Does Health Insurance Cover Erectile Dysfunction?
Some health insurance plans may cover treatments for erectile dysfunction, although coverage typically depends on two factors. The first is the specific details of your particular plan and the second is the type of treatment you seek.
Many health insurance plans may cover treatment of the underlying causes of erectile dysfunction, although far fewer, if any, cover treatments that include prescription medication used to treat the symptoms. Your first goal if you a suffering from erectile dysfunction could be a checkup to rule out any underlying causes, with the hopes of correcting the problem.
What are the underlying causes?
Erectile dysfunction can stem from a host of underlying issues that pertain to your physical or mental health, according to the Mayo Clinic. The clinic notes that a physical issue is behind the condition in most cases, and the issue could be anything involved with your muscles, nerves, hormone levels, blood vessels, or even brain processes.
Several of the more common underlying conditions that can result in erectile dysfunction include high cholesterol, high blood pressure, heart disease, diabetes, obesity, and clogged blood vessels. Others include Parkinson’s disease, multiple sclerosis, low levels of testosterone, and metabolic syndrome. The latter is a combination of issues consisting of high cholesterol, high levels of insulin, high blood pressure, and a higher-than-normal distribution of body fat in the waist area.
Sometimes the condition is caused by a treatment or procedure used to correct another malady, such as prostate cancer treatments or certain prescription medications. Other times, injuries or procedures that have an impact on the spinal cord or pelvis may be to blame. Peyronie’s disease, which is the formation of scar tissue in the penis, can also lead to erectile dysfunction.
Tobacco use and smoking have been linked to erectile dysfunction. It can also stem from the abuse or misuse of alcohol and other substances.
When it comes to mental health, good old stress can often be to blame. Depression and anxiety can hinder an erection, as can other mental health issues that serve as a blockade for sexual feelings and excitement. Relationship issues are also on the list, whether the relationship is suffering from a lack of communication or is strained for any number of reasons.
What if an underlying cause is not to blame?
If you and your doctor have ruled out underlying causes, or you tried treatment for an underlying issue that did not correct erectile dysfunction, other treatment options are still available. One of the most talked-about is Viagra and other oral prescription medications meant to increase blood flow to the area in the hopes of correcting the problem.
Viagra is one of the most well-known medication options, and others include Cialis and Levitra. While the medications are a bit different, the Mayo Clinic notes they all work in the same manner. They help your body best use the nitric oxide it produces to relax muscles and thereby increase circulation in the area.
Even if your health plan does cover the use of these medications, the New York Times says plans may only cover a small percentage of the cost. This can leave you paying a lot of money out-of-pocket for erectile dysfunction medication.
The medications also come with many side effects. These include headaches, stomachaches, a stuffed-up nose, and changes in your vision. They can also be dangerous if you have a medical history that includes stroke, heart disease, high blood pressure, low blood pressure, or diabetes that is neither controlled nor monitored.
One more caveat with the medications is their hazardous interaction with certain other drugs. The Mayo Clinic says not to try them if you already take nitrate medications, are on blood thinners or alpha blockers, or take drugs for high blood pressure.
Are those the only medications that can help?
Another medication that may be more likely to be covered by health insurance is alprostadil, although it may be covered under the medical benefits rather than the prescription benefits. Alprostadil is available as a suppository or injection and comes with its own set of side effects. These include bleeding in the area and the formation of tissue inside the penis.
Testosterone replacement therapy may also help correct erectile dysfunction if the cause stems from low levels of testosterone. Once again, your insurance plan may not cover testosterone under the prescription benefits, although it may be covered under the plan’s medical benefits.
What about options other than medication?
A penis pump is another remedy that can be prescribed for the condition, and one that does not involve the use of medication. While the vacuum-like device is often costly, health plans may cover at least some of the cost. The pump can last for several years, reducing the overall cost when compared to continuous use of costly medications. If you go for a generic pump available without a prescription, you may be able to cut costs even lower.
Visiting with your doctor is the best way to explore the options that may be most effective in your specific case. Reading the fine print in your health insurance plan is the best way to ascertain what treatments may be covered.