Does Medicare Cover Cialis?

Although Medicare doesn't cover Cialis, there are other treatment options that Medicare beneficiaries living with erectile dysfunction (ED) may be able to consider.

Learn about another option for erectile dysfunction covered by Medicare and how to get help paying for Medicare out-of-pocket costs.

Medicare doesn't cover Cialis but may cover other treatments for your sexual health.

Why Medicare Doesn't Cover Cialis

Currently, Medicare does not cover drugs like Cialis or Viagra because they are not considered medically necessary. Therefore, you must pay out of pocket for your Cialis prescription.

Medicare beneficiaries who want prescription drug coverage can consider two options:

• Enroll in a Part D prescription drug plan
  Part D plans are standalone prescription drug plans that cover a range of retail prescription drugs, which Original Medicare doesn't typically cover.

• Enroll in a Medicare Advantage (Medicare Part C) plan that covers prescription drugs
  Medicare Advantage plans cover the same benefits that Original Medicare offers, combined into a single plan.

Medicare Part D plans and Medicare Advantage plans don't typically cover Cialis. You should speak with your plan carrier and your doctor directly before seeking treatment for your erectile dysfunction.

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

Other Treatment Options for Erectile Dysfunction and Sexual Health

Penile implants may be covered by Medicare health insurance if they are deemed medically necessary by your physician.

Speak with your doctor to find out if penile implant surgery is a good option for you and whether or not it will be covered by Medicare. 

Medigap Plans Can Help Pay for Out-of-Pocket Costs for Sexual Health Treatments

Even if your penile implant surgery or other medical treatment is covered by Medicare, there are some expenses that you may have to pay out of pocket, including:

• Deductibles
  Both Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) have deductibles you must meet before Medicare will begin paying its share for their respective services.

  In 2024, the Medicare Part A deductible is $1,632 per benefit period, and the Medicare Part B deductible is $240 per year.

• Coinsurance
  Your coinsurance is the amount you pay for a Medicare-approved service. Your Part B coinsurance is generally 20 percent of the Medicare-approved amount.

Medicare Supplement Insurance (Medigap) helps cover some of Medicare's out-of-pocket costs.

For example, each of the 10 standardized Medigap plans that are available in most states provide at least partial coverage for the Medicare Part B coinsurance or copayments you might face when you receive covered outpatient treatments.

Learn more about Medicare coverage of common procedures

Find Medigap Plans in Your Area

A licensed agent can help you decide on a Medicare option that works for you. Call today to speak with a licensed agent and compare the Medigap plans that are available where you live.

Christian Worstell is a health care and policy writer for MedicareSupplement.com. He has written hundreds of articles helping people better understand their Medicare coverage options.