The high cost of sex
For some older people, the joy of sex can be tempered by financial concerns: Can they afford the drugs they need to enhance their experience between the sheets?To get more news about
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Medicare and many private insurers don't cover drugs prescribed to treat sexual problems. Recent developments, including the approval of generic versions of the popular drugs Viagra and Cialis, are helping consumers afford the treatments. But for many people, paying for expensive drugs may be the only option.
Like many postmenopausal women, 68-year-old Kris Wieland of Plano, Texas, experiences vaginal dryness that can make intercourse painful. Her symptoms are exacerbated by Sjogren's syndrome, an immune system disorder that typically causes dry eyes and mouth and can affect other tissues.
Before Wieland became eligible for Medicare, her gynaecologist prescribed Vagifem, a suppository that replenishes vaginal oestrogen, a hormone that declines during menopause. This enabled her to have pain-free sex. Her husband's employer plan covered the medication, and her co-payment was about $100 every other month.
But after she enrolled in Medicare, her Part D plan refused to cover the drug.
"I think it's very discriminatory that they won't pay for a drug that allows you to have sexual activity," Wieland said. She plans to appeal.
Under the law, drugs used to treat erectile or sexual dysfunction are excluded from Part D coverage unless they are used as part of a treatment approved by the Food and Drug Administration for another condition. Private insurers often take a similar approach, arguing that sexual dysfunction drugs are lifestyle rather than medically necessary, according to Brian Marcotte, CEO of the National Business Group on Health, which represents large employers.
For example, Medicare may pay if someone is prescribed sildenafil, the generic name for Viagra, and another branded drug called Revatio to treat pulmonary arterial hypertension, a type of high blood pressure in the lungs. But it usually won't cover the same drug if it's prescribed for erectile dysfunction.
