Cialis is a drug used for a multitude of disorders, but the main one is erectile dysfunction. Explained below is how each arm of Medicare deals with this pricey drug.
Does Medicare Cover Cialis?
Original Medicare does not cover Cialis. The reason is Medicare does not cover prescription drugs; for that, you will need a Part D plan. If you need a pump for erectile dysfunction, Original Medicare covers that, under Part B.
Does Medicare Part D Cover Cialis?
Medicare Part D, Medicare’s stand-alone/separately purchased prescription drug plan, may cover Cialis. This is up to the private insurers who offers Part D plans in your area, but most likely a plan will not cover Cialis for erectile dysfunction, even if it may cover for BPH.
If your plan does cover Cialis, you generally pay a high percentage of the cost, as Cialis is tiered as a non-preferred brand name or specialty drug.
You should check back during Medicare’s Annual Election Period (Oct 7-Dec 15), to see if any new Medicare drug plans will include Cialis on their formulary (list of covered drugs) next year.
While brand-named Cialis is sometimes covered, Viagra is almost always not covered. Check out our article called “Does Medicare cover Viagra?“
Does Medigap Cover Cialis?
Medigap does not cover prescription drugs; therefore, it does not cover Cialis What a Medigap plan can do is cover your out of pocket costs for the pump mentioned above.
Does Medicare Advantage Plans Cover Cialis?
Medicare Advantage (MA) plans with drug coverage can cover Cialis. That being said, the coverage is often rare, and when it does cover it, you pay a high percentage. It is not recommended to choose your MA plan based on whether it covers Cialis -you’re better off researching your other drugs, and making sure the plan has the right network of doctors and hospitals.
We can run a free comparison of all you drugs to see which Part D and Medicare Advantage plans companies are the best plan for you. Call one of our licensed agents at 800-930-7956.