The push toward cannabis legalization began with medical marijuana. By the 90’s science began to acknowledge that cannabis had multiple medical uses, and getting a medical card offered a variety of benefits for patients. It wasn’t long before states began legalizing cannabis for medical use. But cannabis remains illegal at the federal level, which has left many medical cannabis patients wondering if their insurance companies will cover their medication.
Read on to learn whether medical marijuana is covered by your insurance.
Is Medical Marijuana Covered By Insurance?
The current state of cannabis law in the United States puts insurance companies in a precarious position.
As of Apr 2023, 38 states have legalized medical marijuana, and 24 states have legalized recreational cannabis. At the same time, marijuana remains illegal on the federal level. In fact, it’s still classified as a Schedule I substance under the Controlled Substances Act. According to the Controlled Substances Act, a Schedule I substance has “no currently accepted medical use.” So, while 38 states fully acknowledge the medical potential of cannabis by establishing their own MMJ programs, the federal government sees it as an illicit substance with no medical value.
An insurance company that does business nationwide is forced to choose between honoring federal or non-standardized state laws. Honoring state laws would mean providing compensation for an illegal substance that has “no currently accepted medical use,” according to the federal government. Because of this difficult situation, nearly all insurance companies refuse to cover medical marijuana.
Change may be coming, though.
Some states are pushing to create programs that will pave the way for insurance companies to cover medical cannabis. The New York state senate passed a bill that would require public health insurance companies to cover medical cannabis and would clarify the law to allow private insurance companies to do the same. In March 2023, a Pennsylvania appeals court ruled that the state's medical cannabis law doesn't prohibit health insurers from reimbursing workers for medical cannabis when it is used to treat qualified work-related injuries. The court determined that it is not a federal crime to reimburse patients since insurers aren't recommending cannabis themselves.
On the federal level the SAFE Banking and CLAIM Acts would help to normalize state cannabis laws. Together, they’d allow cannabis businesses to use traditional banking systems and insurance companies to cover legally prescribed medical cannabis. Though neither of these have passed, there’s hope that they will, and the fact that they’re actively receiving attention is a positive sign.
Does Medicaid or Medicare Cover Medical Marijuana?
Plenty of people on Medicare and Medicaid are interested in or already using medical marijuana. So, does Medicaid or Medicare cover medical marijuana? Unfortunately, no.
Both Medicare and Medicaid are federal programs. Because medical cannabis is still illegal on the federal level and it’s not regulated by the FDA, neither Medicaid or Medicare will cover medical marijuana.
Once again, it all comes down to federal law and the way it interprets cannabis. With cannabis still classified as a Schedule I substance, Medicare and Medicaid would essentially be using federal money to purchase illegal drugs for people by covering the cost of medical marijuana. So until cannabis scheduling changes dramatically, Medicaid and Medicare won’t cover the cost of medical marijuana for patients.
Are There Any THC Medications Covered by Insurance?
The question of cannabis and medical insurance gets even murkier when you consider synthetic cannabinoids and pharmaceuticals approved by the FDA. Somewhat surprisingly, there are actually three THC-based medications approved by the FDA that are covered for most patients. These medications are:
- Marinol
- Cesamet
- Syndros
All three of them are approved for treating some of the more severe symptoms that THC is reported to help, like the nausea and vomiting associated with cancer treatment.
Because cannabis is still a Schedule I substance at the federal level, the manufacturers of these medications got around the law in an interesting way; they made the THC in a lab. All three medications are based on a synthetic form of THC created without the cannabis plant. Explicitly because the THC in these medications is not natural, they are considered legal, and the FDA was willing to approve them.
With all three of these being FDA approved pharmaceutical drugs and not classified as Schedule I substances, they are covered by most major insurance providers.
Is CBD Covered by Insurance?
The first cannabis-derived medication ever approved by the FDA is a form of CBD. The medication, Epidiolex, was approved for treating severe cases of epilepsy. Interestingly the approval came shortly after the 2018 Farm Bill was passed. Since CBD is legal on the federal level and the medication is approved by the FDA, Epidiolex is covered by most insurance providers.
If you need help reducing the cost of your cannabis medication, check out our guide on Cannabis Sizes & Prices (and Are Premium Brands Worth It?).
The information in this article and any included images or charts are for educational purposes only. This information is neither a substitute for, nor does it replace, professional legal advice or medical advice, diagnosis, or treatment. If you have any concerns or questions about laws, regulations, or your health, you should always consult with an attorney, physician or other licensed professional.
