Does Medicaid cover Cialis?
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State Medicaid programs may exclude tadalafil for erectile dysfunction (42 U.S.C. 1396r-8(d)(2)(H)), but the exclusion does not reach its FDA-approved use for benign prostatic hyperplasia. Check your state's drug list.
What Medicaid specifically requires
Sources: 42 U.S.C. 1396r-8(d)(2): drugs that may be excluded or restricted (Current code)
About Medicaid coverage
- KFF: 13 state Medicaid programs covered GLP-1s for obesity in fee-for-service as of January 2026, down from 16 in October 2025. California, New Hampshire, Pennsylvania and South Carolina ended coverage. KFF: Medicaid coverage of and spending on GLP-1s, Jan 16, 2026
- North Carolina ended Medicaid GLP-1 obesity coverage in October 2025 and reinstated it in December 2025. KFF: Medicaid coverage of and spending on GLP-1s, Jan 16, 2026
- MassHealth ended coverage of drugs used for weight loss, including Wegovy, Zepbound and Saxenda, on July 3, 2026. Coverage continues with prior authorization for cardiovascular disease, MASH and sleep apnea. MassHealth Pharmacy Facts #271: anti-obesity medications, Mar 12, 2026
- California Medi-Cal removed Wegovy, Zepbound and Saxenda from its drug list for weight loss on January 1, 2026; members under 21 are reviewed under EPSDT. Anthem Blue Cross (Medi-Cal): GLP-1 Coverage Considerations, Nov 14, 2025
- CMS announced the BALANCE model in December 2025, a voluntary program to negotiate lower GLP-1 prices for Medicaid and Medicare. KFF: Medicaid coverage of and spending on GLP-1s, Jan 16, 2026
Medicaid not the right plan?
Coverage varies between carriers and even between plans at the same carrier. Compare GLP-1 coverage across 20 US insurers and programs, or run the insurance pre-check to estimate your specific plan's odds.
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Frequently asked
Does Medicaid cover Cialis?+
State Medicaid programs may exclude tadalafil for erectile dysfunction (42 U.S.C. 1396r-8(d)(2)(H)), but the exclusion does not reach its FDA-approved use for benign prostatic hyperplasia. Check your state's drug list.
Does Medicaid require prior authorization for Cialis?+
Yes. Medicaid requires prior authorization for Cialis. Your prescriber submits the request with the documentation listed in the Medicaid criteria on this page.