Is Viagra covered by insurance?

Viagra is a popular prescription drug used to treat erectile dysfunction (ED) that has been helping men improve their sex life for more than 20 years. And while ED is a common condition—studies predict 322 million cases worldwide by 2025—Pfizer’s “little blue pill” isn’t exactly cheap, an average of $100+ per pill. 

Although insurance, Medicare, or Medicaid do not commonly cover Viagra and many other ED drugs, there are still several ways to make erectile dysfunction treatment more affordable.

Is Viagra covered by insurance?

Commercial health insurance plans do not typically cover brand-name ED drugs like Viagra, Cialis, Levitra, and Stendra. Insurance is more likely to cover the generic version of these medications (sildenafil, tadalafil, vardenafil). Even if these medications are included in your plan’s formulary, there will likely be restrictions to insurance coverage, such as prior authorization or quantity limits.

If your health plan covers any of these medications, you most likely will still have a copayment, although the amount depends on your specific plan. When you discuss coverage with your insurance provider, be sure to ask how much your copay will cost. 

Consult your primary care physician or urologist when evaluating ED drugs, as the best drug for you largely depends on your health history, lifestyle, and other current medications.

Does Medicare cover Viagra?

Most Medicare prescription plans do not currently cover brand-name Viagra. Some Medicare drug plans will cover generic ED medications but only if they’re medically necessary and prescribed to treat other medical conditions besides erectile dysfunction. For example, generic Cialis (tadalafil) may be covered when prescribed for BPH, or Medicare may cover Revatio (sildenafil), which is indicated for use in pulmonary arterial hypertension.

Each Medicare plan has a formulary (a list of covered drugs) that you should review before choosing a plan. Use the Medicare Plan Finder to look for a plan that includes ED medications.

Note: Medicare Part B may cover other ED-related services, such as exams, diagnostic tests, penile implant surgery, and coloplast devices.

Does Medicaid cover Viagra?

Medicaid also does not often cover Viagra or other ED drugs, as they’re usually prescribed for lifestyle issues and not deemed “medically necessary.” If prescribed for health problems other than erectile dysfunction, however, generic versions of these medications may be covered. 

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

How to save on Viagra

So far, we’ve determined that if you need Viagra, you can’t always count on assistance from your insurance provider or Medicare plan. And brand-name Viagra can be prohibitively expensive. However, even if your insurance doesn’t provide coverage, there are still ways to get erectile dysfunction drugs at a discount. You just need to know a few tricks. 

1. Use SingleCare

SingleCare is all about making prescriptions more affordable. Whether you have insurance or not, SingleCare can find the lowest prices at your local pharmacies and use coupons to drop the price even further. It’s completely free to use. For example, generic Viagra costs $11.51 for 30, 100 mg tablets with SingleCare, and generic Cialis costs $15 for 30, 20 mg tablets with SingleCare.

2. Ask your doctor for a larger quantity 

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 much lower price per pill than buying them one at a time. Even if insurance or Medicare Part D does cover your medications, bigger (larger quantity) prescriptions can still save you money. Each time you fill a script, you owe a copay, which is based on your deductible and how many pills are filled. If you don’t need to refill quite as often, you’ll end up having fewer copays.

If you’re sold on this idea, consult your healthcare provider about changing your current prescription. 

3. Ask for a generic version

Not only are the generic versions of Viagra, Cialis, or Levitra more likely to be covered by insurance, but they’re also a lot cheaper. 

Take sildenafil, for example. This generic Viagra costs an average of $1,394 per 30, 100 mg tablets, while the brand-name equivalent goes for around $2,867 per 30, 100 mg tablets. That’s a massive difference. And it’s the exact same medication. The same goes for tadalafil (generic Cialis) and vardenafil (generic Levitra). 

4. Switch to a cheaper brand

You’ll find that some ED drugs are more affordable than others. In some instances, Cialis, Levitra, and other alternative ED drugs might be more cost-effective than Viagra. You’ll want to check with your healthcare provider, of course, before diving into any new medication.

RELATED: Sildenafil alternatives and how to switch your Rx

5. Treat the underlying cause

Erectile dysfunction can be a symptom of another medical condition, such as high blood pressure or diabetes. Insurance, Medicare, and Medicaid are much more likely to cover medications for these health conditions over ED. 

RELATED: What causes erectile dysfunction?

ED can also be a side effect of certain medications. Ask your healthcare provider to review your list of medications for a culprit. 

Additionally, ED could be improved or treated with natural remedies like smoking cessation, stress management, exercise, and diet. If your health insurance plan doesn’t cover ED drugs, you may try treating it with a different approach.