Does Medicare Cover Cialis for BPH

Cialis is a popular drug typically used to treat erectile dysfunction associated with BPH. Since it’s a subscription drug obtained at a retail pharmacy, it isn’t covered under Original Medicare, though it may be covered under Medicare Advantage or Medicare Part D.

Benign prostatic hyperplasia, or BPH, is an age-associated enlargement of the prostate gland. The condition often causes difficulty urinating and erectile dysfunction. While Cialis is used for several disorders associated with BPH, the primary use is for erectile dysfunction caused by BPH.

Original Medicare does not cover Cialis. And while Medicare Part D is a stand-alone plan purchased for subscription drug coverage, most plans don’t cover Cialis if it’s prescribed to treat erectile dysfunction, though it may cover the drug if it’s prescribed for other health issues associated with BPH.

Medicare Advantage plans may also cover Cialis, though coverage is usually rare. If your plan does cover Cialis, you may pay a higher percentage of the cost since Cialis is typically tiered as a specialty drug.

Why Does Medicare Not Cover Cialis?

Original Medicare doesn’t cover prescription drugs from a retail pharmacy. While your specific Part D or Medicare Advantage plan may cover Cialis, in most cases, it doesn’t. You can check with your coverage provider for more details.

If Cialis is prescribed for erectile dysfunction, you may want to ask your doctor about a pump as this is covered under Original Medicare, Part B.

How Well Does Cialis Work for BPH?

Cialis was originally developed for the treatment of erectile dysfunction. It was discovered that the drug also helps alleviate symptoms of BPH, and it was approved in 2011 for the treatment of both conditions.

The drug works by increasing a chemical in your body called cyclic guanosine monophosphate. This chemical increases blood flow to the penis and relaxes muscle cells in the prostate. Studies have shown that men who took 5 mg of Cialis per day experienced significant improvements in symptoms associated with BPH and erectile dysfunction. The drug also has mild side effects.

Does Medicare Cover Tadalafil for BPH?

Tadalafil is the generic version of Cialis. Like Cialis, tadalafil isn’t covered by Original Medicare and, in most cases, isn’t covered by Part D or Medicare Advantage. In some cases, however, if you’re prescribed tadalafil for BPH specifically or for pulmonary arterial hypertension, Medicare Part D or Medicare Advantage may cover it.

Why Does Medicare Not Cover Cialis?

Original Medicare doesn't cover prescription drugs. For prescription drugs, you'll need a Medicare Part D or Medicare Advantage plan. However, if Cialis is prescribed for the treatment of erectile dysfunction, it usually isn't covered.