Medically reviewed by: Thomas Fischer (Pharmacist). This article has been written according to strict guidelines and medical standards.
Medically reviewed by: Thomas Fischer (Pharmacist)
Health insurance is something most people tend to rely on. This is regards to when it comes to the payment of medical-related costs and the medication itself. Health insurers, however, do not cover all medical expenses. There are specific rules and regulations that they do need to abide by.
This article will look at whether or not health insurance covers Cialis. Cialis is primarily an erectile dysfunction medication. However, it is a medication that is sometimes prescribed for the treatment of other conditions.
Does Health Insurance Cover Cialis?
In general, health insurance does not cover the expense of Cialis. The average health insurance company often offers no coverage for medication relating to sexual health. Even if a doctor or medical health professional prescribes the drug, it does not guarantee coverage.
Patients with sexually related ailments tend to be left paying the bill themselves. Due to this evasive stance of health insurance regarding erectile dysfunction medications, like Cialis, obtaining it has become an expensive endeavor.
The price factor and the fact that health insurers won’t assist financially can lead some men to try to obtain Cialis from illicit sources. This is an attempt to find it for a lower price. Fortunately, there are other generic medications. Medications that offer these patients a cheaper and legal alternative to the black market.
Did you know?
Why Doesn't Health Insurance Cover Cialis?
Cialis is an expensive original erectile dysfunction medication. It should only be taken under the instruction of a doctor or other health care professional.
Health insurance providers are not particularly discriminatory towards the drug Cialis. The brand of the erectile dysfunction medication doesn’t make a difference. In general, health insurance providers don’t usually cover medicines for erectile dysfunction. However, some health insurance providers may cover it in the event of it being used for an ‘off-label” condition. An example of this is benign prostatic hyperplasia (BPH).
The only time that this is not the case is if the medication is approved by the food and drug administration (FDA) to treat a different condition. It is for this reason that erectile dysfunction medication, such as Cialis, cannot be covered by health insurance providers.
Unfortunately, patients who suffer from this condition have to foot the bill of their medication out of their own pockets. Fortunately, before the patient is advised to take medication, they have to be examined by a doctor or medical health professional.
The examination process will help the doctor find a possible underlying cause. However, should the patient’s condition still require some form of erectile dysfunction medication, the health insurance will not be able to assist.
Does Medicare Cover Cialis?
Medicare refers to the health insurance that is funded by the federal government of the country. This program is in place to assist the elderly, and other social welfare members of society with their medical needs since Medicare is funded by the government. Money is generated from taxpayers, and there are a lot of debates about what should and should not be covered.
People will have to pay for these sexual health medications or equipment out of their own pockets. It should be noted that Cialis and related medications are not very cheap. It can become a challenge to obtain such medicines when it needs to be paid for in cash by the person. Patients on Medicare generally already require financial help.
However, part D of Medicare, which comes with a high premium, may cover ED medications. It’s worth checking with your state department of health to confirm if this is an option for you.
What Does Cialis Cost Without Insurance?
In terms of price, Cialis is considered an expensive type of medicine. It is one of the first medications of its kind. This ingredient is a phosphodiesterase five inhibitor. The cost of Cialis is approximately $400 for a month’s supply (30 pills). This works out roughly $13.33 per pill of Cialis. It is a costly medication. The question of why Cialis is so expensive can be asked. The answer is two-fold:
- Cialis is one of the first medications of its kind. Tadalafil is its active ingredient.
- As an original medication, it had to pass numerous, costly clinical trials.
How this works to drive up the price is as follows:
When original medications are first created, the company has to conduct expensive tests. Those tests are known as clinical trials. The purpose of these tests is to ensure that the medication is safe to be taken and that it works for its intended purpose.
The company has to cover all these costs. Once the product is approved and manufactured, the organization of the original medication tries to recover the loss in the price it charges for the drug. In other words, the cost of the clinical trials is passed on to the consumer. When an original medication is clinically approved, after it’s manufactured, its price does not have a ceiling.
There is no ceiling because there is little competition to encourage the sellers to reduce the price. These are the main two reasons why original medications such as Cialis are so expensive.
Our tip: How to buy Cialis with online prescription
How Can A Patient Obtain A Prescription For Cialis?
The first step to obtaining a prescription is for the person to recognize the symptoms of erectile dysfunction. Then the patient will need to go and consult a doctor. The doctor makes an informed assessment based on the individual applicant’s medical history.
There are two ways this can be done: by physically visiting a doctor at a clinic, or by going online and choosing a telehealth provider.
GP Clinic Visit
If the person prefers to meet with the doctor face-to-face, the following process may be followed. The current medical condition of the patient is considered along with any medications the person is currently taking.
The doctor or medical health professional will assess other aspects. Aspects aside from just the patient’s medical history. The current health conditions of the applicant will also be examined to find the root cause of the medical condition. The doctor will also take into account any risk factors and contraindications that may affect the person adversely.
The medical health professional will also assess if there are psychological factors that may be causing the issue of erectile dysfunction in the patient. If this is the case, the doctor will suggest other therapies first.
The doctor may recommend that the person seek counseling or talk therapy alternatives. This step comes before attempting to take any medication for the problem of erectile dysfunction. In other cases, the medical health professional may refer the patient to a specialist.
The patient may meet with a specialist such as a urologist to first ascertain if there is not a more significant medical health issue. At times it may be found that the person’s problem of erectile dysfunction is alleviated by one of the other solutions proposed by the medical health professional.
All these aspects must be taken into account if the doctor believes that it is best to put the person on Cialis at this point. The doctor or medical health professional will issue a script to the patient. Erectile dysfunction can be perceived as an embarrassing issue. A patient may be hesitant to physically consult a doctor or medical health professional about the problem. Fortunately for them, there is the middle ground.
Online Doctor as an Alternative
A patient is still able to seek medical advice from a doctor without needing to attend a consultation physically. This option eliminates the awkward factor of having to describe the symptoms of erectile dysfunction in person. However, they can still get medical advice.
This middle ground can be found in the form of telehealth and telemedicine services. These services are primarily aimed at remotely assisting patients with their medical needs. These services usually employ qualified medical health professionals who can help and consult with patients over various technological platforms.
They are still able to make informed assessments without necessarily having to meet the patient in person. The person must ensure that the telehealth provider that they have selected is authentic and verified.
The telehealth provider will usually ask the patient to complete a form as well as some other documentation so that an accurate assessment can be made. The doctor or qualified telehealth medical professional will assess the patient’s condition.
They will then confirm if erectile dysfunction medication is needed. At that point, they will provide the patient with a prescription. The patient can then use the prescription at a traditional pharmacy or online via the telehealth doctor’s partner pharmacy.
- Are Tadalafil and Cialis the Same Thing? Differences & Similarities
- Viagra or Cialis – Which Treatment Is Better For Me?
- Tadalafil Or Sildenafil – Which Is Better For Me?
- Stendra vs. Cialis – Which Treatment Is Better For Me?
- Cialis vs. Levitra – Which Medicine Is Better For Me?
- Viagra, Cialis, or Levitra – Comparing Three ED Medicines
Article Sources
- Questions and Answers for Cialis (tadalafil). In: U.S. Food and Drug Administration. URL: https://www.fda.gov/
- Parker-Pope, Tara (August 28, 2009). “The Cost of Treating Erectile Dysfunction“. New York Times.
- CIALIS- tadalafil tablet, film coated. Eli Lilly and Company. URL: https://uspl.lilly.com/
- A Study of Tadalafil and Sildenafil in Men With Erectile Dysfunction in China. Information provided by (Responsible Party): Eli Lilly and Company. URL: https://clinicaltrials.gov/ct2/show/NCT01352507