Does Medicare Cover Cialis?

Erectile dysfunction is common in the U.S.A. And as men get older, they become more susceptible to experiencing it. 

Erectile dysfunction can be treated using medications like Cialis and Viagra. Cialis is a branded medication. Its generic variant is called Tadalafil. 

So a common question many people have is, “Does Medicare cover Cialis?” In this article, we answer that question in clear, plain English. You will also find the average costs of Cialis and other helpful info.

Does Medicare Cover Cialis?

The short answer is no. In most cases, Medicare will not cover the cost of Cialis. That said, there may be some situations where you can get these costs covered. Below we’ll take a closer look at this to see when you might be able to get Medicare to pay for your Cialis. 

Original Medicare

Original Medicare (Medicare Part A and Part B) does not provide coverage for Cialis. That is because Original Medicare mainly covers medically necessary services, equipment, and treatment rather than prescription drugs. Prescription drug coverage may be provided by either Medicare Advantage plans or by Medicare Part D. 

Part C Coverage for Cialis

Medicare Advantage plans (Medicare Part C) that have prescription drug coverage also do not provide coverage for Cialis and other medications for erectile dysfunction.  Medicare Advantage plans cover everything Original Medicare covers and some additional benefits. However, exactly what it covers and your out-of-pocket costs will vary depending on the specifics of your plan. 

Part D Coverage for Cialis

Just like with Original Medicare as well as Medicare Advantage plans, Medicare Part D usually does not provide coverage for Cialis or other medications for erectile dysfunction. 

However, a limited number of Medicare Part D plans do provide coverage for Cialis. But Medicare Part D plans may only provide coverage for Cialis if it is to treat benign prostatic hyperplasia or BPH.

On the other hand, many Medicare Part D plans provide coverage for Revatio, an alternative to Viagra as well as Cialis. You can use the Medicare.gov “Find a Medicare Plan” tool to look for a Medicare Part D plan that covers medications for erectile dysfunction such as Cialis, Revatio, and Viagra. 

Or if you are enrolled with a Medicare Part D plan, you can contact your plan provider and ask if Cialis is covered. 

Cialis is listed as a Tier 3 drug in the Medicare drug formulary. Most of the time Tier 3 medications are preferred branded medications. Tier 3 medications are more expensive than Tier 1 and 2 medications. 

How Much Does Cialis Cost?

Cialis costs around $13 per pill. A 30-day supply of 5 mg Cialis tablets can cost around $400. The generic version, Tadalafil, costs around $5 per 5 mg tablet.

What Are The Differences Between Viagra And Cialis?

One of the most notable differences between Viagra and Cialis is how long they last in the person’s system. Cialis can last up to 18 hours. On the other hand, Viagra can only last up to 4 to 6 hours. Some of the differences in their side effects include: 

• Cialis
  • Flu-like symptoms
  • Low blood pressure
  • Blurred vision
  • Abnormal ejaculation
• Viagra
  • Nasal congestion
  • UTI

They also have common side effects like nausea, headaches, and facial flushing.

Note: Medicare coverage changes all the time. And your specific coverage may vary from plan to plan for Medicare Advantage and Medigap plans. Always be sure to double check with your health care provider and/or Medicare insurance provider about what your plan covers and what it does not.

Additional Info on Medicare Coverage

This article is part of our series on “What does Medicare cover?”

Also, you can check out other articles in this series including: Does Medicare cover Accu Chek test strips?