American Male Medical is pleased to bring you a guest blog from Boomer Benefits Danielle Kunkel:
Does Medicare cover erectile dysfunction?
Medicare is our national health insurance program for people aged 65 and older. It also includes certain younger individuals with disabilities. This program provides medically necessary inpatient and outpatient care for most American seniors. Citizens and permanent residents how have lived in the U.S. continuously for at least 5 years are eligible to enroll in Medicare.
We get lots of questions about Medicare’s coverage of erectile dysfunction. Since this is common in older male adults, it’s important to understand the benefits provided.
Benefits Under Medicare Part B
In general, Medicare will pay for medically necessary treatment for the underlying causes of most health conditions, including erectile dysfunction. If you have a health condition that contributes to ED, Medicare will likely cover the diagnosis and treatment of that condition.
Medicare provides treatment for health conditions like obesity, diabetes, and sleep apnea. It also offers a number of screenings to determine whether underlying disease may be present, such as cardiovascular screenings. If your doctor suspects that tobacco use may be contributing to your health condition, Medicare may provide smoking and tobacco use cessation counseling.
Part B may also cover pumps for ED under the durable medical equipment benefits.
These treatments are usually provided on an outpatient basis, so the coverage falls under Medicare Part B. Part B provides for 80% of the cost of your outpatient medical care after you first meet the small Medicare Part B annual deductible, which is $183 in 2018.
You are responsible for paying the other 20%. If you enrolled in supplemental coverage such as Medigap insurance or a Medicare Advantage plan, your policy may help to cover some or all of this as well as your other ordinary deductibles and copays.
Benefits under Medicare Part D
Your Medicare doctor may prescribe medications for ED treatment but these are excluded from Part D and aren’t covered.
However, while Medicare Part D may pay for other prescription drugs that treat the underlying causes of ED. Example – if your doctor suspects diabetes or a heart condition is causing ED, he can prescribe medications to treat them.
Most Part D plans offer a number of medications to treat underlying health conditions such as these. All Part D plans offer at least two medications in every covered therapeutic class. This provides your doctor with choices in medications that he or she may prescribe to you.
For medications not covered by Part D, beneficiaries can also consider online discount programs like GoodRX or patient assistance programs from the drug manufacturer to help them pay for medications like Viagra.