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Erectile dysfunction currently affects millions of people in the United States alone. Popularly known as the blue pill, Viagra is an FDA-approved PDE-5 inhibitor that effectively addresses ED concerns.
The blue pill works by relaxing both the arteries and blood vessels in your penile region, allowing more blood to circulate toward your member, aiding erection.
However, it’s worth noting that while the drug helps with achieving and sustaining erections firm enough for intercourse, it doesn’t instantly cause erections. Sexual stimulation or arousal is still needed. And when you orgasm or ejaculate, your erection should naturally subside on its own.
If your doctor has prescribed Viagra to help treat your erectile dysfunction symptoms, you might be surprised by the impact the popular blue pill can have on your pocket! Bearing in mind that erectile dysfunction is a health problem that can have far-reaching consequences on your overall health and quality of life, you might be wondering whether Viagra, the treatment option, is covered by insurance. Peruse the article and find out whether Viagra is covered by insurance as well as the current cost of the drug.
So, is Viagra covered by health insurance?
First and foremost, you should contact your insurance provider to see whether your current plan covers Viagra. After all, every health insurance plan has different coverage policies regarding what they will and won’t cover. Nearly every insurance firm has a listing of medications they will cover under different plans on their official web pages.
With that in mind, Viagra, in its brand name form, is not covered on insurance plans by most insurance providers. But since the release of the generic version of the medication, sildenafil, several health plans now provide insurance coverage for sildenafil under their prescription drug coverage.
Are erection pills covered by insurance?
As already explained, a number of insurance companies don’t offer coverage for Viagra. However, a few insurance providers only provide coverage for the generic version of Viagra, sildenafil. The primary reason why insurance firms don’t provide coverage for Viagra or any other brand name ED medications is that they don’t want to pay for expensive brand name ED medications.
Currently, there are four major types of erectile dysfunction medications approved by the Food and Drug Administration (FDA) in the United States, including:
- Viagra (sildenafil).
- Cialis (tadalafil).
- Levitra (vardenafil).
- Stendra (avanafil).
As already mentioned, most insurance providers don’t offer coverage for brand-name ED medications. And this simply implies that Viagra insurance coverage is incredibly rare, especially since the FDA approved the sale and use of its generic counterpart, sildenafil.
Insurance firms are more likely to cover the generic version, sildenafil because it’s nearly half the price of the brand-name Viagra.
Cialis is in the same boat as its Viagra counterpart. Insurance firms are highly hesitant to offer insurance coverage for the Cialis, the brand-name medication. However, they are willing to cover the fairly affordable generic version.
But it is worth noting that Cialis is also commonly used in the treatment of benign prostatic hyperplasia, BHP, a condition commonly referred to as enlarged prostate. When prescribed for BHP, then it’s highly likely that insurance will cover Cialis.
Once again, many insurance firms will shy away from offering coverage for the relatively costly brand-name Levitra, opting to cover the generic version, vardenafil.
Stendra is a lesser popular ED medication and doesn’t have a generic version. It is less likely to be covered by insurance firms as well.
It is imperative to note that even if your insurance health plan provides coverage for any of these brand or generic ED medications, you most likely will still have a co-payment, depending on your specific coverage.
How much does Viagra cost per pill without insurance coverage?
If your health insurance plan doesn’t cover Viagra, the out-of-pocket drug costs can be significantly high. It can cost up to $2100 for 30 pills of a 100mg dosage. The average cost of Viagra is about $79 per pill, regardless of the dosage. It is worth noting that Viagra is available in 25, 50, and 100-mg dosages. Of course, every pharmacy has its own rates, so it’s worth shopping around!
So, why isn’t Viagra covered by insurance?
Besides their relatively high prices, most insurance providers don’t provide cover for medications that are specifically prescribed to treat sexual-related problems. Also, under the law, medications used to treat erectile dysfunction are generally excluded from part D coverage, barring they are used as part of a treatment approved by the FDA for a different health problem.
Some private insurance firms usually go by the same approach, reasoning that medications used to treat sexual health concerns are lifestyle-oriented rather than medically necessary.
For instance, Medicare may pay if an individual is prescribed sildenafil, the generic version of Viagra, to treat pulmonary arterial hypertension, a condition characterized by high blood pressure in your lungs. But it won’t provide coverage for the same medication if intended for ED.
But usually, insurance providers don’t offer cover for ED medications because of their ridiculously high costs. Medications that treat sexual problems such as Viagra can be highly expensive. For instance, a 10-tablet prescription for the drug in a typical 100-mg dosage may cost at least $600.
Thankfully, the emergence of the generic versions of the drug now means Viagra is available at relatively affordable prices and is also covered by some health insurance providers.
Is generic Viagra covered by insurance?
First things first, you need to consult your insurance provider to confirm whether they provide cover for generic Viagra or any other erectile dysfunction medication.
It is worth noting that generic Viagra, sildenafil, is the unbranded version of Viagra. It not only features the same ingredient as its branded version counterpart but also works exactly the same way.
As earlier explained, most insurance firms provide cover for the generic versions of erectile dysfunction medications, including sildenafil, the generic Viagra version.
Is Sildenafil as good as Viagra?
Even though there are many branded and generic types of erectile dysfunction medications, including Cialis, Spedra, Levitra, Viagra remains the most popular. Perhaps this may be attributed to the fact that Viagra was the first treatment option widely available for helping men suffering from ED symptoms.
Sildenafil is practically the generic version of Viagra and features the same active ingredient. This implies that it works in a similar way as its branded version cousin.
The two medications boast the same amount of active ingredient, sildenafil citrate, in every single dose. In medical terms, this is referred to as bioequivalence. Simply put, this means that the manner in which the two medications function, how long they take to work, their effectiveness, and how long they last in your system, are all the same.
And most importantly, the bioequivalence implies that you must steer clear of both Viagra and its generic version cousin, sildenafil if you have been advised by your healthcare provider against taking either of them.
Sildenafil and Viagra both function by inhibiting the PDE-5, an enzyme that regulates muscle contraction in the penile region. These drugs allow your blood vessels and arteries in the penis to relax and expand, enhancing the blood circulation to the area and essentially making it fairly easier for you to achieve a lasting erection.
It is necessary to be sexually stimulated for both drugs to function appropriately, so you will have to get in the mood, relax, and allow the magic pill to do its thing!
So, how much does it cost to treat erectile dysfunction?
There is no standard cost of treating erectile dysfunction. This is not only because there are several erectile dysfunction treatment options, but because there are numerous potential causes of ED.
The first thing your healthcare provider will do is to ensure you are actually getting the right treatment for any health problem that could be responsible for your ED symptoms.
And depending on the cause as well as the severity of your erectile dysfunction symptoms, and any existing medical conditions, your doctor might come up with a variety of treatment options. Usually, if your erectile dysfunction is caused by an underlying health condition, treating that particular condition should clear up your ED symptoms.
Before recommending a particular treatment option, your healthcare provider will explain to you both the benefits and risks of each treatment and will take your preferences into account. What’s more, your partner’s preferences might impact your treatment options.
Currently, there are four oral treatment options that are FDA-approved. These medications include Viagra, Cialis, Levitra, and Stendra. All these drugs are PDE-5 inhibitors and work by improving blood flow toward your member, enhancing your chances of achieving an erection with sexual stimulation.
These ED medications vary in terms of dosage, cost, how long they work as well as side effects. Potential side effects include nasal congestion, stomach upset, backache, headache, flushing, nausea, among others.
Your healthcare provider will take into account your personal situation to determine what medication might prove effective for your case.
Does Blue Cross Blue Shield cover erectile dysfunction?
Popularly known as BCBS, Blue Cross Blue Shield is a top-notch health insurance provider that provides a huge network and extensive coverage. The company provides various types of insurance plans including, dental insurance, corporate health insurance, group insurance plans, high-deductible health insurance, Medicare, Medicaid, small business health insurance, HSAs as well as individual health insurance.
Unfortunately, Blue Cross Blue Shield doesn’t currently provide insurance cover for erectile dysfunction. In fact, one of the major drawbacks of BCBS is that the company doesn’t guarantee Medicare prescription medication coverage.
The Bottom line: Is Viagra Covered By Insurance?
So, is Viagra covered by insurance? Like we said earlier, you need to consult your insurance provider to confirm whether they cover Viagra or any other erectile dysfunction medication.
And while most health insurance companies might be reluctant to cover brand-name FDA-approved ED drugs, a number are currently willing to provide coverage for generic versions of the same medications. You only need to do your research to find the right company.
