Is Viagra (sildenafil) covered by insurance?

Felix Gussone, MD - Contributor Avatar

Reviewed by Felix Gussone, MD, Ro, 

Written by Rachel Honeyman 

Felix Gussone, MD - Contributor Avatar

Reviewed by Felix Gussone, MD, Ro, 

Written by Rachel Honeyman 

last updated: Apr 13, 2023

4 min read

If you're looking to try Viagra to treat your erectile dysfunction (ED), you might be surprised by what a big dent this little blue pill can make in your wallet. Considering ED is a medical condition with far-reaching impacts on your health and quality of life, you might think it's a given that Viagra (and other erectile dysfunction drugs that work in a similar way) would be covered by insurance. Unfortunately, that's not always the case. 

So, is Viagra covered by insurance? Unfortunately, the answer depends on your insurance plan. The good news is, even if your insurer does not cover Viagra, cheaper alternatives to Viagra are likely available to you. Continue reading to learn more about the cost and coverage of ED medication.

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Is Viagra (sildenafil) covered by insurance?

Viagra, as a brand-name drug, is not covered by most insurance plans. As with any medication, treatment, or diagnostic test, every health insurance plan has different policies about what they will and won't cover. Many insurance companies have a listing of drugs they'll cover under different plans available on their websites. 

For instance, some large group plans under Blue Cross Blue Shield appear to require prior authorization before determining if they cover sildenafil, as well as other phosphodiesterase-5 (PDE5) inhibitors (the drug class Viagra is a part of), such as Cialis (tadalafil) and Levitra (vardenafil)

No matter your insurance plan, it's important to call your insurance provider to verify which medications they'll cover and under what circumstances. They may have certain requirements for prior authorization (where someone from the insurance company will need to review the prescription from your healthcare provider before authorizing coverage). Or, they limit how much you can get at once and how many refills are available. You'll also need to find out about any copayments. 

Viagra is not the only medication available to treat erectile dysfunction. When you call your insurance provider for verification, be sure to also ask about insurance coverage for any of the following medications as well (if Viagra isn't covered): 

  • Sildenafil citrate (this is the active ingredient in Viagra)

  • Cialis (or its generic counterpart, tadalafil)

  • Levitra (vardenafil)

  • Stendra (avanafil)

If your insurance provider covers certain medications but not others, speak with your healthcare provider to see if switching to a covered medication makes sense for you. Your insurance provider may also offer different coverage for different dosages or uses. For example, Cialis is available in two ways: as-needed (2.5 mg, 5 mg, 10 mg, or 20 mg) or daily (2.5 mg and 5 mg). Your insurance may cover one but not the other. 

If your insurance does cover any of these medications, you may still need to pay a copay, or coverage may only go into effect after meeting your deductible. Every plan is different. 

Viagra Important Safety Information: Read more about serious warnings and safety info.

Cialis Important Safety Information: Read more about serious warnings and safety info.

What does Viagra cost out-of-pocket?

If your insurance plan does not cover Viagra, the out-of-pocket drug costs can be quite high. It can cost up to $2,000 for 30 pills of a 100 mg dose. Every pharmacy offers its own rates, though, so it's worth shopping around. Other PDE5 inhibitors may be slightly more affordable, but still pricey.

The cash price for Cialis varies widely based on the dosage. For the lowest dose (2.5 mg), Cialis generally costs around $350 for 30 pills, while the highest dose (20 mg) can cost over $2,000. 

The average retail price for Levitra is around $1,700 across all dosages for 30 pills

Finally, Stendra, a less commonly prescribed medication for ED, costs around $1,600 out-of-pocket.

Telehealth options such as the service through Ro can help you access Viagra or a generic for a lower cost and have it delivered directly to your door. 

Sildenafil and Revatio: cheaper alternatives to Viagra

There are two cheaper versions of Viagra available: generic Viagra (also named sildenafil) and generic Revatio. Both drugs have the same active ingredient as Viagra, sildenafil citrate. 

Revatio is an FDA-approved medication for treating a specific type of high blood pressure in the lungs.

Revatio has the same active ingredient as Viagra. The difference between Revatio and Viagra is the available doses. While Viagra and generic Viagra comes in 25 mg, 50 mg, and 100 mg tablets, Revatio comes in 20 mg tablets. Some healthcare providers prescribe generic Revatio at doses of 20 mg, 40 mg, 60 mg, 80 mg, or 100 mg to treat ED. However, this is considered off-label prescribing since Revatio and its generic form are not specifically FDA-approved for ED.

Generic Revatio is a much more affordable alternative to Viagra, available for as low as $10 for 30 doses of 100 mg (depending on the pharmacy).

Is Viagra (sildenafil) covered by Medicare or Medicaid?

If you're on a Medicare or Medicaid plan, you will need to look into your specific plan benefits to find out about prescription drug coverage. In general, there's a better chance of one of the generic versions—sildenafil citrate, tadalafil, or vardenafil—being covered under your Medicaid or Medicare plan than their brand-name counterparts. Medicare part D plans are for prescription drug coverage. 

How does Viagra treat erectile dysfunction?

Viagra, Cialis, Levitra, and their generic counterparts are all examples of PDE5 inhibitors, medications that treat erectile dysfunction. PDE5 inhibitors block an enzyme called PDE5.  Blocking PDE5 with PDE5 inhibitors causes better blood flow to the penis. Better blood flow to the penis makes for stronger, and longer-lasting erections

How to purchase Viagra (sildenafil)

Viagra and other PDE5 inhibitors are only available by prescription, which means you can’t purchase Viagra at your local drugstore. To get a prescription for erectile dysfunction medication, have an open and honest conversation about your symptoms with your healthcare provider. While discussing your sex life with a provider may feel uncomfortable, you’re not alone–erectile dysfunction is very common. Nearly 30 million men in the U.S. experience ED each year. 

If you’re concerned about picking up your prescription for ED medication at a pharmacy, some reputable online pharmacies can ship Viagra discreetly to your home address. But be careful–Viagra is extremely counterfeited. Tested samples of counterfeit Viagra have been found to contain pesticides, wallboard, commercial paint, and printer ink.

Make the right choice for your budget

All of these medications work similarly, with some differences in how long they last in the body and side effects. Ultimately, the medication you choose will depend on your healthcare professional's medical advice, as well as what will fit best in your budget. Call your insurance provider to determine if any of these medications are covered under your plan. If they're not covered, shop around for the most affordable options offered by different licensed pharmacies.

DISCLAIMER

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.


How we reviewed this article

Every article on Health Guide goes through rigorous fact-checking by our team of medical reviewers. Our reviewers are trained medical professionals who ensure each article contains the most up-to-date information, and that medical details have been correctly interpreted by the writer.

Current version

April 13, 2023

Written by

Rachel Honeyman

Fact checked by

Felix Gussone, MD


About the medical reviewer

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.

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