Check your specific plan. Medicare and Medicaid generally don’t cover Viagra unless you qualify for specific exceptions, often related to a diagnosed pulmonary hypertension condition. Many private insurance providers will cover Viagra, but only with prior authorization. This means your doctor needs to submit a request demonstrating medical necessity.
Here’s what to do:
Contact your insurance provider directly. Get specifics about your coverage for erectile dysfunction medications. Ask about prior authorization procedures and required documentation. Discuss options with your doctor. They can help you navigate the process and may be able to suggest alternative medications covered by your plan. Explore prescription discount programs. If your insurance doesn’t cover Viagra, consider using a prescription discount card or program. These can often lower your out-of-pocket costs.
Factors affecting coverage include:
- Your specific insurance plan’s formulary (list of covered medications). Your doctor’s justification for prescribing Viagra. Your health status and pre-existing conditions.
Always review your insurance policy carefully or contact your insurer for the most up-to-date information. Be prepared to discuss your medical history and the rationale behind needing Viagra with your doctor and insurance company.
