Medical Marijuana and Medicare Coverage
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Once you get your medical marijuana card, you might assume Medicare will cover some of your costs. But, that isn’t the case. Medicare won’t cover medical marijuana, even if you have a legitimate prescription. But what about Part D? Will Part C cover cannabis? Let’s learn all about coverage for cannabis; when you can expect coverage, and when you’ll be paying for your medication.
Does Medicare Cover Medical Marijuana?
The short answer is no, Medicare won’t cover your medical marijuana. But, Medicare is notorious for not covering things that are alternative therapies or medications. For the most part, you can expect to pay for your cannabis out-of-pocket.
Do Dispensaries Take Medicare Insurance?
No, dispensaries don’t take insurance. Since marijuana isn’t legal at the federal level, insurance companies can’t cover the medication. Also, dispensaries aren’t like the pharmacy. They don’t have a contract with insurance companies to offer your medications at a discount or negotiated rates. Now, some dispensaries do have loyalty programs where you can save money when you buy your supply from them frequently or buy larger quantities of your medication.
Do Medicare Advantage Plans Cover Medical Marijuana?
Since Medicare won’t cover medical marijuana, Part C plans won’t cover it either. Now, if Medicare ever changes coverage to accommodate medical cannabis patients, then Medicare Advantage plans would follow suit.
Will a Medigap Plan Cover Medical Marijuana?
Medigap plans only cover when Medicare covers. Since Medicare won’t cover cannabis with a prescription, Medicare Supplements can’t help cover the cost either. And, since cannabis is a prescription, it’s likely that if Medicare ever covers it, it’ll become a Part D benefit, not a benefit through Medicare.
Does Having a Medical Marijuana Card Affect Medigap Insurance Eligibility?
Outside of the Medigap Open Enrollment Period, insurance companies may charge a higher premium to cannabis patients. It’s best to buy a policy when you’re first eligible for Medicare so you can avoid medical underwriting. Medical marijuana won’t get you denied a policy, but it could increase the cost. Be honest with your agent about your medications so they can help you find the company that will make the most sense for you.
Does Part D Cover Cannabinoid-Based Medications?
While Medicare won’t cover marijuana, Part D may cover prescriptions derived from cannabis. Currently, there are four medications available that have approval through the FDA.
The four medicines containing compounds present in marijuana are:
How to Get Marijuana Derived Medications Covered by Medicare
Medications that derive from marijuana and have FDA approval will have Medicare Part D coverage. But, you have to sign up for Part D separate from Medicare. Our agents can help you find the policy that covers your medications at the lowest cost to you. Give us a call at the number above to discover your options. Or, fill out an online rate form and see plans in your area now.
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Lindsay Engle is the Medicare expert for MedicareFAQ. She has been working in the Medicare industry since 2017. She is featured in many publications as well as writes regularly for other expert columns regarding Medicare. You can also find her over on our Medicare Channel on YouTube as well as contributing to our Medicare Community on Facebook.
5 thoughts on “ Medical Marijuana and Medicare Coverage ”
Very expensive…I have many health issues ex. Wires in my head and stimulator in my chest, autoimmune disease no cure to name a couple.. when I go to the airport I have medical ID and go through pat down….what is disturbing which I find out when my mother and I had to make an emergency trip to her I’ll brother is that even though you have medical ID for medical marijuana, you can not take it out of state so for however period of time you’re gone.. you have to stop taking it….why can’t you use your ID and take the medical marijuana with you.. and if they consider that it may be given to someone else, just place a limit on what you can bring….just like with any drug, you can’t just stop taking your medicines immediately cause it can cause more health issues, even death…maybe if this was approved by Medicare, and covered… this world would be a better place than to have overdosed and deaths occurring because they are picking stuff off the streets that are laced with things like ex. Fentanyl or whatever. And they get it cheaper not knowing what’ they are getting and where it originated from…thank you for allowing me to voice my opinion..
It’s rediculous that the FDA won’t declassify mmj for patient use. You can get a mmj card but not be able to afford to get it to use it.
If the government isn’t going to cover medical marijuana then they shouldn’t be able to collect the taxes on it! Period we cannot get pain meds because of the new laws, and being in chronic pain for more than 20 years! without a doctors prescribed pain meds I really cannot function but they don’t care if you are in pain! It’s cruel u wouldn’t let an animal suffer would you?
Why is it called “Medical Marijuana” if medical insurance doesn’t cover it? Sounds like Uncle Sam just wants more money if you ask me!
Hi Kenny! You’re not the first person to ask that! There’s a lot of prescriptions out there that health insurance doesn’t cover at first. However, that doesn’t mean one day it won’t be covered!
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The legalization of medical Marijuana has been a hot topic over the last 20 years. Learn the facts on Medicare coverage for medical Marijuana.
Does Medicare cover medical cannabis?
The Drug Enforcement Administration (DEA) categorizes cannabis, also known as marijuana, as a Schedule I substance under the Controlled Substances Act. Medicare does not cover cannabis, although it may cover cannabinoid-based medications.
Individual states vary in the legalization of recreational or medical cannabis within state boundaries.
This article explores Medicare’s coverage of cannabis-based prescription medicine and cannabis-related medications. It also discusses the health conditions that these medications may alleviate, compares THC and CBD, and shows costs.
Is CBD legal? Hemp-derived CBD products with less than 0.3% THC are legal federally but still illegal under some state laws. Cannabis-derived CBD products, on the other hand, are illegal federally but legal under some state laws. Check local legislation, especially when traveling. Also, keep in mind that the Food and Drug Administration (FDA) have not approved nonprescription CBD products, which may be inaccurately labeled.
Share on Pinterest Medicare may cover cannabinoid-based medications.
The Food and Drug Administration (FDA) has not approved cannabis as safe and effective for medical use. It is illegal in many states.
If a person lives in a state where marijuana is legal only for medical use, they must have a medical marijuana card (MMJ). Even if a person lives in a state where medical cannabis is legal, their doctor cannot prescribe it but may recommend its use.
Medicare does not cover medical cannabis or any drugs the federal government has declared illegal. However, in 2018 the FDA approved one cannabis-based prescription medicine and three cannabis-related medications, which Medicare cover:
- The epilepsy drug Epidiolex is a pure form of cannabidiol (CBD), one of the more than 120 active ingredients , or cannabinoids, found in cannabis. It treats some severe and rare forms of epilepsy.
- The anorexia drugs Cesamet, Marinol, and Syndros are synthetic drugs based on delta-9-tetrahydrocannabinol (THC), another active component of cannabis.
Research by the National Academies of Sciences, Engineering, and Medicine has provided conclusive evidence that cannabinoids or cannabis can help manage some health conditions. These include:
- chronic pain
- nausea and vomiting caused by chemotherapy
- multiple sclerosis (MS)
Moderate evidence shows cannabis may help with sleep issues, fibromyalgia, chronic pain, low appetite, and Tourette’s syndrome.
A simple way a person can think about the difference between THC and CBD is that THC changes how a person feels, while CBD does not. CBD does not produce the characteristic cannabis high that is typical of THC.
When a person uses medical cannabis, the effects vary depending on what the medication contains. For example, if the medication is CBD dominant, it will contain minimal THC, and a person will not feel high. On the other hand, a medication with more THC may result in a person experiencing a high.
How does cannabis work?
THC and CBD are two chemically similar active components in the Cannabis sativa plant. THC is an abbreviation of the chemical name delta-9-tetrahydrocannabinol and CBD is the shortened form of cannabidiol.
Medications based on the cannabis plant use the plant’s dried flowers, stem, leaves, and seeds.
The human body has hundreds, if not thousands, of cannabinoid receptors that interact with THC and CBD. For example, CBD may help a person \with anxiety, depression, or seizure disorders, while THC can relieve pain, increase appetite, or have a relaxing effect.
Cannabis laws are continually evolving, and states may vary in how they classify THC and CBD.
Medical cannabis, and related programs, are legal in 33 states, Guam, Puerto Rico, the District of Columbia, and the U.S. Virgin Islands as of 2018. If a person lives in a state where marijuana is legal only for medical use, they must have a MMJ.
Each state sets its own rules surrounding the approval and issuance of MMJs. For example, in Washington, D.C., a person would need to take the following two steps:
- Make an appointment with their doctor, who may conduct a physical examination and review the person’s medical history. The doctor may confirm the person has a health condition that medical marijuana could help, and will give a signed recommendation.
- The person gives the signed recommendation and an application form to the state’s pharmacy board. When a person gets medical marijuana authorization, they can register with the Medical Marijuana Authorization Database to get their MMJ card.
The MMJ card typically lasts for 1 year. After this time, a person may need a follow-up visit to their doctor.
In general, Medicare does not cover medical cannabis. The exceptions are the FDA-approved epilepsy drug Epidiolex, and the anorexia drugs Cesamet, Marinol, and Syndros.
Apart from when a person receives a prescription for FDA-approved drugs, medical cannabis may incur some costs.
Costs vary between states, but may include the following:
- Out-of-pockets costs related to a health care visit, such as to a doctor’s office.
- The cost of the medication. Although a person may not have to pay sales tax on the medical cannabis purchase from a medically endorsed retail store, they will generally have to pay the cost of the medication. Costs may vary based on the type and amount.
- A fee for using the medical cannabis card when getting the medication. This may vary depending on the store policy. Some stores may provide the medication at no charge to a person on a limited income.
- Cost for the MMJ card, which a person will need to renew each year.
Medicare prescription drug plans may cover or partly cover the FDA- approved cannabis-based medications. People should check their Medicare plan’s drug list before filling a prescription to determine if Medicare covers the cost.
Cannabis is a federally illegal drug. However, medical cannabis and related programs are legal in more than 30 states. Medicare does not cover the cost of medical cannabis but may cover some costs for some cannabis-based or associated medications.
A person who feels that medical cannabis may help with a medical condition can talk with their doctor. Depending on the state where a person lives, medical cannabis may be an option to relieve some symptoms.
Last medically reviewed on September 30, 2020
Cannabis (or marijuana) is a Schedule I substance. Medical cannabis and related programs are legal in more than 30 states, and Medicare may cover some costs.