Medically reviewed by Thomas Fischer (Pharmacist). This article was written according to medical standards. More Info

Medically reviewed by Thomas Fischer (Pharmacist)More Info

Enjoying a healthy lifestyle involves physical, social, and mental wellbeing. Not only one of these components, but in fact, all three must be present. If any one of these is affected, then your health may not be at its full potential of 100%. Erectile dysfunction (ED), also known as impotence, occurs when there is an inability to have or maintain a firm enough erection to have sexual intercourse. In other words, it can affect your body, mind, and emotions all at once. ED has become a severe health problem all over the globe. It is said that it will affect approximately 52% of men at some point in their lives. And not surprisingly, the prevalence increases with age as it does with other health issues. Around 40% of men over 40 are found to have ED, and this increases to 70% by the age of 70.

The good news is that in 1998 a drug to treat this condition was created, the magic “blue diamond pill,” known as Viagra. It can help men of all ages improve their sex life. Thus it is prescribed as part of the treatment for ED and is extremely popular. It can not only help improve your sex-life, but it can also increase your quality of life.

The problem many people experience when they decide to choose Viagra is the cost. It is a very expensive pharmaceutical, and few health policies cover it. So what are the options? Is Viagra covered by health insurance?

Health Insurance and Viagra Coverage

Erectile dysfunction treatments is one of the main reasons why Viagra or its alternatives may be prescribed to a patient, but not exclusively the only reason. Other options for Viagra are available on the market. These alternatives are called Cialis, Stendra, Levitra, and their generic versions. Each one provides similar functions as Viagra, but their dosage and price vary.

Viagra

The vast majority of health insurance companies choose not to cover Viagra as a prescription drug because of its high cost. Instead, these organizations prefer to offer coverage prescribing the generic alternatives that cost less than half of the original brand and primarily serve the same function and are just as safe.

The generic alternatives that are mostly used are sildenafil, tadalafil, avanafil, and vardenafil. These drugs are not exclusively used for ED. They can also be prescribed for other illnesses. The medications available on the market today to treat Erectile Dysfunction are as follows.

Viagra is the most common drug prescribed for ED and was the first to be discovered. Its generic version is called sildenafil and is much more affordable. For this reason, it is more likely for health insurance companies to cover it over the brand name.

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Why Does Insurance Not Pay for Viagra?

Most insurance companies exclude drugs that are prescribed to patients to treat sex-related problems. Private insurers say these drugs used to treat sexual dysfunction are lifestyle-related and are not medically necessary. They don’t take into consideration that if a man’s sex life is affected, then the rest of his state of health may also find itself transformed. However, ED has an underlying cause related to a man’s physical or mental health. These needs must be met so he can function at one hundred percent and keep a good and stable mental health.

Besides this, Viagra is not covered because of its high cost. Unfortunately, one “little blue pill” can cost, on average, as much as $60. Because of the high price, health insurers may not cover at all the prescription or instead set an insurance plan with a high co-payment that can limit a person’s budget significantly.

Specific rules and restrictions have been established by health insurance companies to decrease payouts and reimbursement policies for Viagra. One of these requirements is to have a prescription and a written medical report from a doctor stating that they have erectile dysfunction caused by a physical illness, not by psychological causes.

Once these conditions have been met, then your insurance company will state how many pills a month they are willing to cover. The number of pills varies depending on the company, but the average stands at six tablets per month, the patient must pay the rest. It doesn’t end there, the reimbursement percentage also varies between insurers, it can range from 50 to 80%, so you still end up having to pay large amounts for these drugs.

Does Medicare Pay for Viagra?

Medicare, in general, does not cover Viagra for the same reasons already discussed above. Their plan A includes medication you may be prescribed as a hospital patient, while Medicare Plan B covers certain drugs given to you during an outpatient visit.

However, there are other private options available, such as a Medicare Part D Plan (PDP) or a Medicare Advantage Prescription Drug (MA-PD).  The PDP plan is developed to work alongside your Medicare coverage. The MA-PD plan can give you additional medication coverage. Both still include the services provided by the original Medicare Plan A and Plan B programs.

Getting Viagra online: How does it work?

Online Prescription & Doctor Services offer patients a safe and discreet alternative to ordering Viagra with online prescription. You just need to answer a few questions in the online questionnaire which is checked by the doctor. After determining the suitability of Viagra, the online prescription is issued and the medication is sent to your desired address.

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How Much Does Viagra Cost Without Insurance?

The cost of Viagra without insurance can fluctuate (s. also The Cost Of Viagra – A Viagra Price Worth Paying). The price will depend on which version of Viagra you have been prescribed and also at what dosage. The difference in prices is excessively broad and can be quite confusing.

If you are looking specifically for brand-name Viagra, then you will find prices starting at $60 per pill. Whereas if you would like to try the generic version called sildenafil, then prices can start at just $2 per pill.

Viagra is a prescription-only medication, any online pharmacies offering to sell it without a script are breaking the law.

Getting a Prescription for Viagra

If you find yourself experiencing ED, do not be afraid to visit a health professional, get yourself treated, and continue enjoying your sex life. Causes of ED may not only be emotional or physical. It is vital to consult with a medical professional and have a general and thorough physical evaluation. For some, this conversation can be uncomfortable and not one they are willing to have with a family doctor.

Telehealth

If you suffer from ED and want a prescription, then a quick, safe, convenient, and more accessible way to get it is by going online and searching for registered online telehealth pharmacies. 

Online pharmacies offer ED drugs at more affordable prices, and for this reason, many men prefer to obtain their prescriptions using this method.

How the Process Works

Firstly, you’ll need to find a registered online pharmacy. Check that they are approved by the NABP. Ensure they have a physical address and contact phone number in the United States. Also, see that they offer medical bios of their medical staff. 

Next, you should register yourself on the website and search for the medicine you wish to order. These pharmacies have accredited doctors that create a medical questionnaire orientated to figure out if you suffer from ED and merit treatment. The form must be filled out in detail. Be very upfront and honest here, mention any pre-existing conditions and current medications. Anything you fail to disclose could have serious effects on your body if they interact with the drug.

A doctor will then be in touch with you. They may call you or it may need to be in the form of a video chat as this is a legal requirement in some states. Once they’ve reviewed your answers, you are then notified that you have or haven’t been approved and a prescription is generated online. 

This prescription can list several alternatives that you must choose from and some offer a “starter pack” that provides you with several drugs in order for you to try them and decipher which one suits you better.

Lastly, you have two ways to purchase the medication.  The doctor can connect you with their partner pharmacy and you wait between 24 and 72 hours for the order to arrive at your doorstep. Alternatively, they can forward the prescription to a local drug store of your choice for you to collect yourself.

ED need not affect your life. Speak with a doctor about your options and consider Viagra as a treatment.

References:
We at Viagra-Prescription.com only use accredited sources and references for content creation. Read our editorial guidelines to learn more about how we determine medical facts and prepare our content in a technically correct, reliable and trustworthy manner.
  1. Viagra (summary of the European public assessment report (EPAR) for Viagra). In: European Medicines Agency. URL: ema.europa.eu, abgerufen am 2. Juni 2018
  2. Blonde L.: Sildenafil citrate for erectile dysfunction in men with diabetes and cardiovascular risk factors: a retrospective analysis of pooled data from placebo-controlled trials. (2006) URL: ncbi.nlm.nih.gov
  3. Shakir SAW, Wilton LV, Boshier A. Cardiovascular events in users of sildenafil: results from first phase of prescription event monitoring in England. BMJ 2001; 322: 651–2.