Check your Medicare plan’s formulary to see if Viagra (sildenafil) is covered. Coverage varies significantly between plans.
Medicare Part D plans use a tiered system. This means medications are categorized into different tiers based on cost, affecting your out-of-pocket expense. Viagra’s tier will determine your copay or cost-sharing.
Your plan’s deductible affects when you start paying your cost-sharing. You’ll likely pay the full cost until you meet your deductible. After that, you’ll pay your copay or coinsurance.
The coverage gap (donut hole) impacts how much you pay once you reach a certain amount of prescription drug spending. Within the coverage gap, you pay a higher percentage of your prescription costs.
Once you reach catastrophic coverage, you generally pay a small copay for your medications. This typically applies after a substantial amount spent out-of-pocket.
Medicare. gov provides a plan finder tool. Use this tool to compare plans available in your area and check medication coverage before enrolling.
Consider consulting a Medicare advisor or pharmacist. They can help you understand your specific plan’s benefits and costs regarding Viagra coverage.
Premium costs vary substantially between Part D plans. Compare the monthly premium with the expected cost-sharing to find the most affordable option for your needs.
Enrollment periods exist for switching plans. Review your needs annually to ensure your Part D plan continues to meet your medication needs.
