Does Medicare Cover Medical Marijuana?
More states are legalizing medical marijuana with each passing year. That may make you wonder whether Medicare will cover the cost of medical marijuana in your state.
Federally, marijuana remains a controlled substance. It’s illegal to possess or use the drug under federal law. However, individual states have passed laws allowing distribution and sale within their state boundaries.
Medicare won’t cover medical marijuana because it’s considered a Schedule I controlled substance. In fact, doctors can’t even legally prescribe it.
Marijuana is usually suggested to treat symptoms like pain, nausea, and seizures. If you’ve received a doctor’s recommendation and your state has legalized medical marijuana, read on to learn what you need to know about coverage for medical marijuana, how and why it’s used, and more.
Medicare doesn’t cover drugs that are illegal according to the federal government. This includes marijuana.
The Food and Drug Administration (FDA) hasn’t cleared marijuana as a safe and effective treatment for any medical use. That’s true even if you live in a state where it’s medically legal. This is another reason Medicare won’t cover medical marijuana.
What about Medicare prescription drug plans?
Medicare Part C, or Medicare Advantage, is health insurance offered by private insurance companies that offers additional coverage beyond original Medicare (parts A and B). Extra coverage may include dental care, vision care, and some prescription drugs.
Medicare Part D is medical insurance that’s also offered through private companies and covers prescription drugs. It doesn’t, however, cover medical marijuana.
Parts C and D could cover the cost of cannabinoid medications that have been approved by the FDA and are available without restriction. This is where some flexibility exists.
Cannabinoid medications, like dronabinol (Marinol, Syndros) and Epidiolex, may be covered by Medicare drug plans because they’re FDA approved.
If you’re unsure what your plan covers, contact your Medicare prescription drug plan directly. They can help you understand whether you have coverage for any cannabinoid medication and how to fill a prescription.
Marijuana has been recommended to ease symptoms like:
Medical marijuana is often suggested to treat the symptoms of AIDS or cancer. Research has shown it can boost appetite and reduce nausea. If you have multiple sclerosis (MS), medical marijuana may help ease pain and reduce muscle stiffness.
Dronabinol can be used to ease nausea and vomiting from cancer treatments and increase appetite in people with AIDS.
Epidiolex can help prevent seizures and is used as a treatment for epilepsy. Both of these medications have been approved by the FDA for these uses.
The federal government considers marijuana illegal and holds strict control of cannabis and cannabinoid-based products. That means research on the possible benefits, or even the side effects, of marijuana use is limited.
Without data from clinical research, the FDA won’t be able to update its position on the safety or effectiveness of medical marijuana.
In 2020, 33 states and Washington, D.C., have approved the sale and use of medical marijuana. Some of those states have also approved marijuana for recreational use.
In states where only medical marijuana is legal, you’re required to get a medical marijuana card.
The rules and steps for getting a medical marijuana card may vary from state to state, but here are the basics:
- Make an appointment with your primary healthcare provider. Your doctor will likely give you a full physical exam and review your medical history. If your doctor thinks medical marijuana might help, they may approve you for a medical marijuana card.
- Renew your marijuana card annually. This may require follow-up visits. Ask your doctor if there are any other additional steps you’ll need to take. Most marijuana cards are registered with the state government.
- Your doctor can’t prescribe marijuana directly. Federal law prevents doctors from prescribing substances that are illegal. Marijuana remains illegal under federal law. Instead, your doctor may suggest you use it.
Even though all types of marijuana are illegal at the federal level, the federal government hasn’t taken steps to prosecute those who use it within a state with legal marijuana trade.
However, it’s still possible to face prosecution under federal law under certain circumstances.
Marijuana contains several dozen active chemicals. The two most well known are cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC).
CBD’s potential benefits include improved relaxation, pain reduction, and lowered anxiety. THC is the chemical responsible for the psychoactive effects of marijuana.
In recent years, CBD has been isolated from THC and is sold even in states that don’t allow medical marijuana. In states where medical marijuana is legal, both CBD and THC products are available for a variety of health issues.
Like medical marijuana, individual states have their own legislation regarding legal levels of CBD. Check your state’s legislation for specific information, and be mindful of other state laws when traveling with CBD.
how Medical Marijuana may affect the opioid crisis
Limited research suggests the use of marijuana is reducing the use of opioids and pain medication with high addiction potential. Because marijuana may help relieve some of the same symptoms as opioids, doctors may not prescribe pain medications if marijuana were an option.
If you have a serious illness, marijuana is sometimes used to treat symptoms like pain, nausea, and seizures. If your doctor has diagnosed you with one of these conditions and your state has legalized medical marijuana, here’s what you need to know about using medical marijuana and how much it will cost.
Does Medicare Cover Medical Marijuana or CBD Products? No – But There Are Some Options!
As of March 2020, 33 states have legalized comprehensive, publicly available medical marijuana/cannabis programs and 13 have approved use of “low THC, high cannabidiol (CBD)” products for medical reasons in limited situations.
With this widespread adoption of using marijuana for health conditions, including pain management, alleviating anxiety, and improving sleep, it’s become a viable alternative to pharmaceuticals, especially for people with chronic conditions, mental illness, or undergoing chemo.
It’s especially attractive to older Americans who are in constant pain due to arthritis or other conditions, who have trouble sleeping, or are battling mental health issues.
All that said, this leaves the question of how accessible medical marijuana is to Medicare beneficiaries. We’ll dive into the specifics in this piece, including whether or not Medicare provides coverage, the associated costs, and options available.
Does Medicare Cover Medical Marijuana?
As of July 2020, Medicare does not provide coverage for medical marijuana because it is still a federally controlled substance. In order for a medication to be covered by Medicare, it must have FDA approval. But because marijuana is not authorized on a federal level, Medicare will not cover it even if you buy a Part D plan.
So far, the only FDA-approved marijuana-based drug is Epidiolex, which is a medication for children two years old or younger suffering from epilepsy.
Thus, even if your doctor believes marijuana is the best treatment choice for you and writes you a prescription, you will still be required to pay entirely out-of-pocket should you choose to move forward.
Will Medicare Advantage Cover Medical Marijuana?
Similar to Original Medicare, insurance carriers that sell Medicare Advantage plans need to abide by the federal guidelines, so they will not offer coverage for medical marijuana prescriptions. However, some Advantage plans may provide coverage for the use of cannabinoid-based medications such as Epidiolex.
What About Medigap?
Despite the wide array of benefits offered through Medigap plans, they too have to follow federal guidelines and will not provide coverage for medical marijuana.
So, What Are My Options?
Although Medicare does not cover marijuana, Part D may cover cannabis-based medications. Currently, there are four medications available that contain marijuana compounds and have FDA approval:
Marinol and Syndros
A synthetic version of the marijuana compound Dronabinol is contained in the brand-name medications Marinol and Syndros. If you pay out-of-pocket without any drug coverage, you could end up paying around $130 each month for Marinol and a whopping $1,300 for Syndros. Having a drug plan that covers these medications can be a massive benefit.
Cesamet is another medication that contains a synthetic compound similar to those in marijuana. The average out-of-pocket cost for Cesamet is more than $2,000 for a month’s supply.
As mentioned above, Epidiolex has an ingredient derived directly from marijuana. Epidiolex has CBD in it, which can help reduce a plethora of symptoms. However, the average out-of-pocket price of Epidiolex is astronomical, costing more than $32,000 per year.
Does Medicare Cover CBD Oil?
Given the growing popularity of CBD or cannabidiol as a treatment for chronic pain, anxiety, and sleeplessness, it’s a great holistic solution for older adults. Moreover, it doesn’t have the psychotic effects of THC as CBD is typically sourced from industrial hemp plants as opposed to marijuana plants.
Yet, despite the availability of CBD products in health and wellness stores and its proven benefits for managing pain, anxiety, depression, insomnia, and many other unpleasant symptoms, Medicare will not provide coverage for it.
Unfortunately, just like marijuana, CBD is yet to be considered legal on a federal level. Until the FDA approves CBD oil, Medicare won’t help pay for it.
The upside here though is that CBD products are not nearly as expensive as medical marijuana. Depending on factors including strain, dosage, and dispensary you purchase from, the cost can range from $50–$1,500.
Do Your Research
While Medicare does not currently provide coverage for medical marijuana or CBD products, that’s not to say it never will, especially since more states are legalizing both recreational and medical marijuana use, and there’s a push to make it federally legal as well.
But for right now, my best advice is to listen to your doctor’s recommendations and do your research on benefits and costs associated with medical marijuana and CBD products to ensure you’re making a well-informed purchase.
Are medical marijuana and CBD legal in your state? Do you use such products? Why or why not? Do they help you with your particular health issues? What benefit have you noticed since you started using? How do you pay for this type of medication? Please share what you know in the comments below.
Does Medicare Cover Medical Marijuana or CBD Products? No – But There Are Some Options! As of March 2020, 33 states have legalized comprehensive, publicly available medical marijuana/cannabis