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Why Is Cialis Not Covered By Insurance?

Wednesday 26 May 2021
Cialis
6 minute(s) read

Table of Contents


I. How much does Cialis cost without insurance?

    i. How much does Cialis cost in Canada? Why is it so cheap at Rx Connected?

II. Are there any insurance plans that cover Cialis?

    i. Medicare

    ii. Medicaid

    iii. Marketplace Insurance

III. Are there other ways to get cheaper Cialis?

    i. Buy Generic

    ii. Lilly Cares: Assistance Program for Cialis

    iii. Buy Cialis from an Online Canadian Pharmacy Service

IV. Buy Canadian Pharmacy Cialis


If you suffer from erectile dysfunction (ED), you may be very eager to procure the medication that will relieve your symptoms. So you approach your doctor and have an intimate discussion about your sexual health. Your doctor then prescribes you Cialis (tadalafil). Relieved, you take your prescription to your preferred pharmacy only to realize that it is not covered by your insurance plan

Why? Many Americans run into the conundrum of needing drugs that are not covered by insurance. This is likely because certain drugs, like Cialis (tadalafil), are not deemed “medically necessary.” This means that unlike, say, a diabetes drug, ED drugs are not required to maintain adequate health. For example, Rep. Steven King (R-Iowa) once told WebMD that if sex was truly medically necessary, there wouldn’t be elderly priests.[1]

Such a decision by insurance companies and government agencies can be controversial. After all, sexual health can be a major component of one’s general health. An unsatisfactory sex life can lead to serious damage to self-esteem, mental health, and relationships. In a way, it can be life-changing. 

Unfortunately, unless there’s a major change in your insurance policy on the horizon, you’re stuck paying out of pocket for your prescription Cialis. But there may still be a way to afford it! In this article, we’ll run through a few potential strategies.

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How much does Cialis cost without insurance?

First, let’s take a look at the prices we’re dealing with. (We will cite prices we found at the time this article was written).

According to GoodRx, brand-name Cialis (5 mg) cost about $13 per pill on the low end. Meanwhile, generic Cialis at 5 mg is similar at about $12 per pill retail price.

a person holding open an empty wallet

How much does Cialis cost in Canada?

Newcomers to Rx Connected may be surprised to learn that Cialis or generic Cialis from Canada on our website is so cheap. This is because drug prices in Canada are kept in check by the government. So our prices are on par with Canadian prices in general.

Using Pharmacy Compass, a Canadian price comparison tool, 5 mg generic and brand name Cialis cost between $2 and $6 per pill, plus a flat dispensing fee of $10.

At Rx Connected, we offer brand-name 5 mg Cialis for $3 to $8 per pill. Generic 5 mg Cialis at Rx Connected costs between $1 and $3 per pill.

Are there any insurance plans that cover Cialis?

In the United States, each insurance agency chooses which drugs to cover. If you are eligible for government-funded insurance like Medicare or Medicaid, then you can apply for these programs to cover your drug costs. The coverage of ED drugs like Cialis (tadalafil) is typically not covered by federal insurance programs, but they may be covered in specific cases. Now, let’s look at your insurance plan possibilities. 

a couple getting into an argument in the sunset

Medicare

Many men suffering from ED are older adults and may be eligible for Medicare. Unfortunately, in general, ED drugs are not covered by Medicare. They are only covered if used to treat another condition like pulmonary hypertension.

Effective January 1, 2007, P.L. No. 109-91, section 103, amended section 1860D-2(e)(2)(A) of the Act to exclude from the statutory definition of a Part D drug “… a drug when used for the treatment of sexual or erectile dysfunction, unless such drug were used to treat a condition, other than sexual or erectile dysfunction, for which the drug has been approved by the Food and Drug Administration” (FDA). An erectile dysfunction (ED) drug meets the definition of a Part D drug when it is prescribed for medically accepted indications other than sexual or erectile dysfunction (such as pulmonary hypertension) for which the drug has been approved by FDA. - Review of Erectile Dysfunction Drugs in the Medicare Part D Program (Department of Health & Human Services) [2]

You can read the amendment yourself on Congress' official website. [3]

Medicaid

ED can affect men from any income bracket. If you are eligible for or enrolled in Medicaid, you may be interested in whether it covers ED drugs like Cialis.

Because Medicaid is chiefly run through the state, check your state Medicaid program to confirm the details. For example, in Washington, tadalafil is listed as a non-preferred drug by Apple Health. [4]

Marketplace Insurance

There are many more health insurance plans available on the Marketplace for Americans ineligible for Medicaid or Medicare. We recommend you spend some time shopping around to see if there’s a plan that works for you.

For example, BlueCross BlueShield of North Carolina covers Cialis for treatment of ED if you’ve tried and found no success with sildenafil and generic tadalafil or if for some medical reason you cannot take sildenafil or generic tadalafil. [5]

an older man in a restuarant

Are there other ways to get cheaper Cialis?

If you can’t find an insurance plan that covers Cialis, there are still a few ways to save!

Buy Generic

If you have no choice but to pay full-price for medication, choose generic.

Generic versions of drugs are almost always significantly cheaper than their brand-name counterparts. The generic form of Cialis is tadalafil.

The belief that brand-name drugs are superior to generic ones is a common misconception. According to the FDA, virtually no difference between generic and brand name drugs exists as they both use the exact same active ingredient.[6] Very rarely, some people may have an adverse reaction to the non-medicinal filler ingredients in either version of the drugs.

Lilly Cares: Assistance Program for Cialis

Eli Lilly, the company that produces Cialis, offers a patient assistance program for those who need some extra help affording their medication. Cialis is listed as an available medication under the Lilly Cares program. [7] However, the program’s website does not indicate whether this assistance can only be used to procure Cialis to treat non-ED ailments.

Buy Cialis from an Online Canadian Pharmacy Service

One easy way to find cheap Cialis: buy it through Rx Connected! As a leading online Canadian pharmacy website certified by the Canadian International Pharmacy Association (CIPA), we are able to ship medications from licensed pharmacies around the world. The medications on our website are cheaper because, in their countries of origin, government agencies negotiate pricing with pharmaceutical companies to ensure prices remain reasonably affordable. No similar negotiation system currently exists in the United States.

Buy Canadian Pharmacy Cialis

Erectile dysfunction is a legitimate medical condition and treating it appropriately can vastly improve your quality of life. At Rx Connected, we believe everyone should be able to afford the medicine they need, regardless of income. So buy Cialis or tadalafil online today and save money! Contact us if you have more questions about our services or to inquire about any available Cialis coupons.

DISCLAIMER: The content in this article is intended for informational purposes only. This website does not provide medical advice. In all circumstances, you should always seek the advice of your physician and/or other qualified health professionals(s) for drug, medical condition, or treatment advice. The content provided on this website is not a substitute for professional medical advice, diagnosis or treatment.