For those patients who are facing sexual dysfunction caused by their medical treatment plan, or as a side effect from a surgery or injury, they often find themselves fighting an uphill battle to regain and reclaim the right to their very own intimacy. In other cases, sexual dysfunction occurs as a side effect to another diagnosed illness or autoimmune disease. Even in these cases, where sexual dysfunction is linked to treatment, insurance companies turn a blind eye to their client’s true needs.  

Your insurance company, and many others like it, do not fully cover- or in some cases, provide any coverage at all for these medications or treatments, because they do not believe that your sexual and intimacy wellness matter as much as your life. The connections have not yet been made correlating how happiness of the whole human, who has all their needs met physically, mentally, emotionally, and intimately, not only live life to the fullest, but also heal much faster than those patients with a sour mindset.  

A simple search on the internet will show you articles, and blogs titled with things like, “We don’t have Sex. We’re on Medicare,” and “Insurance companies kill your sex life after fifty.” While some insurance companies have recently updated their terms and policies, especially on the prescription drug side of things, to offer partial coverage, this still ignores their client’s rights of life.  

In an article written by Michelle Andrews from Kaiser Health News, she is quoted, “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 a different condition. Private insurers often take a similar approach, reasoning that drugs to treat sexual dysfunction are lifestyle-related rather than medically necessary, according to Brian Marcotte, CEO of the National Business Group on Health, which represents large employers” (Kaiser Health News, February 2019). 

What these insurance companies fail to recognize is that a person who feels poorly of themselves due to their medical condition, who is now facing sexual dysfunction and the inability to be intimate or feel at all sexual on top of that, will become depressed, anxious, or not follow their treatment plans accordingly. In these situations where sexuality and intimacy needs are ignored, fractured relationships, ended marriages, and the loss of support systems can be catastrophic for the patient. These patients end up taking more medications to combat their mental illness and feelings, whereas they could have simply tried one medication, or one therapeutic aid, that could have restored their sexual and intimacy need to keep them on a positive track forward.  

At Empowering Intimacy, we believe that all patients should have access to the care and services they medically need, with assistance to pay for, or coverage for those things and medications their doctors deem necessary. We stand in the middle on the battleground to assist patients bridge this wide gap between insurance companies, medical care professionals, and the true needs of the patient. By supporting our patients and helping them find the resources and information they desperately seek, we help to ensure the whole healing of every patient.  

If you have been denied by your insurance company for any treatment related to your sexual dysfunction or symptoms, do not give up! Speak with your doctor, a patient navigator, your medical office’s billing department, or our Empowering Intimacy team for tips to work your way through the system.  

Citations:

National Institutes of Health and Human Services

Medicare.gov

Articles Mentioned: 

https://khn.org/news/the-high-cost-of-sex-insurers-often-dont-pay-for-drugs-to-treat-problems

Andrews, Michelle. Kaiser Health News. 2019. https://abcnews.go.com/Health/health-insurance-skips-coverage-sex-related-prescriptions/story?id=61173009