Is Medical Marijuana Covered by Insurance? 2021 • Benzinga

Health insurance covers a wide range of treatments. Some policies even cover alternative treatments like acupuncture. It doesn’t cover medical marijuana, however. Learn more about medical marijuana, what it treats and why it’s not covered by medical insurance.

Quick Answer: Medical Marijuana and Health Insurance

Is medical marijuana covered by health insurance? The short answer here is no. Because marijuana is still federally illegal, healthcare coverage providers have their hands tied when it comes to offering insurance coverage for medical marijuana as a prescription drug. That being said, doctors can help you get your medical marijuana card or recommend medical marijuana as a treatment in states where it’s legal. It’s likely that until marijuana’s scheduled status is changed and the FDA is able to review it and approve it as a

Is Medical Marijuana Effective as Health Care?

Many people use medical marijuana to treat a variety of conditions. Pain control is the most common, according to the Harvard Health blog. Many use it to treat chronic pain from arthritis, nerve pain and multiple sclerosis. 

Some treatments for pain are addictive or sedating. For example, opiates are addictive, and it’s possible to overdose on them. Opioid-use disorder is a problem in many areas of the country. Pain medications that are sedating make it difficult to complete daily activities, so medical marijuana is an appealing alternative. 

People with Parkinson’s disease, fibromyalgia, endometriosis and cancer also use medical marijuana. Cancer patients use it to help with the side effects of chemotherapy. It’s also been found to be effective for relieving the symptoms of HIV/AIDS and cancer. 

Some have also found it effective for mental health conditions like PTSD, depression and anxiety. 

While medical marijuana can be helpful, some find it difficult to deal with the side effects, which include headaches, dry mouth, dizziness, drowsiness and fatigue. There’s also a relatively small risk of becoming addicted to marijuana (called marijuana-use disorder). 

Be sure to consult your health providers before using medical marijuana to treat these or other conditions. Ask about how it might interact with other prescriptions you take, and don’t stop taking any prescriptions without talking to your doctor. 

Where is Medical Marijuana Legal?

Medical marijuana is legal in 36 states as of September 2021 — Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Hawaii, Illinois, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island,  South Dakota, Utah, Vermont, Virginia, Washington and West Virginia — and Washington, D.C. Guam, Puerto Rico and the U.S. Virgin Islands also allow medical marijuana. 

State laws vary significantly when it comes to who can qualify to use medical marijuana. In general, you typically need to have a specific condition such as:

• Alzheimer’s disease
• ALS
• HIV/AIDS
• Cancer
• Crohn’s disease
• Epilepsy
• Seizures
• Glaucoma
• Multiple sclerosis
• Chronic pain

Does Insurance Cover Medical Marijuana?

While recreational and medical marijuana is legal in many states, it’s still an illegal Schedule I drug on a federal level. That means health insurance companies will not cover it because it’s technically illegal. Doctors also can’t prescribe medical marijuana. They can recommend it as long as they’re following the protocols for medical marijuana in their state, but not all doctors will. 

Medical insurance companies also won’t cover medical marijuana because it’s not on their drug formularies. With health insurance, prescription medications are listed on a formulary. The formulary determines what prescriptions will be covered and how much the insurance company will pay toward those prescriptions. 

Prescriptions are typically only added to a formulary if they’re approved by the Food and Drug Administration (FDA). It’s unlikely that medical marijuana will be approved by the FDA anytime soon. One of the biggest hurdles to FDA approval is a lack of research. Marijuana is difficult to research because of its status as a Schedule I drug. As long as it’s illegal on the federal level, it will be extremely difficult to research. Without research on safety and efficacy, the FDA won’t approve it. 

Even if medical marijuana is legalized on the federal level, it’s possible it won’t be covered by health insurance. After all, many medications aren’t covered by insurance, including herbal remedies, vitamins, pain relievers and cold medicine. Health insurance companies may find that dealing with all the different strains and delivery methods involved with medical marijuana is too complex to add to their formula and not cover it. 

FDA-Approved Synthetic THC Medications

The FDA-approved medications that contain a synthetic form of THC, one of the compounds found in medical marijuana, include:

• Marinol: This drug is used to treat nausea and vomiting from chemotherapy and loss of appetite and weight loss in people with HIV. 
• Cesamet: Like Marinol, Cesamet is also used to treat severe nausea and vomiting from chemotherapy. 
• Syndros: This is also used to treat nausea and vomiting from chemotherapy and loss of appetite in people with AIDS. 

The FDA also approved Epidiolex in 2018. Epidiolex is a cannabidiol (CBD) oral solution used to treat seizures associated with 2 rare forms of epilepsy. 

All of these FDA-approved medications can be covered by insurance and may appear on a health insurance company’s drug formulary. 

What About CBD?

CBD is another compound found in medical marijuana. CBD is often sold on its own because it doesn’t cause the high associated with THC. Some feel it’s an effective remedy for pain and other health conditions on its own. Many stores, including grocery stores and pharmacies, carry CBD. Dispensaries may also carry CBD products as well as products with both THC and CBD. 

Like medical marijuana, people use CBD for a range of health conditions. They include:

• Pain
• Inflammation
• Multiple sclerosis
• Epilepsy
• Crohn’s disease

CBD also isn’t covered by health insurance. Although it’s legal and doesn’t have the psychoactive side effects that THC does, it’s considered a supplement, so health insurance plans don’t cover it. 

Benzinga’s Best Health Insurance Companies

Although health insurance doesn’t cover medical marijuana, it does cover many other services and prescriptions. Here are Benzinga’s picks for the best health insurance companies. 

Covering the Costs of Medical Marijuana

Because medical insurance doesn’t cover medical marijuana, you’ll need to pay for it yourself. Be sure to follow your state’s protocols for buying medical marijuana. Typically, you’ll need to meet with a doctor to get a recommendation for medical marijuana. When you meet with your doctor, discuss your specific conditions and ask whether the doctor recommends any specific strains or delivery methods. Strains vary significantly in their effects on the body and mind, and some might be better suited to your needs than others. You also don’t have to smoke medical marijuana. There are patches, creams, edibles and other options that might be more comfortable. Some states limit which options are available. 

If you have the option, visit or talk to multiple dispensaries. Discuss what your doctor recommended and what you’re looking for. Get prices for the products you’re interested in. Choose a dispensary that offers excellent customer service (and delivery if you need it) and a competitive price on the products you need. 

If you’re new to medical marijuana, keep track of what you take, how often you use it and how it impacts your symptoms. This information can help you determine whether it’s working for you and whether you need to make adjustments. 

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