Medically Necessary Cialis

Nikita

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I have a client who recently had his prostate removed due to cancer. His doctor has told him he must take Cialis to improve the blood supply to this area It is not for sexual reasons. Does anyone know any Drug plan that would pay for Cialis prescribed for legitimate medical reasons?
 
I have a client who recently had his prostate removed due to cancer. His doctor has told him he must take Cialis to improve the blood supply to this area It is not for sexual reasons. Does anyone know any Drug plan that would pay for Cialis prescribed for legitimate medical reasons?
The Envision plan will cover this for non-ED, prostate health reasons with prior authorization, assuming this plan is available in your prospect's region. The last time I checked--last week--the Medicare plan finder does not show any plan covering this medication for any reason. But if you look on the carrier's formulary it does show as a covered drug with PA and the carrier confirmed that there was an error in what they reported to Medicare.
 
Just checked zip 30328, Fulton county.

5mg Cialis for daily use.

3 BX plans, Envision, 2 Express Scripts plans show it on the formulary. But as WCMason said, it must be for a prostate issue, not just for recreational purposes.
 
I have a client who recently had his prostate removed due to cancer. His doctor has told him he must take Cialis to improve the blood supply to this area It is not for sexual reasons. Does anyone know any Drug plan that would pay for Cialis prescribed for legitimate medical reasons?

Yes, I have a current Coventry mb here in San Antonio who receives coverage for it, but pays a lot. Cialis appears on one of the Aetna formularies for 2016 as generic tier with no prior authorization. Hard to believe. If they don't give it to my mb, I will show them the Formulary and/or let CMS take care of it.
 
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