{"id":53904,"date":"2022-09-15T21:41:37","date_gmt":"2022-09-16T01:41:37","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=53904"},"modified":"2025-12-04T11:03:57","modified_gmt":"2025-12-04T16:03:57","slug":"does-medicare-cover-erectile-dysfunction","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/does-medicare-cover-erectile-dysfunction\/","title":{"rendered":"Does Medicare cover erectile dysfunction treatment?"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Erectile dysfunction (ED) is more common than you might realize. Many men in the United States experience erectile dysfunction every year. By 2025, erectile dysfunction is expected to increase to <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/news\/erectile-dysfunction-statistics\/\"><span style=\"font-weight: 400;\">322 million men worldwide<\/span><\/a><span style=\"font-weight: 400;\">, according to the <\/span><i><span style=\"font-weight: 400;\">International Journal of Impotence Research<\/span><\/i><span style=\"font-weight: 400;\">. The prevalence of <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/erectile-dysfunction-age\/\"><span style=\"font-weight: 400;\">ED increases with age<\/span><\/a><span style=\"font-weight: 400;\">, but ED is not something that you have to just accept and live with. Sexual dysfunction is treatable and even curable. What\u2019s more? Under limited circumstances, you might be able to get the cost of ED treatment covered by Medicare.<\/span><\/p>\n<p><span data-sheets-root=\"1\" data-sheets-value=\"{&quot;1&quot;:2,&quot;2&quot;:&quot;&quot;}\" data-sheets-userformat=\"{&quot;2&quot;:6849,&quot;3&quot;:{&quot;1&quot;:0},&quot;9&quot;:1,&quot;10&quot;:2,&quot;12&quot;:0,&quot;14&quot;:{&quot;1&quot;:2,&quot;2&quot;:0},&quot;15&quot;:&quot;Arial&quot;}\" data-sheets-formula=\"=CONCATENATE(R[0]C[-2],R[0]C[-3],R[0]C[-1])\"><\/span><\/p>\n<h2 id=\"does-medicare-cover-treatment-for-erectile-dysfunction-ed\"><span style=\"font-weight: 400;\">Does Medicare cover treatment for erectile dysfunction (ED)?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Some Medicare Advantage and Medicare Part D prescription drug plans will cover generic prescriptions used to treat erectile dysfunction, but only if they\u2019re medically necessary and prescribed specifically to treat other medical conditions besides erectile dysfunction<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The <\/span><a href=\"https:\/\/www.cms.gov\/medicare\/prescription-drug-coverage\/prescriptiondrugcovcontra\/downloads\/qaeddrugs_070606.pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Division of Drug Plan Policy and Program Analysis<\/span><\/a><span style=\"font-weight: 400;\"> states, \u201cED drugs will meet the definition of a Part D drug when prescribed for medically accepted indications approved by the FDA other than sexual or erectile dysfunction, such as pulmonary hypertension.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Medicare won\u2019t cover treatment options like penis pumps or injections. However, penile implant surgery may be partially covered by Medicare if you qualify. Additionally, you may receive coverage for Coloplast devices.\u00a0<\/span><\/p>\n<h3 id=\"what-s-covered\"><span style=\"font-weight: 400;\">What\u2019s covered<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Any tests involved in diagnosing this health condition are covered under Part B, which is your Medicare outpatient coverage. Part B may also cover any medically necessary outpatient surgeries for ED that Medicare approves, such as penile implant surgery and coloplast devices.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">What Medicare covers for erectile dysfunction:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Exams (Part B)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Diagnostic tests (Part B)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Penile implant surgery (Part B)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Coloplast devices (Part B)<\/span><\/li>\n<\/ul>\n<h3 id=\"what-s-not-covered\"><span style=\"font-weight: 400;\">What\u2019s not covered<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The Medicare prescription drug formulary does not cover Viagra, Cialis, or medications (regardless of brand\/generic status) to treat ED if they are specifically prescribed to treat ED. Medicare does not cover injections or penis pumps either.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">ED treatments not covered by Medicare:\u00a0\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Any brand-name erectile dysfunction drugs prescribed for ED<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Any generic-name erectile dysfunction drugs prescribed for ED<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Any prescriptions that are not FDA approved<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Injections<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Penis pumps<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Note: If you have both ED <\/span><i><span style=\"font-weight: 400;\">and<\/span><\/i><span style=\"font-weight: 400;\"> one of the other indications that ED medications may treat, then you may receive Medicare coverage for that drug if it is prescribed to treat the non-ED condition.<\/span><\/p>\n<h2 id=\"what-do-i-do-if-my-medicare-coverage-is-denied\"><span style=\"font-weight: 400;\">What do I do if my Medicare coverage is denied?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">You can appeal the decision made by Medicare. You can file an appeal in writing within 60 days of the denial. You file an appeal by submitting a <\/span><a href=\"https:\/\/www.cms.gov\/Medicare\/CMS-Forms\/CMS-Forms\/downloads\/cms20027.pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Redetermination Request Form<\/span><\/a><span style=\"font-weight: 400;\">. You must also include a copy of your <\/span><a href=\"https:\/\/www.medicare.gov\/basics\/forms-publications-mailings\/mailings\/costs-and-coverage\/medicare-summary-notice\"><span style=\"font-weight: 400;\">Medicare Summary Notice<\/span><\/a><span style=\"font-weight: 400;\"> (MSN).\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Your MSN is mailed to you every three months. This document breaks down your recent healthcare claims. Note: this notice is not a bill. If you\u2019re unsure what the envelope will look like in the mail, <\/span><span style=\"font-weight: 400;\">here is what you can look for.<\/span><\/p>\n<p><b>Your MSN will show you:<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">A three-month summary of all your services or supplies that providers and supplies bill to Medicare<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The amount Medicare paid<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">The amount you may owe the provider after Medicare pays its portion<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">An authorized representative, such as your healthcare provider, can also file an appeal on your behalf. You just need to complete the \u201cAppointment of Representative\u201d form and your redetermination request form.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you have a Medicare Advantage plan, submit your appeal documents to your plan directly instead of the Center for Medicare and Medicaid Services (CMS).<\/span><\/p>\n<h2 id=\"how-much-does-erectile-dysfunction-treatment-cost-with-medicare\"><span style=\"font-weight: 400;\">How much does erectile dysfunction treatment cost with Medicare?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">You\u2019ll be responsible for 20% of the cost and the annual Part B deductible for any services covered under Part B. However, a Medigap policy may cover the 20% coinsurance and sometimes even the Part B deductible.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you have Medicare Advantage (Part C), you\u2019ll have to look at your summary of benefits to see how much your out-of-pocket costs will be for any covered surgeries or devices.\u00a0<\/span><\/p>\n<h3 id=\"prosthesis-costs\"><span style=\"font-weight: 400;\">Prosthesis costs<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">If the prosthesis is medically necessary, your treatment, which may include all other Coloplast devices, may be covered. Beneficiaries could pay upward of $2,500 to $3,000, depending on what parts of Medicare they\u2019re enrolled in.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you have Medicare Part B (outpatient coverage), you\u2019ll receive coverage for 80% of the allowable costs. You are then responsible for the other 20% if your healthcare provider accepts Medicare assignment.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The good news is that, if you have supplemental insurance like a <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/what-is-medigap\/\"><span style=\"font-weight: 400;\">Medigap plan<\/span><\/a><span style=\"font-weight: 400;\">, you receive coverage for the remaining 20% that Part B doesn\u2019t cover. All Medigap plans, A-N, will cover the 20% coinsurance under Medicare Part B. Unlike Medicare Advantage plans, Medigap plans are standardized by the federal government.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you were eligible for Medicare before 2020 and enrolled in a first-dollar coverage plan, such as Plan F, then you will have zero out-of-pocket costs for penile implant surgery. If you enrolled in Plan G, your only out-of-pocket costs would be the <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/cost-of-medicare-part-b\/\"><span style=\"font-weight: 400;\">Medicare Part B deductible<\/span><\/a><span style=\"font-weight: 400;\">, which is $283 in 2026.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">For those enrolled in a high-deductible Medigap plan, you\u2019ll have to meet the annual deductible before coverage kicks in. The annual deductible for Plan F and Plan G is $2,950 in 2026.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you have a Medicare Advantage plan (Part C), you\u2019ll want to contact your carrier directly to determine your copay. Unlike Original Medicare and Medigap, the insurance companies determine how much of the service they will cover.<\/span><\/p>\n<h2 id=\"other-ways-to-save-on-ed\"><span style=\"font-weight: 400;\">Other ways to save on ED<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Regardless of whether you have Medicare or not, there are a few ways you can save on erectile dysfunction costs.\u00a0<\/span><\/p>\n<h3 id=\"1-medicare-extra-help\"><span style=\"font-weight: 400;\">1. Medicare Extra Help<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">The Medicare <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/medicare-extra-help\/\"><span style=\"font-weight: 400;\">Extra Help program<\/span><\/a><span style=\"font-weight: 400;\"> is a federal resource to reduce the out-of-pocket costs for prescription medications that are covered by Part D (in this case, ED drugs if prescribed for a non-ED indication). Depending on the level of help you\u2019re eligible for, it can eliminate or reduce your Part D premium, deductible, and late enrollment penalty.<\/span><\/p>\n<h3 id=\"2-singlecare-coupons\"><span style=\"font-weight: 400;\">2. SingleCare coupons<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">There are free drug coupons available through SingleCare for ED medications. <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/can-i-use-singlecare-and-medicare\/\"><span style=\"font-weight: 400;\">Even if you currently have Medicare<\/span><\/a><span style=\"font-weight: 400;\"> or another type of health insurance, a <\/span><a href=\"https:\/\/www.singlecare.com\/prescription-discount-card\"><span style=\"font-weight: 400;\">SingleCare prescription discount card<\/span><\/a><span style=\"font-weight: 400;\"> can save you money.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The cost of <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/sildenafil-citrate\"><span style=\"font-weight: 400;\">sildenafil citrate<\/span><\/a><span style=\"font-weight: 400;\"> without insurance is around $1,372 for 30, 100 mg tablets. However, with SingleCare, you could pay as low as $16 for 30, 100 mg tablets using a SingleCare coupon. You may also save more money on ED drugs such as <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/vardenafil-hcl\"><span style=\"font-weight: 400;\">Levitra (vardenafil)<\/span><\/a><span style=\"font-weight: 400;\"> and <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/cialis\"><span style=\"font-weight: 400;\">Cialis<\/span><\/a><span style=\"font-weight: 400;\"> (<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/tadalafil\"><span style=\"font-weight: 400;\">tadalafil<\/span><\/a><span style=\"font-weight: 400;\">) by using SingleCare rather than your applicable insurance coverage.\u00a0<\/span><\/p>\n<h3 id=\"3-manufacturer-rebates-and-coupons\"><span style=\"font-weight: 400;\">3. Manufacturer rebates and coupons<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">There may be coupons available through the manufacturer. Contact the drug manufacturers to find out if you qualify.<\/span><\/p>\n<h3 id=\"4-patient-assistance-programs\"><span style=\"font-weight: 400;\">4. Patient assistance programs<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">There are patient assistance programs available to certain people. Eligibility requirements often include insurance and income restrictions. One of these programs is the Pfizer Patient Assistance Program, which provides eligible patients with their Pfizer medicines for free. Other manufacturers and nonprofit organizations also offer patient assistance programs.<\/span><\/p>\n<h3 id=\"5-free-samples-at-your-doctor-s-office\"><span style=\"font-weight: 400;\">5. Free samples at your doctor\u2019s office<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Sometimes, the drug company representatives will leave free samples of medications at your healthcare provider&#8217;s office. However, this is not a long-term solution to save money on your prescriptions.<\/span><\/p>\n<p><small><em>The SingleCare prices in this article are the most accurate at the time of publishing in ZIP code 23666 as of Dec. 4, 2025. Prices vary by pharmacy.<\/em><small> <\/small><\/small><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Erectile dysfunction (ED) is more common than you might realize. Many men in the United States experience erectile dysfunction every year. By 2025, erectile dysfunction is expected to increase to 322 million men worldwide, according to the International Journal of Impotence Research. The prevalence of ED increases with age, but ED is not something that [&hellip;]<\/p>\n","protected":false},"author":133,"featured_media":53905,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[2],"tags":[8922,15],"coauthors":[20918],"class_list":["post-53904","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-company","tag-erectile-dysfunction","tag-medicare","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Does Medicare cover erectile dysfunction treatment? | SingleCare<\/title>\n<meta name=\"description\" content=\"Medicare plans do not cover ED meds like Viagra unless they are prescribed to treat a condition other than ED. Penis pumps and injections are also not covered, but penile implant surgery may be partially covered.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.singlecare.com\/blog\/does-medicare-cover-erectile-dysfunction\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Does Medicare cover erectile dysfunction treatment?\" \/>\n<meta property=\"og:description\" content=\"Medicare plans do not cover ED meds like Viagra unless they are prescribed to treat a condition other than ED. 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