Medicare, the entitlement program sold as insurance to make sure seniors don’t have to choose between essential medications and food, has spent more than $240 million on penis pumps since 2001.

Keeping in mind we’re only talking about pumps — this doesn’t include how much taxpayers have spent on erectile dysfunction (ED) medicines like Viagra or Cialis. That’s a whole different category.

According to data collected by the Centers for Medicare and Medicaid Services (CMS), Medicare has spent more than $240 million of taxpayer money on penis pumps for elderly men over the past decade, and will surpass a quarter of a billion dollars this year for costs since 2001.

The cost to taxpayers for the pumps more than quadrupled during that period, from a low of $11 million in 2001 to a high of more than $47 million in 2010. And these represent only the costs for external devices, technically classified as “Male Vacuum Erection Systems,” not implantable devices or oral drugs such as Viagra.

All that’s necessary to qualify? A diagnosis of erectile dysfunction. Then you’re on the gravy train of free, taxpayer-subsidized devices, medications, and treatments.

If a medical exam and history shows a senior on Medicare meets the relevant threshold—a diagnosis of ED—he becomes eligible for a wide range of options under the Medicare Prosthetic benefit. Treatment Options covered by Medicare include “oral medications, pharmacological injections, intra-urethral suppositories, vacuum erection devices, and implantable penile pumps.”

The category is rife with fraud, too. An Illinois man recently pled guilty to bilking Medicare of more than $2 million by purchasing adult products online for $26, repackaging them as medical devices, and billing Medicare $284 a piece.

Question: Why are we covering penis pumps in the first place? They’re a luxury — not a medical necessity. Why not cover plastic surgery, too?