Although medical marijuana has been proven to be an effective treatment for conditions like cancer and PTSD, it still is not covered under insurance. There are a few obstacles preventing insurance from covering medical marijuana. First of all, medical marijuana is considered a controlled illegal substance under federal law. This classification is one barrier for insurance to cover it. Another barrier is that the Food and Drug Administration (FDA) has not approved the use of medical marijuana. In addition, the FDA has not yet approved a plan for clinical trials of this drug. Before approval of medical marijuana, the FDA will want clinical studies on its safety and effectiveness. It’s important to note that health legislation is administered through state and federal exchanges. Insurance companies will have to wait until the federal law is changed and the FDA approves the usage of medical marijuana.
Change on the Horizon
Change is slowly in the horizon with medical marijuana. For example, there have been changes in the state of NY. Insurers in NY state now have to cover doctor’s visits that are related to medical marijuana. But, there is a caveat. The visit cannot be for the sole purpose of medical marijuana. Patients first must be diagnosed with a medical condition that has medical marijuana recommendation. Patients must get a medical marijuana card, and then insurers must approve the claim. In 2017, a NJ judge delivered an unprecedented ruling on medical marijuana involving a worker’s compensation case. The judge ruled that the worker’s compensation medical carrier cover medical marijuana for the claimant’s neuropathic pain. In Canada, a judge ruled that the insurance carrier would have to cover medical marijuana for a claimant’s chronic pain due to a car accident.
Medicare, Medicaid and Insurance with the Veteran’s Administration (VA)
Both Medicare and Medicaid are federal entities, so neither one covers medical marijuana. If you have Medicare or Medicaid, you’ll have to go out of pocket for treatment. Medical marijuana is not covered under Plan B, nor is it covered as a prescription add-on. If you currently use marijuana and have health coverage with the VA, you cannot bring the medical marijuana on VA property.
Other options for medical marijuana include health savings accounts (HSAs) and flexible spending accounts (FSA). With an HAS, you pay for things that insurance doesn’t, and this money can be used for co-pays. Same thing with FSAs. Keep in mind that this money cannot be used to purchase any substances that are illegal.
Although medical marijuana may not be covered now, this issued is being addressed in the courts. Many petitioners have brought cases to the court to change the drug classification of medical marijuana. This is the door to opening insurance coverage for medical marijuana. It is also being discussed as an argument to eliminate the opioid epidemic in this country. And with thousands dying every year from opioids, it’s a strong argument.
Medical Marijuana Dispensaries
Currently, marijuana dispensaries do not take medical insurance. Most medical marijuana dispensaries are cash-only. Paying with a credit card like Visa is difficult due to the fact many credit card companies have declined services for the purchase of marijuana. And it doesn’t matter if marijuana is legal in the state. However, debit cards are sometimes accepted through third parties. This helps circumvent the banks that have an issue with dispensaries.
What It Means for Medical Marijuana Patients
The bottom line is that the current landscape of medical marijuana leaves patients to go out of pocket for medical marijuana. And these out of pocket expenses vary depending on what state you live in. The least expensive states for medical marijuana include Nevada, Colorado, Washington and California. The most expensive states for medical marijuana include Iowa, Vermont, North Dakota and Virginia.
The only other option for medical marijuana is to use a drug that the health insurance does cover. Cesamet and Marinol are both man-made THC drugs that health insurance companies do cover. Marinol has been shown to help with nausea and vomiting due to chemotherapy, and Cesamet has been shown to help those with pain due to multiple sclerosis.
If you’re wondering how to pay for medical marijuana, you need to consider all of the available legal options. It’s best to talk with your doctor to help find the best choice for you.