Does Presbyterian Healthcare Services Cover Viagra?
HealthRX.com
Presbyterian coverage for Viagra is not yet confirmed
From the public record
Medicare Part D spending on sildenafil
Medicare Part D spending on sildenafil products was $46.3M in 2024 across 838,936 claims, compared with $52.8M in 2023 (-12.3%). Average spending per claim was $55.14, before rebates.
| Measure | Value | Note |
|---|---|---|
| Total spending, 2024 | $46.3M | |
| Total spending, 2023 | $52.8M | |
| Change in spending, 2023 to 2024 | -12.3% | |
| Claims (prescription fills), 2024 | 838,936 | |
| Average spending per claim, 2024 | $55.14 | |
| Sildenafil Citrate: spending, 2024 | $38.9M | 837,854 claims |
| Revatio: spending, 2024 | $7.2M | 684 claims |
| Viagra: spending, 2024 | $164,848 | 398 claims |
How this was calculated
Summed total spending and claims over every brand and generic row with this generic name in the CMS file, using the Overall manufacturer rows. Combination products excluded. Average per claim is spending divided by claims.
Every single-ingredient sildenafil product in Part D (Sildenafil Citrate, Revatio, Viagra), 2024. Not limited to Viagra.
Gross drug cost before manufacturer rebates, so net cost is lower. Part D excludes some uses by law (for example erectile dysfunction, weight loss and hair growth), so claims reflect covered uses only. Compounded products are not included.
From the public record
Pharmacy acquisition cost (NADAC) for Viagra
Retail pharmacies paid an average of $83.70 per unit for VIAGRA 100 MG TABLET as of 2026-11-11, compared with $83.51 twelve months earlier (+0.2%). This is a pharmacy purchase cost, not a patient price.
| Measure | Value |
|---|---|
| VIAGRA 100 MG TABLET, now | $83.70 per unit |
| VIAGRA 100 MG TABLET, 12 months earlier | $83.51 per unit |
| Change over 12 months | +0.2% |
How this was calculated
Matched NADAC product codes to the FDA NDC Directory, kept finished single-ingredient products, and listed the product descriptions with the most package codes. The earlier price is the same package code in the file one year before.
Viagra (brand-name sildenafil) in the weekly NADAC file of 2026-11-11, compared with the file of 2025-11-12
NADAC is the average invoice price retail pharmacies pay, from a voluntary survey. It leaves out rebates, dispensing fees and markups, and it is not what a patient or insurer pays. Compounded products are not surveyed.
At a glance
- Presbyterian coverage / not confirmed for Viagra or generic sildenafil
- Viagra / prescription only, approved for erectile dysfunction [1]
- Brand product / Viagra, NDA 020895, current holder Viatris [1]
- Generic sildenafil / coverage not confirmed
- Prior authorization / not confirmed for Presbyterian plans
- Quantity limits / not confirmed for Presbyterian plans
- Where to check / your plan's current drug list
Does Presbyterian cover Viagra?
We could not confirm whether Presbyterian Healthcare Services covers Viagra. Coverage, tier, prior authorization and quantity limits depend on the specific plan, so the plan's current drug list is the document that answers the question.
What the FDA record does show is the product's status. Viagra is a prescription-only product indicated for erectile dysfunction [1]. It was originally approved on 03/27/1998 under NDA 020895 as sildenafil citrate tablets in 25, 50 and 100 mg strengths, and the current NDA holder is Viatris [1].
What people on Reddit report
These are accounts from people with employer, private, public or Medicare coverage describing which erectile dysfunction pills their plans covered. None mention Presbyterian.
But most people don't have public insurance. It's like 2 to 1 for private usage. Covered by my husband's private work insurance: Viagara Cialis Testosterone for men Oral estrogen (more dangerous than patches) Not covered: Testosterone *for women* Hormone implants (the ones that are the size of a grain of rice with est and progest) Hormone patchesRead the source discussion
I'm in public healthcare, Viagra, Cialis, etc isn't covered by any commercial plans on the insurance exchange. If it's covered at all it would be through a big self insured company like GE. What you're seeing is being applied pretty evenly to both sexes, and it sucks for everyone who needs it.Read the source discussion
Most insurance plans cover it but people over 65 apparently don't have sex, at least according to my urologist, as he wrote me the scrip and gave me a GoodRx card and recommended Costco.Read the source discussion
Does Presbyterian cover generic sildenafil?
We could not confirm that either. Generic sildenafil may be listed separately from brand Viagra, with its own tier.
What to look up on your Presbyterian plan
- Is Viagra listed, and at which tier?
- Is generic sildenafil listed, and at which tier?
- Does either medicine require prior authorization?
- Is there a quantity limit per fill?
Member services can answer these if the drug list does not.
Check what you know
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Frequently asked questions
Does Presbyterian Healthcare Services cover Viagra?
Does Presbyterian cover generic sildenafil?
Does Presbyterian require prior authorization for Viagra?
Is Viagra prescription only?
What is Viagra approved to treat?
References
Show all 3 referencesHide references
- Drugs@FDA: FDA-Approved Drugs.
- Reddit participants. Why does our Healthcare system hate women?! I bet the "little blue pill" for men is coverage by insurance. But nope. Not the "little pink pi (r/Menopause). Accessed 2026-11-11.
- Reddit participants. How to ask doctor to prescribe viagra. (r/NoStupidQuestions). Accessed 2026-11-11.