ED Treatments and Insurance Coverage

Sexual intimacy is a very important part of life, especially continuing into later age. Many couples experience an increase in sexual activity later in life, and maintaining the ability to have healthy intercourse is important to all of those couples. Erectile dysfunction is a fairly common problem, affecting around one in four men. Its prevalence rises in men over the age of 60, and it can pose a serious impediment toward experiencing a fulfilling relationship with your loved one. It not only helps to know what forms of treatment are out there, but also which ED treatments are covered by insurance and which are not.


For more information, check out our “Guide to Erectile Dysfunction“.


While countless ED treatments are advertised, there are only a handful of effective treatments on the market for erectile dysfunction: among those are surgery, prescription medications, penile injections, and vacuum therapy. Unfortunately insurance coverage has become scarce or nonexistent for proven ED solutions. For many years Vacuum Therapy was one of the only effective treatments for ED that was routinely covered by insurance.

In July of 2015, Medicare dropped coverage of vacuum therapy for ED patients. The absence of coverage had already been established for other erectile dysfunction treatments: there’s seldom any coverage of medication or injection for ED, as is true for penile implants. Some private insurance companies may still offer coverage for vacuum therapy, but the private companies tend to follow the example that Medicare sets, so coverage is now being phased out by private insurance carriers. Since it’s been a slow process, there’s still a lot of misinformation out there, and your doctor may not be aware that vacuum therapy or other treatments are being dropped by your insurance provider.

How to Get Insurance for ED Treatments

Exceptions do exist, and coverage is still applicable by some insurance companies and in some cases. Those cases vary from insurance company to insurance company, and coverage is often determined by exclusions in your policy, and whether or not medical necessity has been determined. The acceptable definition of medical necessity may vary between insurance policies, but letters of medical necessity can only be submitted in the form of documentation from your doctor.

Whether or not letters of medical necessity meet the requirements of your policy is dependent upon the policy. To make this determination of coverage do not rely upon your doctor or the provider of any erectile dysfunction treatment.  To be absolutely certain contact your insurance company to find out if, and when ED related products are covered.

In addition, your insurance company will be able to tell you what the eligibility requirements are for coverage of ED products, as well as how to apply for coverage if you are eligible. Once again, this process varies from company to company, and is based on medical necessity.

Even if you’re not covered under insurance for ED treatments, vacuum therapy remains the most affordable ED treatment and is proven effective in over 90% of men. Surgery and penile implants are incredibly expensive to undergo uninsured, and ED medication can cost you indefinitely, as prescriptions need to be refilled regularly. Our vacuum therapy systems start at $199, even if you’re completely uninsured. A vacuum therapy system will last several years if kept in good care, and Soma Therapy-OTC comes with a 1-year warranty, with a lifetime warranty available for $99.

While vacuum therapy systems do need to be maintained with occasional replacement parts such as tension rings, the overall cost of a system remains low, even if you can’t get insurance to cover it. So if you’re worried about treating your ED without insurance, there’s a healthy, natural, affordable solution available.

Call us at 1-800-827-8382 to learn more!


Ready to talk to you physician? Learn how to prepare for your first physicians visit about ED.