Viagra, also known by its generic name, Sildenafil, is a well-known medication that treats erectile dysfunction (ED). ED is a common condition that affects millions of men. 

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

Does Medicare Cover Viagra? 

The short answer is no. In most cases, Medicare will not cover the cost of your Viagra. 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 Viagra.  

Original Medicare (Medicare Part A and Part B) does not provide coverage for Viagra. This is because Medicare does not consider Viagra, or other erectile dysfunction medications, to be medically necessary medications.  

There is an exception to this, however. In some cases, Medicare may provide coverage for Revatio which is another brand of Sildenafil. But Medicare will only cover it if you will be taking this drug to treat pulmonary arterial hypertension (PAH).  

Part C Coverage for Viagra 

Medicare Part C plans that have prescription drug coverage usually do not provide coverage for Viagra or other medications for erectile dysfunction.  

However, some Medicare Advantage plans (Medicare Part C) provide coverage for Sildenafil, the generic medication of Viagra.  

Medicare Advantage plans cover everything Original Medicare covers as well as offer some additional benefits. However, coverage and out-of-pocket costs will vary depending on the specifics of your plan.  

Now, all this said, you can try to appeal for a coverage decision for Viagra to try to get your plan to pay for it. To do this, you’ll need a letter from a doctor to your Medicare Part C plan explaining why Viagra is medically necessary for you. 

Part D Coverage for Viagra 

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

However, the majority of the Medicare Part D plans provide coverage for Revatio. You can use Medicare.gov’s “Find a Medicare Plan” tool to look for a Medicare Part D plan that covers medications for erectile dysfunction such as Revatio and Viagra.  

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

How Much Does Viagra Cost? 

Viagra can cost from $30 to $50 for one tablet. It is usually more expensive than its generic counterpart. The average cost of a 25 mg dose of Sildenafil range from $16 to $30 for 30 tablets.  

What Is Erectile Dysfunction? 

Erectile dysfunction is the inability to get or maintain an erection of a male’s genitals. It can be caused by a physical condition such as diabetes. Or it can be caused by a psychological one such as anxiety. It can also be caused by certain medications such as antidepressants and sedatives.  

Though Sildenafil and Viagra are the go-to medications for erectile dysfunction, there are also alternative treatments such as testosterone and injectable alprostadil.  

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 over the counter drugs?

Leave a Reply

  1. What Does Medicare Cover? - Medicare Plan Tips

    […] Viagra […]

  2. Does Medicare Cover a Bone Density Test? - Medicare Plan Tips

    […] Also, you can check out other articles in this series including: Does Medicare cover Viagra? […]