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Is Medical Marijuanas Covered by Insurance?

    • Currently, medical marijuana is not covered by insurance providers because of its Schedule I drug designation, meaning it has no medical use—at least in the eyes of the federal government.

 

    • However, there are a few ways people are finding hope that medical marijuana will be more financially accessible in the future, with the use of reimbursement in workers’ compensation claims and the exciting introductions of new state and federal bills.

 


More and more states are creating medical marijuana programs for people living with conditions like nausea, chronic pain, and anxiety. For many, these programs provide legal, life-saving access to relief from their suffering.

Despite this progress, there are still some significant barriers to medical marijuana access, particularly when it comes to health insurance coverage.

Marijuana products and doctor costs aren’t covered by most insurance policies due to federal marijuana laws, despite the lived experiences of thousands of patients who are finding relief through medical marijuana.

Learn more about this unfortunate disconnect and its impact on the healthcare industry, and discover what passionate medical marijuana advocates are doing to change it.

The Process of Obtaining Medical Marijuana

If your state has a comprehensive medical marijuana program in place, you might assume that medical marijuana would be covered by insurance like many other drugs.

But medical marijuana is a special case. While many states have legalized its use in recent years, it’s still federally recognized as a Schedule I drug under the Controlled Substances Act. So even though many individual state governments recognize the medical value of marijuana, the federal government currently does not.

This has a few consequences for medical marijuana users. For one, the process of obtaining medical marijuana looks different than obtaining other pharmaceuticals:

  • Obtained by recommendation, not prescription – Because marijuana is a Schedule I drug, doctors are not allowed to prescribe it for any reason. The penalty for doing so is the suspension of their DEA registration, which allows doctors to prescribe medicine. How do patients obtain medical marijuana, then? A small loophole: instead of a prescription, doctors can write you a recommendation.
  • Medical marijuana card – After receiving a recommendation from a licensed doctor, you’re then required to carry a medical marijuana card that proves you’re allowed to use marijuana to treat a health condition. Most state programs also require you to get your card renewed every year by a doctor.
  • Dispensary/pharmacy visits – Instead of picking up a prescription from a traditional pharmacy, you need to visit a marijuana dispensary or cannabis-specific pharmacy (in the case of Louisiana) to get the products you need. Your doctor can recommend certain products and doses for your specific symptoms, but they can’t write a traditional script.

Marijuana’s Schedule I designation also has unfortunate impacts on your health insurance. Both public providers like Medicare and Medicaid, as well as private providers, are usually unable to cover medical marijuana as a prescription drug.

What Insurance Does and Doesn’t Cover

There are two reasons health insurance companies currently can’t cover medical marijuana expenses:

  • Illegal acts and exclusion clauses – Most health insurance plans do not cover the use of any illegal substances. Since marijuana is a Schedule I drug, it’s considered illegal under these clauses, even if its use isn’t illegal in your state.
  • Lack of FDA approval – All health insurance plans have a drug formulary or a list of drugs they’ll cover. In order to be on the drug formulary, a medication must be approved by the Federal Drug Administration (FDA), which requires thorough research and testing.

It’s important to note that, in addition to medical marijuana products not being covered, visits with cannabis doctors aren’t always covered, either. But this varies by state and provider—there’s no harm in asking your medical marijuana doctor if they accept your health insurance policy.

Medical Marijuana: What Are You Paying For?

Now that you know why insurance won’t cover your medical marijuana expenses, how much can you expect to pay?

The cost of obtaining medical marijuana involves more than just the product itself. You also have to consider:

  • Doctor’s appointments
  • Medical marijuana card application and renewal fees
  • Travel costs for doctor’s and dispensary visits

These costs can vary depending on where you live. In most states, marijuana costs between $200 and $400 per ounce, even in states with a medical marijuana program.

And how much does it cost for a medical marijuana card? These costs also vary widely. In some states, like Massachusetts and New Mexico, cards are free. Most states, however, charge anywhere from $25 to over $150 for a card application and each annual renewal.

Most state programs require you to pay for a card (and subsequent renewals) out of pocket. Though there are some states, like California and New York, that offer cost reductions or fee waivers.

You also have to consider your medical marijuana doctor’s costs. Often, doctors will charge you for a visit, even if they don’t give you a medical marijuana recommendation. Some insurance plans will cover these visits, but some won’t. You may also encounter fees you weren’t anticipating.

TeleLeaf works differently: you only have to make a one-time payment, with no hidden fees. And, if you’re not approved for a card, you’ll get 100% of your money back, guaranteed.

Our support doesn’t end with a recommendation, either. We connect you with pharmacists who will give you personalized product and dosage recommendations based on your specific symptoms.

Find out more about how TeleLeaf is changing the game when it comes to medical marijuana recommendation services.

The Push for Medical Marijuana Coverage

Some people have the privilege to pay for medical marijuana out-of-pocket, but many don’t.

With all the legal hurdles discussed in this article, affordable medical marijuana may seem like a distant fantasy. But there are some exciting new developments in the fight for insurance coverage being led by individuals who believe in the healing powers of medical marijuana:

  • In New York, a bill was passed by the Assembly Health Committee that would require public health insurance providers, like Medicaid, to cover medical marijuana expenses, and would allow private insurance providers to do so if they wish.
  • The Medical Marijuana and Cannabidiol Research Expansion Act was signed into law in 2022, allowing for more essential research into the healing potentials of medical marijuana. Data collected as part of these efforts will help inform future legislation that may ease access for patients.

These laws would not be possible without the fierce advocacy work of patients and doctors alike. We at TeleLeaf have worked tirelessly to spread awareness of the life-saving impact of medical marijuana for those living with chronic conditions and to make it more accessible—and affordable—for those who need it most.

The Potential of Medical Marijuana Reimbursement

Medical marijuana reimbursement under workers’ compensation is currently allowed in six states, with several other states allowing insurance companies to choose whether or not they reimburse medical marijuana purchases.

This is great news for those using medical marijuana to treat work-related injuries.

Reimbursement gets around the legal snag insurance companies run into with covering medical marijuana. While they can’t cover its cost, they can repay you after you’ve purchased it in some cases. This is great news for insurance companies too; by reimbursing medical marijuana, they don’t have to cover the costs of far more expensive medications, like opioids.

For now, medical marijuana reimbursement is only available under workers’ comp in certain states. But hopefully, in the future, insurance companies will see the value in reimbursing its use in other cases, both to save money and to provide people with a more holistic treatment option.

Medical Marijuana Recommendations Made Easy and Affordable

Here at TeleLeaf, we’re working to demystify the medical marijuana recommendation process, one referral at a time. In a world where sterile, clinical studies take precedence over real patient experiences, we put you and your needs first.

We understand how essential medical marijuana can be to improving patients’ quality of life. That’s why we’re doing all we can to eliminate the barriers preventing people in need from finding all-natural, plant-based relief.

Instead of booking an in-person appointment and waiting days or weeks to be seen by a provider, set up a virtual appointment with TeleLeaf and get approved for a medical marijuana card today.


Sources:

Verywell Health. Why Health Insurance Won’t Pay for Medical Marijuana.
https://www.verywellhealth.com/why-health-insurance-wont-pay-for-medical-marijuana-1738421

Chicago Tribune. Average marijuana price by state.
https://www.chicagotribune.com/medical-marijuana-costs-by-state-20140901-htmlstory.html

NBC News. ‘Ridiculous’ price of medical marijuana leaves patients scrambling.
https://www.nbcnews.com/news/us-news/ridiculous-price-medical-marijuana-leaves-patients-scrambling-n1274085

PropertyCasualty360. States that require payment, reimbursement for medical marijuana.
https://www.propertycasualty360.com/2023/05/15/states-that-require-payment-reimbursement-for-medical-marijuana/?slreturn=20240029132045

Ithaca Journal. Kelles, Lupardo co-sponsor legislation requiring Medicaid to pay for medical marijuana.
https://www.ithacajournal.com/story/news/2023/03/27/medical-marijuana-in-ny-may-be-covered-by-medicaid-public-insurance/70041138007/

Congress.gov. H.R.8454 – Medical Marijuana and Cannabidiol Research Expansion Act.
https://www.congress.gov/bill/117th-congress/house-bill/8454

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