Does Medicare Cover Viagra?

Erectile dysfunction (ED) is a common symptom of male aging that affects more than 2 out of every 5 men age 65 and over.¹ And Viagra is the most well-known medication used to treat ED, with more than 65 million prescriptions doled out over the last 20 years.² 

So you might then assume that Viagra is covered by Medicare. However, that assumption would not be entirely true. 

Viagra is not covered by Medicare Advantage (Medicare Part C) or Medicare Part D prescription drug plans. However, generic forms of the drug may be covered by many Medicare Advantage and Part D plans.

Generic forms of Viagra can also be used to treat other conditions besides ED such as pulmonary arterial hypertension (high blood pressure in the lungs), and some Medicare plans may cover these generic drugs when prescribed to treat other conditions unrelated to erectile dysfunction. 

So the best way to sum it up is this: Medicare does not cover Viagra, but Medicare Advantage and Medicare Part D may cover generic versions of Viagra. 

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Which Drugs Similar to Viagra May Be Covered by Medicare?

Viagra is a brand name version of the generic drug sildenafil. Sildenafil can be used to treat erectile dysfunction but may also be used to treat other conditions. Many Medicare Advantage or Medicare Part D plans may cover generic sildenafil. 

Revatio, another brand name version of sildenafil, may be covered by Medicare Advantage or Medicare Part D when prescribed for treatment of pulmonary arterial hypertension.

Why Doesn’t Medicare Cover Viagra?

In most cases, Medicare only covers services or items that are considered “medically necessary.” And although erectile dysfunction affects a significant number of Medicare beneficiaries, treatment of the condition is not considered medically necessary and therefore not covered by Medicare. 

Does Original Medicare Pay for Drugs Like Viagra?

Medicare Part A provides some coverage of medications when they’re used in an inpatient hospital or skilled nursing setting or as part of hospice or home health care. But Medicare Part A does not typically cover medications that you would pick up at a retail pharmacy such as Viagra or other erectile dysfunction drugs. 

Medicare Part B covers some medications that have to be administered by a health care professional in an outpatient setting, such as certain types of injections. But like Part A, Medicare Part B does typically cover any medications prescribed by a doctor that are then picked up at a pharmacy. 

Medicare Advantage and Medicare Part D plans are different from Original Medicare (Parts A and B) because they're sold by private insurance companies and are able to offer some additional benefits not found in Original Medicare. 

Medicare Part D plans specifically cover prescription drugs. Medicare Advantage plans often include prescription drug coverage along with other benefits like dental, vision, hearing and more. 

What Are the Side Effects of Viagra?

While Viagra is known to be highly effective in treating ED, it may also come with possible side effects that include:

• Nausea or headaches
• Upset stomach
• Body aches
• Redness or flushing of the face or body

More serious side effects may include vision or hearing loss, confusion, shortness of breath, fainting or chest pain. Call a doctor if you experience any such symptoms. 

What Are Additional Treatments for Erectile Dysfunction?

Other treatments for erectile dysfunction may include:

• Testosterone pills or creams
• Vacuum pumps
• Blood vessel surgery 
• Alprostadil urethral suppository
• Injectable alprostadil 

Dietary changes, kegel exercises and other physical exercises may also be elective in improving sexual function, along with talk therapy to address any possible psychological causes of ED.