Will Medicare pay for Cialis?

Cialis is a name-brand, popular drug with several benefits and some side effects. But does Medicare cover Cialis?

That depends on what Cialis is treating in your body. Even the best health insurance companies may decide against giving you help with a Cialis prescription.

Our guide has everything you need to know about how Medicare covers Cialis

After you learn everything about how Medicare covers Cialis, enter your ZIP code in the free comparison tool above to compare multiple insurance quotes.

Will Medicare pay for Cialis?

The short answer is no. Medicare Parts A and B won’t cover Cialis at all.

Cialis is the brand name of the drug tadalafil. Adcirca and Alyq are known as generic Cialis (tadalafil). Adcirca and Alyq are covered under Medicare Part D.

Does Medigap or Medicare Advantage cover Cialis?

Medigap is supplemental health insurance that doesn’t cover Cialis. Medicare Advantage is similar to Medicare Parts A and B, and it won’t cover Cialis or other tadalafil alternatives.

Why? Medicare Part D only covers prescription drugs that are on the list of approved medications.

How much does Cialis cost?

Cialis (tadalafil) is a tier-five drug. The tier-five drug costs are usually more expensive than drugs in the other four tiers.

Let’s look at the cost of Cialis by milligrams (mg).

Cialis Prescription Cost

Since Medicare doesn’t cover Cialis (tadalafil), the best way to save is through Cialis coupons.

The Cialis cost per pill is between $5 and $49.

Therefore, you may be stuck with the bill. Shop around on the internet for Cialis coupons to get lower prices.

Does Medicare Part D cover Cialis?

The short answer is no. Medicare Part D won’t provide coverage for Cialis if it’s for erectile dysfunction (ED).

Does Medicare cover Cialis for BPH?

Your Medicare Part D coverage may pay for the medication if your Cialis prescription is for benign prostatic hyperplasia (BPH).

However, your health care provider must prescribe the drug for you to receive help from your Medicare company.

What are the top BPH alternatives that Medicare covers?

Tadalafil comes in 2.5, 5, 10, or 20 mg tablets (usually in a quantity of 30 pills). If Medicare doesn’t accept your Cialis prescription for BPH, your doctor may prescribe these medications instead.

• Alfuzosin (Uroxatral)
• Doxazosin (Cardura)
• Silodosin (Rapaflo)
• Terazosin (Hytrin)

Your doctor may suggest these medications before other BPH treatments and procedures.

Case Studies: Medicare Coverage for Cialis

Case Study 1: John’s Medicare Part D Coverage

John is a 70-year-old Medicare beneficiary with Part D prescription drug coverage. He has been prescribed Cialis by his healthcare provider to manage his erectile dysfunction. John checks his Medicare Part D plan’s formulary, a list of covered drugs, and finds that Cialis is included. He pays the required copayment for each prescription refill and receives the medication without any issues.

Case Study 2: Mary’s Original Medicare and Supplemental Plan

Mary, a Medicare beneficiary with Original Medicare and a supplemental insurance plan, consults her doctor for erectile dysfunction and is prescribed Cialis. She confirms with her supplemental plan provider that Cialis is covered, pays the copayment, and receives the prescribed medication.

Case Study 3: David’s Medicare Advantage Plan

Case Study 4: Sarah’s Medicare Coverage Limitations

Sarah, a Medicare beneficiary with financial limitations, seeks assistance to afford Cialis. Her doctor recommends applying for Medicare’s Extra Help program. After approval, Sarah receives substantial assistance through Extra Help, making it affordable for her to obtain Cialis.

Case Study 5: James’ Medicare Part D Formulary Exclusion

James, a Medicare beneficiary with Part D prescription drug coverage, discovers that his Medicare Part D plan does not include Cialis in its formulary. As a result, the plan does not cover the medication’s cost. In this case, James discusses alternative treatment options with his healthcare provider or explores switching to a different Medicare Part D plan that covers Cialis.

Does Medicare Cover Cialis: The Bottom Line

If you happen to get Medicare Part D to approve your Cialis for BPH, you may be limited to one round of the prescription at a time or a limited number of Cialis tablets.

Does Medicare pay for Cialis? No, it doesn’t.

Medicare is hesitant about providing coverage for Cialis authorization, so you may have a hard time getting it.

You should shop at the top Medicare companies to get reliable coverage. But who are the best insurance companies?

Some insurance companies share the same restrictions as Medicare, but it’s always worth shopping around.

Now that you know more about how Medicare covers Cialis, compare multiple companies in your area by entering your ZIP code below.