When it comes to aging, one of the most frustrating concerns for men is the development of erectile dysfunction. This condition can manifest in varying ways, including the inability to achieve an erection at all, the inability to maintain an erection and the inability to achieve a full erection. Although erectile dysfunction can be a challenge, it’s important to note that it is a normal part of the aging process and can affect men at different times in their lives. Thankfully, developments in medical science within the past few decades have provided men suffering with erectile dysfunction a potential solution in the form of medications like Viagra.
What is Viagra?
Viagra (sildenafil) is one of the most popular drugs cleared by the U.S. Food and Drug Administration for the direct treatment of erectile dysfunction. The onset of the drug’s effects typically requires that Viagra be taken at least 30 minutes before engaging in sexual activity, meaning it is not a daily treatment. The medication works by dilating blood vessels, thereby increasing blood flow required to achieve an erection. Viagra has been shown to be an effective erectile dysfunction treatment for many men, but it should not be taken by men who also suffer from certain cardiovascular conditions as blood pressure concerns may present themselves.
Medicare Coverage of Viagra
Although Viagra is one of the most popular options for erectile dysfunction patients, it is not covered under Medicare’s Part D prescription drug benefit. This is because the Medicare insurance program disqualifies any and all drugs prescribed to enhance sexual performance. Much like weight loss drugs, erectile dysfunction medications are treated as lifestyle enhancers and not considered medically necessary.
There is the possibility, however, that Viagra may be covered under Part D of your Medicare insurance when the drug is prescribed as a treatment for cardiovascular conditions which require increased blood flow through blood vessel dilation. In such cases, your doctor would need to document your treatment and may need to show that other treatment methods have failed in case the coverage is called into question.
Furthermore, some Medicare Advantage plans may provide benefits that allow for discounts on Viagra. In other situations, Medicare Advantage plan members may receive reimbursement for medications like Viagra.
Medicare Part A offers benefits for recipients who need temporary care in a skilled nursing facility, meaning it is likely that treatment for erectile dysfunction will not be deemed medically necessary in such circumstances. As a result, Medicare coverage will not provide benefits for Viagra under Part A unless the medication is prescribed for a cardiovascular condition.
Medicare Part B offers coverage for medical treatments that are provided under a physician’s care in a clinical setting when the treatment is deemed medically necessary. Some clinics that specialize in erectile dysfunction treatment will provide a test dose in the office to evaluate the efficacy of the treatment, but in the vast majority of cases, this will not be considered medically necessary and will not be provided under Part B of your Medicare coverage.
Are There Alternatives to Viagra?
It’s important to note that erectile dysfunction is not always the result of aging or biological changes. In some cases, psychological factors are the main cause for those facing problems achieving or maintaining an erection, and these types of problems can affect men of all ages. When this is the case, medications may or may not be effective, and instead, counseling and behavioral changes may provide a larger benefit.
Additionally, weight loss and other lifestyle changes may be needed in order to combat erectile dysfunction that is not the result of biological changes. Before beginning any type of treatment on your own, always speak to your physician to discuss your options and address the underlying cause of your erectile dysfunction first.
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