# Encore Vacuum Device Review: The Unglamorous Thing That Works

> A medical-grade vacuum device produces a usable erection in around 90% of men, works when nothing else does, costs about $130 once, and nobody markets it. Also: Medicare stopped paying for these in 2015, and most people still do not know.

- **Source:** ED Treatment Guides (https://www.edtreatmentguides.com/encore-vacuum-reviews)
- **Last updated:** 2026-08-02
- **Type:** review
- **Service:** Encore
- **What it is:** Medical-grade vacuum erection device from an established manufacturer. Sold with or without a prescription through medical supply retailers
- **Editorial rating:** 4/5
- **Best for:** Men who cannot take PDE5 inhibitors, men where tablets have stopped working, and penile rehabilitation after prostate surgery.
- **Recommended:** Anyone on nitrate medication, anyone for whom tablets have failed, and anyone who wants the lowest lifetime cost of any effective treatment. It is the least fashionable recommendation on this site and one of the soundest.
- **Medications offered:** Encore Deluxe — battery and manual pump heads, cylinder, tension rings, case; Encore Standard — manual pump only; No medication. This is mechanical therapy
- **Availability:** Available nationwide. No prescription is required to buy one, though a prescription helps if you want an FSA or HSA reimbursement or a clinician's sizing advice.
- **Website:** https://timmmedical.com/vacuum-therapy-systems/
- **Commercial relationship:** No commercial relationship. Links to this service earn us nothing.

## Key points

- **Around 90% of men achieve an erection sufficient for intercourse** — the highest success rate of any non-prescription option.
- Works mechanically, so it is **unaffected by nerve damage, artery disease or hormones**, and completely safe with nitrates.
- About **$130 once**, then nothing. Roughly a tenth of a subscription over five years.
- **Medicare has not covered these since 1 July 2015** under the ABLE Act, and Medicare Advantage cannot cover them either.
- Buy medical-grade for the **vacuum limiter**. Novelty pumps without one are how injuries happen.

## Scores

| Criterion | Score | Note |
| --- | --- | --- |
| Clinical quality | 4.4/5 | The strongest evidence of any non-prescription option we cover. Vacuum devices appear in the AUA guideline, produce an erection sufficient for intercourse in around 90% of men, work independently of nerves, arteries and hormones, and are used in penile rehabilitation protocols after prostatectomy. Held below the top only because long-term continuation rates are frankly poor. |
| Transparency | 4/5 | An established medical device manufacturer selling a cleared product, with specifications, ring sizes and instructions published rather than teased. No inflated FDA language and no miracle claims. The gap is that retail listings are scattered across medical supply resellers with inconsistent pricing. |
| Value | 4.5/5 | The best value of anything on this site over a five-year horizon. Around $130 once, then nothing. No subscription, no refills, no renewals, no price rise after the introductory period. Tension rings are the only consumable and they cost a few dollars. |
| Experience | 2.8/5 | The weak point, and the honest reason continuation rates are low. It interrupts sex, it takes practice, the erection pivots at the base and feels different, and the whole thing is about as spontaneous as it sounds. Most of the men who abandon it do so in the first month. |
| Privacy | 4/5 | A one-off purchase of a physical object, with no questionnaire, no prescriber required and no recurring charge. It ships in a box that is not discreet in the way a pill is discreet, and it lives somewhere in your house — which is a different privacy problem from a data one. |

**Overall: 4/5**

## Pros

- **Around 90% of men achieve an erection sufficient for intercourse**
- Works mechanically — unaffected by nerve damage, artery disease or hormone levels
- **Completely safe with nitrates**, unlike every PDE5 inhibitor
- Around $130 once, with essentially no running cost
- Standard in penile rehabilitation after prostate surgery
- Battery and manual pump heads in the Deluxe, so it works either way
- A vacuum limiter, which is the safety feature that separates medical-grade from novelty

## Cons

- **Interrupts sex** — there is no way around this
- Long-term continuation is often under 50%, mostly for that reason
- The erection pivots at the base and can feel cool or numb
- Takes several sessions of practice before it works reliably
- **Medicare has not covered these since July 2015**
- Needs care with anticoagulants, and the 30-minute ring limit applies

## Pricing

| Plan | Price | Includes |
| --- | --- | --- |
| Encore Deluxe (battery + manual) | About $125–$170 | Both pump heads, cylinder, seven tension rings in assorted sizes, loading cone, case |
| Encore Standard (manual) | About $135 | Manual pump, cylinder, rings, case |
| Replacement tension rings | A few dollars each | The only consumable. Replace when they lose elasticity |
| Five years of the cheapest subscription, for scale | $1,200+ | For comparison. A vacuum device costs roughly a tenth of that over the same period |

_Prices checked 2026-08-02. Verify on the provider's own site before ordering._

## Verdict

This is the treatment nobody advertises, which is exactly why it is under-used. A medical-grade vacuum erection device draws blood into the penis with negative pressure and holds it there with a tension ring at the base, and it produces an erection sufficient for intercourse in around 90% of men. That figure holds where drugs fail, because the mechanism does not care about your nerves, your arteries or your testosterone — it is physics. It is standard equipment in penile rehabilitation protocols after prostatectomy, it appears in the AUA guideline, and it is the option for men taking nitrates for angina, for whom every tablet on this site is absolutely contraindicated. The Encore Deluxe, with both battery and manual pump heads, runs around $130 to $170 once, and then costs essentially nothing forever. Over five years that is a tenth of the cheapest subscription. Now the honest part, and it is the reason we scored experience at 2.8: it interrupts sex, it takes practice, and the erection feels different — it pivots at the base because the rigidity stops where the ring does, and it can feel cool or slightly numb. Long-term continuation is frequently under 50%, and almost all of that attrition happens in the first month, before anyone has got good at it. Two practical notes that catch people out. First, Medicare stopped covering vacuum erection devices entirely for dates of service on or after 1 July 2015 under the ABLE Act — and Medicare Advantage plans cannot offer it either, so anyone telling you it is covered is working from old information. Second, buy medical-grade. The single feature that matters is a vacuum limiter that caps the negative pressure, and the cheap novelty pumps sold without one are how people injure themselves.

## How it works, and why it works when drugs do not

A vacuum erection device is three parts: a clear cylinder that fits over the penis, a pump that removes air from it, and an elastic tension ring that transfers from the base of the cylinder onto the base of the penis. Removing air creates negative pressure, negative pressure draws blood into the erectile tissue, and the ring then stops it draining back out. You have an erection, and it lasts as long as the ring is on.

> **Why this is a different category of treatment**
>
> Every drug on this site works by amplifying a signal your body is already producing — sildenafil does nothing without arousal and intact nerve signalling, because it blocks the enzyme that breaks down the messenger rather than creating the messenger. A vacuum device does not participate in that chain at all. It moves blood mechanically. That is why it works after prostate surgery, in advanced diabetic neuropathy, with severe vascular disease, and in men for whom tablets have simply stopped doing anything.

It is also why it is the answer for the group with the fewest options. If you take nitrates for angina, PDE5 inhibitors are absolutely contraindicated — the combination can drop blood pressure catastrophically. That rules out sildenafil, tadalafil, vardenafil, avanafil and every compounded mixture of them, permanently, not just today. A vacuum device has no interaction with anything, because there is nothing to interact.

## The evidence, which is better than the marketing budget

**What the literature and guidelines say**

| Question | Answer |
| --- | --- |
| Does it produce a usable erection? | In around 90% of men, across a wide range of underlying causes |
| Is it in the guidelines? | Yes — vacuum erection devices are a recognised option in the AUA erectile dysfunction guideline |
| Does it work after prostate surgery? | Yes, and it is used deliberately in penile rehabilitation protocols to maintain tissue oxygenation while nerves recover |
| Does it work in diabetes? | Yes. Mechanical action is independent of the neuropathy that limits drug response |
| Do people keep using it? | Often not. Long-term continuation is frequently reported under 50%, and dropout is concentrated in the first weeks |
| Is it safe with nitrates? | Yes. No pharmacological interaction exists |

_See our [vacuum device treatment page](https://www.edtreatmentguides.com/treatments/vacuum-erection-device) for the full clinical picture and the rehabilitation protocols._

The gap between a 90% success rate and a sub-50% continuation rate is the whole story of this product, and it is not a mystery. Men stop because it is awkward, not because it fails. Which means the single highest-value thing you can do is get through the first three or four attempts — the learning curve is short and steep, and most of the people who quit never reached the top of it.

## Medicare stopped paying for these in 2015

> **The fact most retailers have not updated**
>
> The Achieving a Better Life Experience (ABLE) Act of 2014 eliminated Medicare coverage for vacuum erection devices. For dates of service on or after **1 July 2015**, the relevant codes (L7900 and L7902) are statutorily non-covered. Because the exclusion is statutory, **Medicare Advantage plans cannot offer it as a supplemental benefit either**. You will still find retailer pages saying 'many insurance plans including Medicare may cover VEDs with a prescription'. For Medicare, that has been wrong for over a decade.

So the practical position is: assume you are paying cash. That is less painful than it sounds, because the cash price is around $130 and there is nothing after it — the reason this was ever an insurance question is that devices used to be billed at several times the retail price.

- **Commercial insurance** — Some plans do cover VEDs, usually with a prescription and often only after documented failure of oral therapy. Worth one phone call before you buy. Our [insurance appeals guide](https://www.edtreatmentguides.com/guides/insurance-appeals) covers what to do with a denial.
- **FSA and HSA** — Generally eligible as a medical expense, particularly with a prescription or a letter of medical necessity. This is the most reliable way to make it pre-tax money.
- **VA benefits** — Veterans' coverage operates separately from Medicare and has historically provided devices. Ask your VA provider directly.
- **Medicare** — No. Not since 1 July 2015, and not through Medicare Advantage.

## Buying one: the feature that actually matters

> **Buy one with a vacuum limiter**
>
> This is the only specification that matters for safety. A medical-grade device caps the negative pressure it can generate. A novelty pump without a limiter can be pumped to pressures that rupture blood vessels, cause petechiae and bruising, and in the worst cases do lasting damage. The price difference between a limited and an unlimited pump is small. The difference in what can go wrong is not.

- **Battery or manual?** — The Deluxe includes both heads, which is why it is the one worth buying. A battery head is easier if hand strength or dexterity is limited — arthritis, neuropathy, after a stroke. A manual head gives finer control over the rate, which some men prefer, and never needs a battery at the wrong moment.
- **Ring sizes** — The Deluxe ships with seven tension rings in assorted sizes, and getting this right is most of the difference between a device that works and one that does not. Too loose and the erection drains; too tight and it is painful and the 30-minute limit becomes a hard ceiling you will feel.
- **Cylinder fit** — The cylinder needs to seal against the body. A loading cone helps get the ring on. Trimming pubic hair at the base genuinely improves the seal, which is the sort of thing nobody tells you and everybody discovers.
- **Lubricant** — Water-based, generously, at the base of the cylinder. Without it there is no seal, and without a seal there is no vacuum. This is the single most common reason a first attempt fails.

## Getting through the first month

Given that most abandonment happens early, this section is the most useful thing on the page. Treat the first few sessions as practice, alone, with no expectation of sex at the end of them.

1. **Practise on your own first**, three or four times. The goal is competence with the equipment, not an occasion.
2. **Lubricate the cylinder base generously.** Most failed first attempts are seal failures, not device failures.
3. **Pump slowly, in stages.** Rapid pumping is uncomfortable and no faster in practice. Pause when you feel pressure build.
4. **Get the ring size right.** Start with the middle of the range supplied and adjust. A ring that is too tight is the main source of pain complaints.
5. **Start the thirty-minute clock the moment the ring is on.** This is the same limit as any [constriction ring](https://www.edtreatmentguides.com/treatments/constriction-rings) and it is not negotiable.
6. **Expect it to feel different.** The erection pivots at the base because rigidity stops at the ring, and it may feel cool. That is normal and not a sign anything is wrong.
7. **Involve your partner early.** Men who present it as a shared piece of equipment rather than a private embarrassment are markedly more likely to still be using it a year later.

> **When to stop and ask a clinician**
>
> Pain during use, bruising or pinpoint red spots, numbness that persists after the ring is off, or trapped ejaculation that is uncomfortable. Also check first if you are on anticoagulants, have sickle cell disease or another bleeding disorder, or have [Peyronie's disease](https://www.edtreatmentguides.com/causes/peyronies-disease) — all of which need advice before you start rather than after.

## Frequently asked questions

### Do vacuum pumps really work for ED?

Yes — around 90% of men achieve an erection sufficient for intercourse, which is the highest success rate of any option you can buy without a prescription. The mechanism is mechanical, so it works where drugs fail: after prostate surgery, in advanced diabetic neuropathy, and in severe vascular disease.

### Does Medicare cover a vacuum erection device?

No. The ABLE Act of 2014 eliminated Medicare coverage for VEDs, and for dates of service on or after 1 July 2015 the relevant codes are statutorily non-covered. Because the exclusion is statutory, Medicare Advantage plans cannot cover them either. Some commercial plans still do, and FSA and HSA funds are generally eligible.

### Do I need a prescription?

No, you can buy one over the counter. A prescription is still worth having — it helps with FSA, HSA and commercial insurance reimbursement, and it means a clinician has sized the device and checked nothing rules it out for you.

### How much does the Encore Deluxe cost?

Around $125 to $170 depending on retailer, for both pump heads, the cylinder, seven tension rings and a case. Replacement rings cost a few dollars. There is no subscription and nothing recurring, which is why it is the cheapest effective treatment over any multi-year period.

### Is it safe if I take nitrates?

Yes. There is no drug and therefore no interaction. For men on nitrate therapy for angina — where every PDE5 inhibitor is absolutely contraindicated — a vacuum device is one of the few effective options available.

### Why do so many men stop using it?

Because it interrupts sex and takes practice, not because it stops working. Continuation is often reported under 50%, and dropout is concentrated in the first few weeks. Practising alone three or four times before using it with a partner is the single biggest predictor of sticking with it.

### What is the difference between this and a cheap pump online?

A vacuum limiter. Medical-grade devices cap the negative pressure they can generate; novelty pumps often do not, and over-pumping can rupture blood vessels and cause bruising or lasting injury. It is the only specification worth being fussy about.

### How long can the ring stay on?

Thirty minutes, maximum — the same rule as any constriction ring. Remove it immediately for pain, numbness, coldness or colour change, and never fall asleep with one on.

## Sources

- American Urological Association. [Erectile Dysfunction: AUA Guideline](https://www.auanet.org/guidelines-and-quality/guidelines/erectile-dysfunction-(ed)-guideline) (2018)
- National Institute of Diabetes and Digestive and Kidney Diseases. [Treatment for Erectile Dysfunction](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/treatment)
- Urology Care Foundation. [What is Erectile Dysfunction?](https://www.urologyhealth.org/urology-a-z/e/erectile-dysfunction-(ed))
- National Library of Medicine. [PubMed — search the primary literature](https://pubmed.ncbi.nlm.nih.gov/)
- U.S. Food and Drug Administration. [Device registration and listing — what it does and does not mean](https://www.fda.gov/medical-devices/how-study-and-market-your-device/device-registration-and-listing)

## Related pages

- [Encore Deluxe Review: 90% Success, $130 Once, and Nobody Advertises It](https://www.edtreatmentguides.com/encore-vacuum-reviews/encore-deluxe)
- [Vacuum Erection Devices: How Penis Pumps Actually Work](https://www.edtreatmentguides.com/treatments/vacuum-erection-device)
- [Vacuum Device vs Injections: Choosing Your Second-Line Treatment](https://www.edtreatmentguides.com/compare/vacuum-vs-injections)
- [Best ED treatments without a prescription](https://www.edtreatmentguides.com/best-otc-ed-treatments)
- [What to Do When ED Medication Doesn't Work](https://www.edtreatmentguides.com/guides/when-medication-fails)

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_This page is general health information, not medical advice. It cannot account for your own history, medications or risk factors. Talk to a licensed clinician before starting, stopping or changing any treatment._

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