Medicare Part A and Medicare Part B usually dont cover most direct erectile dysfunction treatments, they may help cover penile implant surgery if a doctor deems it to be medically necessary.3

What About Medicaid

Another government-funded policy, Medicaid often does not cover Viagra or other ED drugs, as theyre usually prescribed for lifestyle issues and not deemed medically necessary. If prescribed for health problems other than erectile dysfunction, however, they may be covered.

Medicaid policies can vary from state to state, so you should check with your specific states program before writing this option off.

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What Is The Impact

Drug shops and pharmacies are an important source of supply for contraceptives in many countries. Oral contraceptives are available over-the-counter in the majority of countries and data on supply sources for pill and condom users indicate that pharmacies play an important role in meeting the increasing demand for temporary family planning methods . Social marketing programs in Africa and elsewhere routinely encourage contraceptive users to access pills, condoms, and even injectable contraceptives from pharmacies and other retail outlets.

Drug shops and pharmacies are preferred by some marginalized or underserved populations, including males and youth.

Is Viagra Available Without A Prescription

If youre in the United States and you see Viagra being advertised as available without a prescription, run in the opposite direction. Viagra is not legally available in the United States without a prescription, but a system does exist in the United Kingdom for approval of certain patients without a doctors visit. Under this system, patients with a suitable medical and sexual health history may purchase Viagra with the approval of a pharmacy staff member or healthcare provider. However, the option is limited to certain pharmacies and is not widely available. For the most part, Viagra that is advertised as available without a prescription is counterfeit and being sold illegally.

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Does Medicare Part C Cover Viagra

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.

Health Insurance Coverage And Viagra

Some private health insurance plans may cover the cost of Viagra, at least in its generic form. Whether or not coverage is extended may also be dependent on the reason that the drug is prescribed. Much like Medicare, private insurers are usually hesitant to cover the costs of any type of drug that is used for the treatment of sexual or erectile dysfunction.

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Does My Health Insurance Cover Viagra

The FDA approved Viagra in 1998, and it quickly became a popular prescription medication used by millions of men on a global scale. Although effective, the drug remains expensive and is rarely covered by health insurance plans. In this article, we will discuss the complexities surrounding viagra.

As a natural part of ageing, erectile dysfunction is common and affects more than 30 million men in the US. Viagra is a well-known medication to treat this issue. A single pill can increase the blood flow to the penis and restore the ability to achieve an erection.

How Does Viagra Work

PDE-5 inhibitors like Viagra work by inhibiting a natural chemical that causes blood to flow out of an erect penis. However, PDE-5 isnt the only thing that determines the length of an erection. Your heart, blood vessels, hormones, nerves, and mood all work together to cause an erection, which means that issues with any of these areas can cause erectile dysfunction. When an erection occurs, a chemical called cGMP causes the tissues and muscles in the penis to relax, allowing blood to flow in. The blood volume can be up to eight times the amount that is in a flaccid penis. The blood gets trapped, and under normal circumstances, eventually released, allowing the erection to subside and blood flow to return to normal. PDE-5 is a chemical that causes the breakdown of cGMP, and Viagra works by blocking it. When the active ingredient in Viagra is used to inhibit PDE-5, the cGMP does not get broken down and the tissues in the penis stay relaxed and engorged with blood, allowing you to keep an erection.

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