Does Medicare cover erectile dysfunction treatments?

Does Medicare cover erectile dysfunction (ED) treatments? Medicare generally does not cover ED medications when they are prescribed for ED, but it may cover diagnostic tests and penile implant surgery. ED is common. Research suggests it affects about 40% of men between ages 40 and 70, and it is almost always treatable. However, treatment is not always covered by insurance.

Whether Medicare covers ED treatment depends on the treatment and the type of Medicare coverage. In general, Medicare Part D does not cover oral medications such as Viagra (sildenafil) or Cialis (tadalafil) when they are prescribed for ED. However, Original Medicare (Parts A and B) and Medicare Advantage (Part C) may cover penile implants.

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Which ED treatments may be covered by Medicare?

Healthcare provider visits and diagnostic tests for ED may be covered under Medicare Part B, which is included in Original Medicare and Medicare Advantage (Part C). Part B may also cover penile implant surgery for ED when it is medically necessary and performed as outpatient care.

Medicare Part D does not cover medications prescribed to treat ED. However, if the same medications are prescribed for another approved use, such as an enlarged prostate (benign prostatic hyperplasia [BPH]) or pulmonary arterial hypertension (PAH), a Part D plan may cover them. Tadalafil is approved by the US Food and Drug Administration (FDA) to treat ED, BPH, and PAH, and sildenafil is approved by the FDA to treat ED and PAH, under different brand names and doses.

Medicare Advantage plans include everything in Part A and Part B, plus extra benefits such as dental and vision, and usually include Part D coverage. Some Part D plans may offer coverage of oral ED medications known as PDE5 inhibitors, such as sildenafil or tadalafil, as a supplemental benefit. Coverage depends on the specific plan benefits.

Medicare may also cover testosterone replacement therapy (TRT) for hypogonadism, a condition that causes low testosterone, which is one possible cause of ED. Coverage depends on the diagnosis and the plan. For example, one Medicare contractor policy covers TRT for symptomatic hypogonadism caused by a testicular, pituitary, or brain disorder, but not for age-related low testosterone alone.

Which ED treatments may not be covered by Medicare? 

Medicare generally does not cover oral medications for ED, such as Viagra or Cialis. The one exception is when they are prescribed to treat another approved use, such as BPH or PAH. Medicare also does not cover herbs or supplements for ED, penis pumps, penis injections, topical creams or gels for ED, experimental ED treatments, or cosmetic procedures such as penis fillers.

Medicare does not list sex therapy as a separate covered service. However, Part B covers psychotherapy from Medicare-enrolled healthcare providers, so counseling may be covered when it is provided as part of a covered mental health service.

Here is a quick review of what Medicare does not cover for ED:

• ED supplements or herbs

• ED creams or gels

• Penis pumps

• Penis injections

• Penis fillers or other cosmetic procedures for ED

• ED pills when prescribed for ED, including sildenafil, tadalafil, avanafil, or vardenafil

• Sex therapy as a standalone service

• Unapproved treatments for ED, such as alprostadil cream

• Experimental treatments for ED

Coverage varies by treatment and plan. These steps can help confirm what a Medicare plan covers:

• Call Medicare. Dial 1-800-MEDICARE (1-800-633-4227) to talk to someone about whether your ED treatment is covered. Phone lines are staffed 24 hours a day, seven days a week (except some federal holidays).

• Use live chat on Medicare.gov. Medicare.gov offers a live chat option to ask whether your ED treatment is covered.

• Review the drug formulary online. Medicare’s Plan Finder can show whether a medication is on a plan’s formulary. A plan may list sildenafil or tadalafil because it covers them for another condition, such as PAH or BPH, not for ED.

• Use Medicare’s price lookup tool. With the Procedure Price Lookup tool, you can search for outpatient procedures such as penile implant surgery to compare estimated costs.

If Medicare does not cover your ED treatment, you still have options. Depending on why coverage was denied, you may be able to:

• Appeal Medicare’s decision. If Medicare denies payment for an ED treatment you already received, or denies coverage for a treatment you think it should cover, you can work with your healthcare provider to file an appeal. The appeal process has five levels, and filing an appeal does not guarantee coverage. Appeals are unlikely to change coverage for treatments excluded by law, such as ED medications prescribed for ED.

• Ask whether a related condition applies. Sildenafil and tadalafil are also prescribed for conditions such as PAH and BPH, and a Part D plan may cover them for those uses. While Medicare does not cover these medications when they are prescribed for ED, a healthcare provider can determine whether another condition applies.

• Consider lower-cost alternatives. Generic sildenafil or tadalafil may cost less than brand-name Viagra or Cialis. Over-the-counter creams or gels for ED, such as Eroxon, are also available but are not covered by Medicare.

• Pay the cash price for your ED treatment. Generic sildenafil and tadalafil are available on Ro if a healthcare provider determines treatment is appropriate, with cash prices listed on Ro’s pricing page.

The cost of ED treatment with Medicare depends on whether the treatment is covered and which part of Medicare applies.

If a penile implant is considered medically necessary, Medicare Part B may cover both the procedure and the device. You are responsible for 20% coinsurance (20% of the Medicare-approved amount) and the annual Part B deductible ($283 in 2026). If you have already met your Part B deductible for the year, you owe only the 20% coinsurance. Hospital outpatient settings may also charge a co-pay for each service.

A Medigap policy may cover more of your share of costs under Original Medicare. If you have a Medicare Advantage (Part C) plan, check your plan details to understand your expected costs. The typical cost of penile implant surgery with Medicare ranges from $1,676–$3,748.

If your Medicare plan includes coverage for ED pills, the cost depends on your plan. Some plans have a co-pay or coinsurance, while others charge the full price until you meet your deductible.

 For reference, here are typical cash prices for one tablet of:

• Sildenafil: $5–$26 

• Viagra: $91–$113 

• Tadalafil: $5–$26

• Cialis: $11–$35 

If your oral ED medication is covered, the maximum deductible for Part D is $615 for 2026 and $700 for 2027. After the deductible is met, you generally pay 25% coinsurance until you reach the out-of-pocket threshold for the year ($2,100 in 2026 and $2,400 in 2027). After that, you pay nothing for covered Part D medications for the rest of the year.

If Medicare does not cover an ED treatment, you pay the full cash price. A 2024 study estimated the following costs of various ED treatments for people with Medicare, in 2022 dollars:

• Penis pumps: $213 (one-time cost)

• Oral ED medications: $696 per year

• Penile implant surgery: $1,600 (a Medicare-covered procedure)

• Penis injections: $3,947 per year

• Intraurethral alprostadil: $4,022 per year

There are several ways to lower the cost of ED treatment without Medicare:

• Choose generics over brand-name medications. Generic tadalafil, sildenafil, avanafil, and vardenafil are typically more affordable than brand-name options such as Viagra or Cialis.

• Order a longer supply. Getting a 90-day supply of ED medication may reduce costs for some people, depending on the pharmacy and plan. On Ro, quarterly plans are offered at a $15 discount every three months for Ro Sparks and a $20 discount every three months for Daily Rise Gummies.

• Price shop. Calling different pharmacies may lower the price of ED medication. Asking different healthcare providers about pricing for penis injections or other procedures may also help.

• Use a pharmacy discount card. Free discount cards are available on websites such as GoodRx, SingleCare, and Optum Perks. These coupons may lower the cash price of a prescription at specific pharmacies, but the prescription must be paid for in cash.

• Check eligibility for the Viagra savings offer. The manufacturer’s savings offer can save up to $4,200 per calendar year on up to 12 fills of Viagra, but it is not valid for prescriptions reimbursed in whole or in part by Medicare, so many people with Medicare may not qualify. The manufacturer of Cialis has stated there is no savings card for Cialis.

• Use health savings account (HSA) or flexible spending account (FSA) funds. ED pills, injections, and topical creams or gels may be eligible for reimbursement.

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Traditional ED treatments such as Viagra and Cialis are not always covered by insurance, and Medicare is no exception. In practice:

• Diagnosis and surgery: Part B may cover healthcare provider visits, diagnostic tests, and medically necessary penile implant surgery, usually with 20% coinsurance after the annual deductible.

• Medications: Part D may cover sildenafil for pulmonary arterial hypertension (PAH) and tadalafil for PAH or an enlarged prostate, depending on the plan’s formulary. ED medications prescribed for ED are excluded.

• Everything else: Penis pumps, penis injections, penis fillers, ED supplements, ED creams or gels, and unapproved or experimental treatments are generally not covered, so the cash price applies, although plan benefits can vary.

• Checking coverage: Calling 1-800-MEDICARE or visiting Medicare.gov for live chat, formulary searches, and the procedure price lookup tool can confirm what a specific plan includes.

• Lowering costs: Generic medications, price shopping, pharmacy discount cards, and longer supplies may reduce the cash price. Manufacturer savings offers may not be available to people with Medicare.