Why Is Cialis Not Covered By Insurance?

Table of Contents

I. What is the cost of Cialis without insurance coverage?

    i. How does pricing compare with Canadian pharmacies?

II. Is Cialis covered by any insurance providers?

    i. Understanding Medicare provisions

    ii. Medicaid coverage for Cialis

    iii. Plans from the Health Insurance Marketplace

III. Strategies to reduce Cialis expenses

    i. Consider opting for the generic tadalafil

    ii. Utilizing Lilly Cares for financial aid

    iii. Securing Cialis through a Canadian online pharmacy

IV. Purchase Cialis from a certified Canadian pharmacy

If you experience erectile dysfunction (ED), acquiring Cialis (tadalafil) may become a priority for you. After discussing your sexual health concerns with your doctor, you leave the consultation with a prescription in hand. However, upon arriving at your pharmacy, you discover that your insurance plan does not cover the medication.

So, what could be the reason behind this? The reality is that many individuals encounter obstacles when needing medications that aren’t included in their insurance coverage. In the case of Cialis, it is often classified as a non-essential medication which means that, unlike vital treatments for diabetes or heart conditions, ED medications are not universally deemed necessary for health maintenance.

The rationale behind insurance companies and regulatory bodies declaring Cialis as non-essential can be contentious. Indeed, sexual health significantly contributes to overall well-being; an unsatisfactory sexual life can adversely impact one’s self-esteem, mental health, and interpersonal relationships—resulting in profound life changes.

Unfortunately, unless you anticipate significant changes to your insurance policy, out-of-pocket expenses for Cialis may be unavoidable. However, there are options available to potentially alleviate these costs. This article will guide you through several effective strategies.

What is the cost of Cialis without insurance coverage?

Let’s examine the costs you might encounter; we'll reference the pricing available at the time of writing.

Per GoodRx, brand-name Cialis at a dosage of 5 mg ranges from about $13 per pill on the lower end. In comparison, generic Cialis, also at 5 mg, is similarly priced at around $12 per pill when purchased at retail.

a person holding open an empty wallet

How does pricing compare with Canadian pharmacies?

For individuals exploring the potential to purchase Cialis at reduced prices, Canadian pharmacies like RxConnected can offer significant advantages. The Canadian government regulates drug prices, leading to lower costs. For instance, the pricing for Cialis or its generic equivalent might be between $2 to $6 per pill in Canada, in addition to a flat dispensing fee of $10.

At RxConnected, we provide brand-name 5 mg Cialis for approximately $3 to $8 per pill, while generic 5 mg options can range from $1 to $3 per pill.

Is Cialis covered by any insurance providers?

In the United States, each insurance company decides which medications to include in their coverage plans. If you qualify for government-backed insurance like Medicare or Medicaid, you may apply to see if these plans cover some or all of your medication costs. Generally, however, erectile dysfunction medications such as Cialis (tadalafil) are excluded from coverage, except under specific circumstances.

Let’s dive deeper into your options regarding insurance.

Understanding Medicare provisions

Older adults suffering from ED may be eligible for Medicare, but generally, this insurance does not cover ED medications like Cialis. Coverage is limited only to instances where the drug is used to treat other qualifying conditions, such as 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) [1]

You can review the amendment directly on Congress' official website. [2]

Medicaid coverage for Cialis

ED affects men from diverse financial backgrounds. If you qualify for Medicaid, it’s crucial to determine if your state covers ED medications like Cialis.

Medicaid operates at the state level, so check your local Medicaid program for specific coverage details. For example, in Washington, tadalafil is listed as a non-preferred medication under Apple Health. [3]

Plans from the Health Insurance Marketplace

Numerous health insurance options are accessible through the Marketplace, especially for individuals ineligible for Medicaid or Medicare. We advise taking time to compare different plans to find one that suits your needs.

For instance, some plans like BlueCross BlueShield of North Carolina may cover Cialis for ED treatment if you have tried both sildenafil and generic tadalafil without success or have a medical reason precluding you from those alternatives. [4]

Strategies to reduce Cialis expenses

If you’re unable to find an insurance plan that covers Cialis, consider these strategies to save money!

Consider opting for the generic tadalafil

If you must pay out-of-pocket for Cialis, choosing the generic version, tadalafil, can lead to considerable savings.

Generic medications frequently cost much less than their brand-name equivalents. Tadalafil is the generic for Cialis and is generally much cheaper, making it an appealing alternative.

There’s a common misconception that brand-name drugs are always superior to generics. In reality, according to the FDA, there is virtually no difference in effectiveness between generics and their brand counterparts, as they both contain the same active ingredient. [5]

Lilly Cares: Assistance Program for Cialis

Eli Lilly, the manufacturer of Cialis, offers a patient assistance program for individuals needing help affording their medication. Cialis is among the medications included under the Lilly Cares program. [6]

However, the program may not specify if assistance can only be used for non-ED-related conditions.

Securing Cialis through a Canadian online pharmacy

A convenient way to obtain affordable Cialis is to purchase it through a certified online Canadian pharmacy like RxConnected. As a reputable online pharmacy, we ship medications from licensed pharmacies around the world. The lower prices often result from government regulations in the countries of origin, ensuring more affordable options.

Buy Cialis from a certified Canadian pharmacy

Erectile dysfunction is a legitimate medical condition, and receiving appropriate treatment can significantly enhance your quality of life. At RxConnected, we believe everyone deserves access to the medications they need, irrespective of their financial situation. Consider purchasing Cialis or tadalafil online today to enjoy substantial savings! If you have further questions about our services or inquire about existing Cialis discounts, don't hesitate to reach out to us.

FAQs

Where should I buy Cialis?

If you’re wondering where to procure Cialis, you have multiple options, including your local pharmacy. However, the best approach might be purchasing from an online Canadian pharmacy such as RxConnected. With us, you’re able to choose between generic and brand-name Cialis, both at competitive prices, while enjoying discreet delivery to your doorstep.

When should I take Cialis for best results?

Cialis generally takes about 30 minutes to begin working, but the timeframe may vary from person to person. It’s advised to take Cialis at least 30 minutes before engaging in sexual activity. For those taking Cialis daily, adhering to a consistent schedule at the same time each day can yield optimal outcomes.

What other methods are available for saving on Cialis?

Most health insurance policies, including Medicare prescription drug plans (Part D), typically do not cover Cialis expenses, leaving many men with ED to seek affordable options independently. While coupons may be beneficial, purchasing through an online Canadian pharmacy often provides the most significant savings.

For instance, RxConnected allows you to access both generic and brand-name options, maximizing your savings—generic tadalafil often offers the most considerable price advantage, sometimes being over three times cheaper than the brand-name variant when purchased in bulk.

How much does Cialis cost per pill?

The cost of Cialis per pill depends on several factors:

• Whether you choose generic tadalafil or brand-name Cialis
• The specific dosage required
• The quantity purchased

For instance, ordering a three-month supply of 90 generic tadalafil 5 mg pills may reduce the cost to approximately $1.12 per pill. Conversely, for 84 brand-name Cialis 5 mg pills, the price may come to around $3.67 per pill. For detailed pricing, visit our Cialis product page for current options.

How much Cialis can I take?

The maximum recommended dose of Cialis is 20 mg, typically prescribed for those taking it on an as-needed basis. Generally, one should not exceed a daily intake of 20 mg of Cialis. Consistently exceeding this dosage can lead to adverse effects impacting your brain, kidneys, lungs, and more. Overdosing may result in side effects such as headaches or back pain, and caution should be exercised. Only use higher doses if explicitly instructed by a healthcare professional.

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 professional(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.