FAQ

Frequently asked questions

Does insurance cover Viagra or Cialis?
Usually not. Most US plans exclude ED medication specifically, brand and generic alike. Some cover tadalafil when it is prescribed for benign prostatic hyperplasia rather than for ED, which is a conversation to have with your prescriber rather than a loophole to engineer.
Does insurance cover the appointment?
Frequently, yes — a telehealth or in-person visit is often billed as an ordinary consultation even when the resulting prescription is not covered. This is the single most useful thing to establish, and most people never ask.
Is my copay cheaper than paying cash?
Often it is not. Ask the pharmacist to run both your insurance and a free discount card and charge you the lower — that is a routine request. You cannot combine the two on one fill, but you can always take the better of them.
Does a discount card count towards my deductible?
No. Coupon purchases are cash transactions and do not count towards a deductible or out-of-pocket maximum. If you expect to hit either this year, run the arithmetic across the whole year rather than one fill.
My claim was denied — is that the end of it?
Not necessarily, particularly where there is an underlying condition involved. See appealing an insurance denial for what actually works and what the deadlines are.