Medicare Coverage for Male Sexual Health
Medicare does cover penile implants if your physician determines that a penile implant is deemed medically necessary.
If Medicare does pay for your penile implant surgery, a Medicare Supplement (Medigap) plan can help cover your out-of-pocket Medicare costs like deductibles and copays.
How Much Does It Cost to Get a Penile Implant With Medicare?
If Medicare Part B covers outpatient surgery or other care services associated with your penile implant, you should be prepared to pay a number of out-of-pocket costs:
Medicare Part B Deductible
Before Medicare will pay its share of the procedure, you must meet your Medicare Part B deductible. In 2024, the standard Part B deductible is $240 per year.
Medicare Part B coinsurance
Under Part B, Medicare recipients must pay 20% of all Medicare-approved costs of services.
Understanding Erectile Dysfunction
Many men over 60 years old suffer from erectile dysfunction, or ED, an affliction that makes it hard to achieve or sustain an erection.
Well-known ED treatments include prescription medications, such as Viagra. But Viagra, despite its name recognition, isn’t covered by most Medicare Part D prescription drug plans.
That means seniors have to pay out of pocket for Viagra or seek another option.
One of those options is a penile implant. This is a medical prosthesis that is custom fit and placed, via surgery, in one’s penis in order to produce a natural-feeling erection.
Deciding between a penile implant and other options is a personal decision. Work together with your doctor to decide if a penile implant is the best option for you.
Find Medigap Plans That Help Cover Your Penile Implant Procedure
If you have a penile implant that is covered by Medicare, you may likely face out-of-pocket Medicare costs such as deductibles, coinsurance and copayments.
A Medicare Supplement Insurance (Medigap) plan can help cover some of these costs.
For example, each of the 10 standardized Medigap plans that are available in most states provide at least partial coverage for the Medicare Part B coinsurance or copayments you might face when you receive covered outpatient penile implant surgery.
Learn more about Medicare coverage of common procedures
A licensed agent can help you decide on a Medicare option that works for you. Call today to speak with a licensed agent and compare the Medigap plans that are available where you live.
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Christian Worstell is a health care and policy writer for MedicareSupplement.com. He has written hundreds of articles helping people better understand their Medicare coverage options.