Is Viagra Included in the Insurance Policy?

Erectile Dysfunction (ED) refers to a disorder wherein men find it difficult to hold their erection for a significant period of time. It happens because of insufficient flow of blood in the penis. There can be a lot of reasons for erectile dysfunction. The reasons may be psychological, a side effect of some other medicine, due to some previous chronic illness, fatigue, alcohol consumption or even due to some injury in the past.

Usually, erectile dysfunction is considered a normal disorder and does not warrant as any serious medical problem. However, Canadian Health&Care Mall favors that in cases where this disorder is chronic and not just occasional, people may want to try out various treatments. While some treatments include lifestyle changes, others might suggest medicinal drugs which counter the effects of erectile dysfunction.

Medicinal Drugs for Erectile Dysfunction

Sildenafil or more commonly known as Viagra is one such drug for erectile dysfunction which helps by inhibiting certain enzymes which are found in blood. There are other drugs too besides Viagra such as Tadalafil, Vardenafil which are helpful in the same.

While in rare cases, people may experience some small side effects such as headaches and digestive issues and such for the most part they are safe and used by millions of people every day.

Viagra

Does Health Insurance Cover Viagra?

Many people ask this question whether Viagra is covered under health insurance, since the cost of the pill is as high and per pill basis. However, Canadian Health&Care Mall explains that insurance companies do not seem to have a clear say when it comes to drugs for erectile dysfunction. While there are some insurance companies that do take it under them, an overwhelming majority does not. And this comes out to be especially bad news for elderly people since statistically, they form the largest group that benefits from this drug. On the other hand, one can find many private health insurance companies such as Aetna and United Healthcare who do have provisions to include Viagra under the medical insurance if it has been ‘prescribed by the doctor’ on the ground that the patient really does need it as a measure for medical treatment.

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So how would you know whether or not Viagra is covered by your insurance agency? The simplest and the most effective way is by reading the terms of provided by your insurance company and enquiring them. If you look closely you will find that there is a list of drugs that are attached will include all those drugs that are covered by the insurer and their respective rates. Usually, the drugs are divided into different tiers; namely Tier I, Tier II and Tier III. While the tier I medicines are the most common ones and have the cheapest co-pays, medications under Tier II might be a little more expensive because of a brand name and therefore may require the patient to pay a little higher.

Finally, Tier III drugs are considered no essential and so there are put at the highest price. Viagra and other such drugs for erectile dysfunction come under the third category.

In order to know if your insurance company covers this drug, examine the company’s formulary or you can inquire them. If it does include Viagra, then you can go to a doctor and get a ‘Prescription’ which makes you eligible or even consult your doctor about your condition.

There has been a long going argument about provisions for pay of erectile dysfunction versus that of birth control pills for women. A lot of lawsuits have been filed against the health insurance companies and provide insurance for erectile dysfunction drugs but not for birth control pills for women. While the government has not yet cleared their stance on it, there are people who fear that filing of too many lawsuits will result in price hike of both the drugs. There are still others who argue that while the government health care centers do not have to, but that the private health care centers should incorporate Viagra under their policy.

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Viagra can be considered a very useful drug for treating the disorder for erectile dysfunction, if it is not covered by your health insurance, chances are that you might find it a little too expensive for regular use.