Is Medical Marijuana Covered by Insurance?Erica Smith
There are currently 37 states that allow medical marijuana use as of 2021, and as a result, you may assume that your health insurance would cover your medical cannabis use.
Unfortunately, this does not happen.
Despite legalization in several states, medical marijuana is still technically illegal at the federal level, so that most insurers won’t cover its use or recommendations.
Despite its legal status as a Schedule 1 substance, cannabis has a high potential to be misused. The DEA has yet to reschedule medical marijuana, so adding it to insurance formularies would likely take years, even if rescheduled.
As a result, the use of medical cannabis – including prescriptions, doctor’s visits, signing up to receive a medical marijuana card, and purchasing medicine – isn’t covered by insurance right now or is unlikely to be covered shortly in most states except for those in which the practice is permitted. However, that doesn’t necessarily mean medical marijuana has to be very expensive to be used as a supplement to healing.
Medicare is one of the major health insurance programs run by the federal government. Due to its legal status, it cannot cover medical marijuana as a part of its health insurance program. Although cannabis is currently legal for medical use in 75% of the states in the country, Medicare is still bound by federal law because they are a public authority.
As a result of its Schedule I status, researchers find it very difficult to conduct medical research on cannabis and prove that it has medicinal properties. The DEA placing it on a lower schedule (II or III) would create a level playing field for research. However, it would take much longer still to build up a body of research to achieve approval by the United States Food and Drug Administration to use medical marijuana on a federal level.
After this has been accomplished, there will be a probationary period during which major pharmaceutical corporations, such as Moderna and Pfizer, will have exclusive access to formulations based on cannabis. Once this has occurred, could Medicare consider adding these medications to its drug formulary and ensuring that Medicare pays for their cost?
Currently, the FDA has approved a small number of prescription medications based on cannabinoids. Among the CBD-based tinctures that contain hemp cannabinoids, Epidiolex is the only one with natural hemp cannabinoids.
Some synthetic versions of THC are also available via prescription, including Cesamet, Marinol, and Syndros. They are usually prescribed for cancer patients, chemotherapy patients, or patients with cachexia due to AIDS/HIV or cancer. Although, these versions of synthetic THC are more potent than natural THC in potency. Many patients enjoy the cannabinoids and terpenes that come with cannabis, in addition to the THC derived from cannabis.
It is also worth mentioning that Medicaid is another federally-run health insurance program that offers medical coverage to low-income patients to provide them access to affordable health care and medicines.
However, because Medicaid is a public service, it cannot cover any portion of the costs associated with medical marijuana use.
Although some states are willing to reimburse some portions of the costs associated with the doctor’s visit involved with receiving a recommendation or certification from the doctor.
Medicaid in New York reimburses for services such as patient evaluations and certifications but not for products. Conversely, New Hampshire and New Mexico allow state-level reimbursements for medical marijuana purchases.
More recently, medical marijuana reimbursement has been successfully argued in Pennsylvania and New Jersey courts.
On a national level, Medicaid is on the same side of the pool as Medicare and is likely unable to assist medical marijuana patients for several years.
Private Health Insurance Plans
Most private health insurance plans will not cover services and visits related to medical marijuana.
Most of these companies operate nationally, so they must comply with federal requirements regarding medical coverage. That is why many do not want to risk their legal status to enter the illegal territory of medical cannabis, even though it is legal in so many states.
If the DEA rescheduled cannabis or Congress legalized it, most insurances would likely not cover your purchase. Health Savings Accounts (HSA) may someday accommodate purchases of medical cannabis, but most plans don’t cover Tylenol or vitamins.
Several entrepreneurial businesses aim to address the needs of the many patients who require affordable cannabis medicines. One such company, Novus Cannabis MedPlan, is one of several new companies offering marijuana insurance coverage, but it remains to be seen whether it can provide coverage effectively and reliably.
How does having a medical marijuana card affect the cost of health insurance?
Health insurance costs and coverage are not affected by medical marijuana in most cases. Sometimes, life insurance providers may raise the rates they charge if they find out that a person uses medical marijuana, but this is not common.
As a result, if you use medical marijuana during a crash or traffic stop and are exposed to the possibility of driving under the influence, it could also harm your car insurance policy.
Assistance and Tips for Affordable Medical Marijuana
Understandably, it can be overwhelming to consider the total costs associated with medical marijuana without protecting health insurance benefits. Patients who struggle to afford medical marijuana add further stress to their already debilitating medical conditions by being unable to afford much-needed medicine.
There is usually a difference between $5-20 for a gram of flower, $20-60 for an eighth ounce/3.5 grams, and $400 for an ounce. It is possible to keep your flower costs low by finding ways to store, stretch, or buy it in bulk. Aside from medical marijuana in concentrated forms, you can also obtain it as a vape cartridge or cannabis oil. It can save you time and money, has a longer shelf life, and provides better value for your money.
In many states, cities, and dispensaries, medical marijuana patients can receive assistance through reduced-cost assistance programs. In some cases, you may be able to obtain an ID card for medical cannabis at a discounted or free rate, depending on the state where you live. In addition to partnering with their patients, many dispensaries offer discounts, sales, or patient-relief programs to help people access the medicine they need, allowing them to purchase their medicine reasonably.
Many doctors are doing their part to reduce the cost of getting a recommendation for medical marijuana by taking it upon themselves to do so. In addition to only charging when the patient has been approved, KIF Doctor’s visit costs are comparable to several health insurance plan copays.
Frequently asked questions
Does insurance cover CBD oil?
There is currently no insurance coverage for CBD oil, and many public and private health plans do not reimburse it because it is considered a supplement by the federal government.
An FDA-approved prescription drug containing CBD is Epidiolex, which treats epilepsy in rare cases.
Does insurance cover a medical card?
In most states, medical insurance companies do not cover products or services associated with medical marijuana due to its federal status.
Can insurance reimburse medical marijuana expenses in any state?
In general, only a few states offer coverage for qualifying medical cannabis products or services related to marijuana products to meet state insurance requirements. This does not apply to New York, New Jersey, New Hampshire, or New Mexico. A possible fifth state is Pennsylvania.
Insurance can cover evaluations and certifications in New York (not products). New Mexico allows injured workers who purchase medical cannabis to recover the costs. An instance where this has been determined was in New Hampshire. In that case, the Supreme Court ruled that the workers’ compensation carrier must pay for all the injured party’s proper medical treatment – including therapeutic cannabis as part of that treatment – for as long as they have been injured.
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