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Will My Insurance Cover My Medical Marijuana?


Marijuana use is becoming more common across the country and those who had once viewed it as purely recreational are now seeing the benefits and therapeutic applications marijuana has. This is largely due to the influx of new research and subsequent shift in public opinion because of it. This isn’t to say that total adoption has been undertaken, or even legally completely clear, and this leaves many people wondering about their insurance coverage and these fancy new forms of marijuana. In this post, we will clear up the mystery surrounding insurance and marijuana and look into why the current coverage is the case. 

Does Insurance Cover Medical Marijuana?

No, it does not. The idea makes sense on paper. You pay for health insurance so you can get help on expensive medical procedures and pharmaceuticals recommended by your doctor. So, why shouldn’t medical marijuana be covered by insurance?

The biggest reason is that, according to the federal government, marijuana is still a Schedule I drug. According to the DEA, “Schedule I drugs, substances, or chemicals are defined as drugs with no currently accepted medical use and a high potential for abuse”, and marijuana is on that list [1]. Because of this, insurance companies, and especially government health coverage such as Medicare, cannot cover medical marijuana. 

Another reason is the general conservatism of medicine overall. Before a certain idea, treatment, or drug is to be accepted by the medical community, it must first undergo rigorous testing and research. This is so all the kinks, imperfections, and possible dangers are either discovered or fixed before general application. Overall, this is a very good thing, nobody wants an undiscovered side effect in a popular prescription, but it is a double-edged sword. In the case of marijuana, it means that while some doctors have begun recommending medical marijuana to patients, others are holding out for higher quality and more numerous research papers. 

This carries over to the FDA, who has very strict rules and regulations over what gets approval. If a drug is not approved by the FDA, it probably won’t be covered by insurance. In order to gain FDA approval, a drug must undergo extensive clinical testing. As of now, the FDA has done no such testing with medical marijuana. 

What Does This Mean For Patients?

To start, it means that you are responsible for paying for all steps required to obtain medical marijuana. This includes the medical marijuana recommendation appointment, registration, and, of course, the marijuana itself. If you have a Health Savings Account or Flexible Spending Account, you may be able to use some of the money to pay for the visit to the doctor, but will not be able to use any of the funds to purchase marijuana of any kind

Alright, so medical marijuana isn’t covered by health insurance, does using marijuana affect health insurance rates? This question may not be as crazy as it sounds, as people have started to use medical marijuana in ways and for reasons we previously wouldn’t have guessed, and health insurance companies are taking notice. This has led to both pros and cons for patients, one benefit being reduced prescription use. One study found that, between 2010 and 2013, the use of prescription drugs for which marijuana could serve as an alternative fell significantly [2]. This reduction resulted in an estimated $165.2 million per year Medicare savings in states with medical marijuana laws. On the other hand, some people voice concern over insurance companies covering marijuana and point to rising premiums for that reason. 

Is There Any Form of Marijuana Covered By Health Insurance?

Yes, and they have been approved by the FDA. CBD, one of the cannabinoids produced by marijuana, has been approved to treat certain forms of epilepsy. The common name for this is Epidiolex, and it is extracted directly from the marijuana plant. Compare this to Nabilone, which is a synthetic form of THC, another cannabinoid produced in marijuana. Importantly, both forms of marijuana previously mentioned have been thoroughly tested and approved by the FDA. 

Will Marijuana Be Covered In The Future?

As it stands now, the FDA has shown support for the continued research and use of medical marijuana in certain situations. There have been an increasing number of researchers dedicating time and money to medical marijuana and its uses and mechanisms. As our understanding continues to grow, the laws surrounding medical marijuana use may change. As an example, under the Farm Bill, hemp and hemp products were recently made legal. Because of this, we may soon get easier access to hemp-derived products such as CBD oil and tinctures. This has the added benefit of easier access for scientific pursuits, in turn bringing us one step closer to a deeper understanding. 

In Conclusion

Insurance does not cover medical marijuana or the process of obtaining it. This means that the user is responsible for paying for the doctor’s visit, registration fees, and for the marijuana itself. This is due to a couple reasons, the main one being the DEA considering marijuana a Schedule I drug, meaning it has no accepted medical use. However, there are some marijuana-derived drugs that are covered by insurance, these being CBD- and THC-based Epidiolex and Nabilone respectively. This may change in the future, with marijuana research making more forward strides as time goes on and more medical uses are discovered. 


[1] https://www.dea.gov/drug-scheduling  

[2] https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2015.1661


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