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Erectile Dysfunction

Not Covered by Medicare

Coverage

Erectile dysfunction (ED) is when a male cannot get or keep an erection firm enough to have sexual intercourse. It is sometimes referred to as impotence, although that has become less common.

ED drugs are not deemed medically necessary by Medicare, which is why they do not offer coverage for these drug costs in most cases. If you have a Medicare Part D plan, it may cover the drug Cialis, if prescribed for bladder outlet obstruction or signs of benign prostatic hyperplasia (BPH). Your doctor must diagnose the problem before coverage begins.

Costs

Penile implant surgery is considered an outpatient procedure, so Medicare Part B will cover 80 percent of the Medicare-approved costs. You will be responsible for the remaining 20 percent.

What to Know

It is not uncommon for men to experience occasional ED, but if ED is experienced frequently, it could be a sign of health problems such as diabetes or high blood pressure. Men may experience symptoms of sexual dysfunction from certain physical or psychological conditions that may include:

  • Medical conditions
  • Substance abuse
  • Psychological conditions
  • Medications used to treat many medical conditions or surgeries that involve the prostate or spinal cord may also contribute to sexual or erectile dysfunction in men.

Medicare By State

Medicare is regulated by the federal government. However, private insurance companies are allowed to offer various parts of Medicare, and these plans can differ from state to state.

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