Tricare generally covers Viagra only if prescribed for treatment of pulmonary arterial hypertension (PAH). It’s not typically covered for erectile dysfunction.
To obtain coverage for PAH, your doctor must diagnose you with the condition and document the medical necessity for Viagra’s use in your treatment plan. You’ll need a valid prescription.
Prior authorization is usually required. Check with your specific Tricare plan (Tricare Prime, Tricare Select, Tricare Reserve Select, etc.) for exact procedures. Contact your Tricare provider or visit their website for detailed authorization requirements and forms.
Coverage may vary depending on your plan and formulary. Expect co-pays and other cost-sharing responsibilities. Review your plan’s explanation of benefits (EOB) to fully understand your out-of-pocket costs.
If Viagra is prescribed for erectile dysfunction, Tricare generally doesn’t cover it. Explore alternative treatments or consider private insurance options for coverage. This should be discussed with your physician.
Always confirm coverage directly with Tricare or your Tricare provider before initiating treatment. Information changes, so keep updated and verify details regarding your plan benefits.
