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Will Medicaid Cover Medical Marijuana?


Medical Marijuana has been legal in the United States ever since California passed Proposition 215, or the “Compassionate Use Act,” in 1996. The idea of using cannabis as medicine is nothing new to legislators, yet there are still federal laws inhibiting the full potential benefits of classifying marijuana as a medicine.

In 2016, the state of Florida passed its medical marijuana legislation giving qualified patients the ability to self-medicate with state-approved cannabis products. In order to qualify for a Medical Marijuana Card in Florida, one must first be approved by a Florida Medical Marijuana Physician. DocMJ has a network of qualifying physicians throughout the entire state that are easily accessible for appointments during the day, evening, and even the weekends! 

However, ever since the legislation has passed, there has been one issue that never seems to get fixed: the cost of the program. Typically, when managing a debilitating medical condition, one can turn to their insurance company for financial assistance; however, that is not the case for medical marijuana patients.

Why Doesn’t Medicare Cover Medical Marijuana?

Health insurers in the US will not cover costs for anything that is labeled as illegal. Most insurance policies include an “illegal acts” exclusion stating any health issues occurring due to or related to voluntary involvement in an illegal act are not covered.

Even though medical marijuana has been legalized in most states throughout the country, it is still classified by the federal government as a schedule 1 controlled substance. This was defined in 1970 with the passing of the Controlled Substance Act. This legislation is still in effect today, meaning that technically medical marijuana cannot be covered by insurance companies including Medicare.  

The Food and Drug Administration (FDA) poses another barrier to insurance coverage. Generally, insurance companies do not cover any drug that has not received FDA approval. As of now, the FDA has not legally approved medical marijuana for any indication.

While the FDA has yet to take any real steps towards approval, it does work alongside the Drug Enforcement Administration (DEA) and National Institute on Drug Abuse (NIDA) to support clinical research on medical marijuana. The FDA will want clinical studies to provide long-term data on the safety and effectiveness of marijuana as a medical treatment before it approves it as a medicine, so these studies will hopefully support that development.

What is Medicare?

Medicare is the federal health insurance program for: [a]

  • People who are 65 or older
  • Certain younger people with disabilities
  • People with End-Stage Renal Disease

Medicare is divided into four parts. The different parts of Medicare help cover specific services:

  • Medicare Part A (Hospital Insurance): Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.
  • Medicare Part B (Medical Insurance): Part B covers certain doctor’s services, outpatient care, medical supplies, and preventive services.
  • Medicare Part C (MA Plans): Part C, also known as Medicare Advantage Plans (MA Plans) is an “all in one” alternative to Original Medicare. They are offered by private companies approved by Medicare.
  • Medicare Part D (prescription drug coverage). Part D helps cover the cost of prescription drugs (including many recommended shots or vaccines).

Additionally, if you have health coverage through the Veterans Administration (VA), you may use medical marijuana without fear of losing your benefits. If you currently use marijuana, tell your VA physician so he or she has the best picture of your overall health. 

However, If you need a marijuana recommendation, note that VA physicians cannot provide it. You also cannot ask a VA doctor to recommend you for a marijuana study. And if you do use medical marijuana, you cannot bring it onto VA property per federal laws, which overrule any state statutes.

Currently, none of the above cover the cost of medical marijuana in any state. Parts C and D could cover the cost of cannabinoid medications that have been approved by the FDA and are available without restriction. Cannabinoid medications, like dronabinol (Marinol, Syndros) and Epidiolex, could be covered by Medicare drug plans.

Medicare and Prescription Cannabinoid Drug Plans

An FDA advisory panel has recommended the approval of an epilepsy drug, Epidiolex, that contains CBD. If it gets approved, it will become the first cannabis-derived prescription medication in the United States.

As for synthetic cannabis, the FDA approved three prescription drugs that contain synthetic forms of marijuana compounds or chemicals. Cesamet is one medication with the active ingredient nabilone. According to the FDA nabilone “has a chemical structure similar to THC.” Doctors will prescribe this synthetic cannabinoid medicine to cancer patients struggling with nausea and vomiting after chemotherapy treatments.

The other two FDA-approved synthetic forms of marijuana on the market are Marinol and Syndros. They are used to treat nausea and vomit, as well, but can also improve the appetite of people who are suffering from AIDS.

While those synthetic medications can be helpful in most cases, they do not offer the full potential benefits of whole-plant medical marijuana products. The cannabis plant consists of hundreds of chemicals that work together to produce the maximum benefits possible. These synthetic alternatives do not include the full plant profile, can take longer for the effects to kick in, and can increase a person’s depression and anxiety. 

Will Legalizing MMJ Benefit the Insurance Companies?

In 2017, Health Affairs published a study finding that Medicare could have saved $1.01 billion if medical marijuana had been legalized on a national scale and covered by government insurance programs. The potential savings would have resulted from medical marijuana replacing more costly prescription medications.

In the states that have at least legalized marijuana for medical use, there has been a significant decrease in medicare issued opioid prescriptions.  For example, prescriptions for morphine dropped by 20.7 percent and hydrocodone prescriptions fell by 17.4 percent in those states with legal medicinal marijuana programs.

How to Afford Medical Marijuana in Florida

The team at DocMJ recognizes that medical marijuana can be very costly for some patients. For that reason, they offer a discount program on appointments, as well as a monthly payment plan option. 

In addition to the discounts they offer on appointments, DocMJ has also worked hand-in-hand with many of the state-approved Medical Marijuana Treatment Centers (MMTCs) to bring discount programs to patients state-wide. Most of the dispensaries throughout the state have discounts in place for medicare recipients, pediatric patients, veterans, the elderly, and even students. Some also offer loyalty programs or bulk discounts to ensure you get the most discounts possible on your legal medical marijuana products.

Those looking for relief can also turn to hemp CBD, like Doc-CBD, as a cheaper and more readily available alternative than the CBD offered in MMTC’s.

Qualifying for a Florida Medical Marijuana Card

When Medical Marijuana was passed in Florida, the state published a list of qualifications that must be met in order to qualify for a physician’s recommendation. [c]

A Qualified Patient Must:

  • Be a permanent or seasonal Florida resident
  • Be diagnosed with a qualifying medical condition by a qualified physician
  • Be entered into the Medical Marijuana Use Registry
  • Obtain a Medical Marijuana Use Registry Identification Card

Patients must first be diagnosed with a qualifying medical condition. Below are the state-approved conditions that allow one to qualify for their recommendation.

Qualifying Medical Conditions:

  • Cancer
  • Epilepsy
  • Glaucoma
  • Post-traumatic stress disorder (PTSD)
  • Amyotrophic lateral sclerosis (ALS)
  • Crohn’s disease
  • Parkinson’s disease
  • Multiple sclerosis (MS)
  • Medical conditions of the same kind or class as or comparable to the others listed.
  • A terminal condition diagnosed by a physician other than the qualified physician issuing the physician certification.
  • Chronic nonmalignant pain caused by a qualifying medical condition or that originates from a qualifying medical condition and persists beyond the usual course of that qualifying medical condition.

Once approved by a medical cannabis physician, the patient will be entered into the Medical Marijuana Use Registry. This will generate a unique patient identification number that will be used to apply for your Medical Marijuana Use Registry ID Card. This can be done both electronically or by a paper application. For information and other resources, please visit the Registry Identification Cards page, or view this Instructional Guide for step-by-step instructions.

After your ID Card application is approved, you will be able to purchase medical marijuana products from a licensed medical marijuana treatment center (MMTC) that fits your recommendation placed by your qualified physician. Caregivers are also eligible to apply for a Caregiver ID Card; however, this is an additional cost of $75 to the state. 

Patients and caregivers may only purchase medical marijuana from a state-approved MMTC. Medical marijuana treatment centers may deliver medical marijuana to qualified patients and caregivers. If you do not have an MMTC in your city you can still fill your order by contacting a medical marijuana treatment center and arranging for delivery.

If you believe that medical marijuana is a good option for you, this survey will help determine if you are eligible for a recommendation. Want to skip the wait? Book a risk-free exam with one of DocMJ’s many qualified physicians throughout the state to start your medical marijuana journey as soon as possible!