TRICARE Coverage for Erectile Dysfunction (ED) Guide | TRICARE.com

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## Quick answer Yes, TRICARE covers the diagnosis and treatment of erectile dysfunction (ED) when it is caused by a documented medical condition, such as injury, disease, or surgery. While TRICARE covers doctor visits and most FDA-approved medications (like Viagra or Cialis), it generally does *not* cover treatments for "psychogenic" ED (caused only by mental or emotional factors) or services considered purely "performance-enhancing."

Details

### Medical Necessity and Diagnosis TRICARE policy focuses on **medical necessity**. To get coverage, a provider must determine that the ED is a symptom of an underlying organic (physical) cause. Common covered causes include: * Diabetes or vascular disease. * Prostate cancer treatment or pelvic surgery. * Spinal cord injuries. * Hormonal imbalances (Low Testosterone).

### Coverage for Medications Most ED medications are covered under the TRICARE Pharmacy Benefit, managed by **Express Scripts**. * **Viagra (Sildenafil) and Cialis (Tadalafil):** These are typically available but often subject to "quantity limits" (e.g., 6 to 8 tablets per month). * **Formulary Status:** Generic versions are significantly cheaper. As of 2026, generic sildenafil or tadalafil usually carries a $16 copay for a 90-day supply via Home Delivery. * **Prior Authorization:** Your doctor may need to submit a Prior Authorization (PA) to prove the medication is being used for a physical ailment.

### Surgical and Mechanical Options If medications are ineffective or contraindicated, TRICARE may cover: * **Vacuum Constriction Devices (VCDs):** Covered if prescribed by a doctor for organic ED. * **Penile Implants:** Typically covered if the ED is organic and non-surgical treatments have failed. * **Injections:** Drugs like Alprostadil (Caverject) are generally covered.

### What is NOT Covered * **Psychogenic ED:** If the diagnosis is strictly psychological (stress, performance anxiety) without a physical component, TRICARE typically denies the claim for drugs or devices. * **Non-FDA Approved Treatments:** Experimental therapies, such as "shockwave therapy" for ED, are currently not a covered benefit. * **Over-the-Counter Supplements:** These are never covered.

### Costs for 2026 * **Active Duty:** $0 for all clinical visits and prescriptions at Military Treatment Facilities (MTFs). * **TRICARE Prime (Retirees):** Specialty office visit copay is $42 (2026 rates). * **TRICARE Select (Retirees - Group A):** Specialty office visit copay is $55 (2026 rates). * **Pharmacy:** Generic drugs are $16 for a 90-day mail-order supply; brand-name formulary drugs are $43 (2026 rates).

## Who this affects Coverage rules apply to the following beneficiaries, provided they have a medical diagnosis for organic ED: * **Active Duty Service Members (ADSMs):** Always require a referral through their MTF or Primary Care Manager. * **Retirees and their Spouses:** Includes those on TRICARE Prime and TRICARE Select. * **National Guard and Reserve:** Those enrolled in TRICARE Reserve Select (TRS). * **TRICARE For Life (TFL) Beneficiaries:** TRICARE acts as secondary payer to Medicare for ED treatments.

## Sources * **TRICARE.mil (Covered Services):** https://www.tricare.mil/CoveredServices/IsItCovered/ErectileDysfunction * **Express Scripts (TRICARE Formulary Search):** https://www.express-scripts.com/static/formularySearch/ * **Health.mil (Medical Modernization):** https://health.mil/ * **TriWest Healthcare Alliance (West Region):** https://www.triwest.com/