Haris Ashley
Sildenafil is a medication used to treat erectile dysfunction (ED) and is the generic version of Viagra. It is available at a much lower cost than Viagra, with or without insurance. The average cost for a 25mg dose of generic sildenafil is about $15 to $25 for 30 tablets, while the brand-name version of Viagra costs over $90 per tablet. While most insurance plans do not cover Viagra, some may cover sildenafil. Medicare, for example, may cover sildenafil in the Post-Donut Hole (Catastrophic Coverage) stage, and some Medicare Part D and Part C plans may cover generic versions.
| Characteristics | Values |
|---|---|
| Does medical insurance cover sildenafil? | Generic sildenafil is covered by most Medicare and insurance plans. However, some insurers may cover sildenafil even when they don't cover Viagra. |
| How to save on sildenafil with insurance? | Buying in bulk is cheaper in the long run. With insurance, savings will also come in the form of fewer copays because larger prescriptions mean fewer trips to the pharmacy. |
| How to save on sildenafil without insurance? | The average cost for a 25mg dose of generic sildenafil is about $15 to $25 for 30 tablets by using a coupon at retail pharmacies. GoodRx coupons can also help save up to 80% on the average retail price of the most common prescription of sildenafil. |
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What You'll Learn
Generic sildenafil is covered by most insurance plans
Medicare Part D and Part C plans may cover generic versions of Viagra, but it is not covered under Original Medicare Parts A and B, or Part C. Private insurance companies also offer Medicare Part D with plans approved by Medicare, but costs and types of coverage vary based on location. If you have a Medicare or Medicaid plan, you will need to check your specific plan benefits to find out about prescription drug coverage.
The cost of Viagra without insurance can be over $460 for 30 tablets, and the average cost of a 25mg dose of generic sildenafil is about $15 to $25 for 30 tablets. The average retail price of the most common prescription of sildenafil is about $203, but this can be as low as $13 with a GoodRx coupon.
If your insurance plan does not cover sildenafil, you may be able to submit an appeal for coverage or obtain prior authorization to get the prescription covered. You can also ask your doctor about alternative medications and compare prices at different pharmacies.
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Viagra is generally not covered by insurance plans
Viagra (sildenafil) is a medication used to treat erectile dysfunction (ED) in men. It is not considered to be a medically necessary medication, and therefore, it is generally not covered by insurance plans.
Medicare, for example, does not cover Viagra under Original Medicare Parts A and B, and it is also not covered under Part C. Medicare Part D Prescription Drug Plans (PDP) and Medicare Advantage Prescription Drug (MA-PD) plans are available for purchase through private health insurance companies, but these plans do not generally cover ED medications. However, some Part D and Part C plans may cover generic versions of Viagra.
The reason Viagra is not covered by most insurance plans is that it is considered an elective medication. This means that while ED is not life-threatening and does not require treatment for medical reasons, it can still harm self-esteem and confidence and lead to anxiety and depressive symptoms. As a result, some people may seek alternative treatments or generic versions of Viagra, which are much more affordable even without insurance.
Generic sildenafil is covered by most insurance and Medicare plans, but some pharmacy coupons or cash prices may be lower. Insurance companies are typically more strict about covering expensive, brand-name drugs than cheaper generics. The average retail price of a common prescription of sildenafil is about $203, but this can be as low as $13 with a GoodRx coupon.
If your insurance plan does not cover Viagra, there may be other options to reduce the out-of-pocket drug costs. You can try to appeal to your insurance company, which usually requires working with your doctor to submit a letter explaining why the drug is medically necessary. You may also be able to obtain a prior authorization or submit a prescription coverage form to get your medication covered.
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Sildenafil is cheaper than Viagra
Sildenafil is the generic version of Viagra. They are both PDE-5 inhibitors with almost identical chemical compositions and the same active ingredient. They are both used to treat erectile dysfunction (ED) and are equally effective. However, Viagra is relatively expensive, and Sildenafil is a much more affordable generic alternative.
The price difference between Viagra and Sildenafil is significant. Viagra is manufactured and sold by Pfizer as a branded, diamond-shaped blue pill, whereas Sildenafil is currently made by a lot of different pharmaceutical companies and comes in a little white pill. The average retail price of the most common prescription of Sildenafil is about $203, but you might be able to get that same prescription for as little as $13 with a GoodRx coupon. Sildenafil debuted at an average cash price of around $30 per pill, which is roughly 50% cheaper than Viagra. According to the U.S. Food and Drug Administration (FDA), generic drugs cost up to 85% less than the same brand-name medication.
Some insurers may cover Sildenafil even when they don't cover Viagra. However, generally, medications for erectile dysfunction are not covered, especially brand-name versions. Viagra is not covered by almost all insurance plans and is not considered medically necessary by Medicaid. Sildenafil is covered by most Medicare and insurance plans, but some pharmacy coupons or cash prices may be lower.
If your insurance plan doesn't cover Sildenafil, you may be able to submit an appeal for coverage or obtain prior authorization to get the prescription covered. You can also try to save money by buying in bulk. On GoodRx, the lowest price for thirty 20 mg pills of Sildenafil is about $13, or $0.43 per pill. For a prescription of sixty 20 mg pills, the lowest GoodRx price will go up to about $17, but each pill will only cost $0.28 (35% cheaper).
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Medicare Part D and Part C plans may cover generic sildenafil
Medicare Part D and Part C plans may also cover generic sildenafil because it is considered medically necessary. To determine whether your Medicare Part D or Part C plan covers generic sildenafil, you will need to check your drug formulary, or the list of drugs that your plan covers. It is important to note that plan formularies can change at any time, so be sure to check for both Viagra and generic sildenafil regularly.
If your Medicare Part D or Part C plan does not cover generic sildenafil, you may be able to submit an appeal for coverage or obtain a prior authorization to get the prescription covered. You can also look for coupons on drug manufacturers' websites, medication discount websites, or from your preferred pharmacy to help lower the cost of generic sildenafil.
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Coupons can help lower the cost of sildenafil
Sildenafil is a medication used to treat erectile dysfunction and pulmonary arterial hypertension, or high blood pressure in the lungs. It is available as a generic drug and under the brand names Viagra and Revatio. While some insurance plans may cover sildenafil, it is not typically covered by most plans, especially the brand-name versions.
Even if your insurance covers sildenafil, you may find that coupons can help lower the cost of the medication. For example, GoodRx offers coupons that can reduce the cost of a sildenafil prescription from about $203 to as little as $13. Similarly, FamilyWize offers coupons that can save you up to 97% on sildenafil citrate prices. RxSaver also offers coupons for sildenafil that can help you save up to 80% on the medication.
In addition to these options, ScriptSave WellRx offers a prescription discount card that can save you up to 80% on brand and generic prescription drugs, including sildenafil citrate. This card can be used at participating pharmacies across the United States to receive discounts on your prescriptions. However, it is important to note that this discount card cannot be used together with insurance.
When deciding whether to use a coupon or your insurance to pay for sildenafil, it is worth comparing the discounted price with your insurance copay. In some cases, the discounted price may be lower than your copay, making it more affordable to use the coupon instead of your insurance. Additionally, buying in bulk can also help lower the cost of sildenafil in the long run, as larger prescriptions mean fewer trips to the pharmacy and, consequently, fewer copays.
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Frequently asked questions
Sildenafil is covered by most insurance plans, but some pharmacy coupons or cash prices may be lower. Some insurers may cover sildenafil even when they don't cover Viagra.
Without insurance, the average cost for a 25mg dose of generic sildenafil is about $15 to $25 for 30 tablets.
If you don't have insurance, you can use a GoodRx coupon to save on sildenafil. The average retail price of the most common prescription of sildenafil is about $203, but you might be able to get that same prescription for as little as $13 with a GoodRx coupon.
Medicare generally doesn't cover Viagra or other ED medications. However, Medicare Part D and Part C plans may cover generic versions of Viagra, and Medicare Part D plans may cover another brand of sildenafil called Revatio, which is used to treat pulmonary arterial hypertension.
