Subscribe
Medical marijuana is frequently used for chronic pain and anxiety, as well as to treat symptoms associated with glaucoma or cancer. As a holder of a medical marijuana card, you may be wondering: is marijuana covered by Medicare?
Does Medicare cover medical marijuana?
Medical marijuana has not been legalized in every state and has not received approval from the FDA to be used in its standard form. Marijuana is also classified as a Schedule I drug, which means Medicare does not cover it. This rule also refers to Medicare Advantage (Part C) and Part D, no matter if it was legalized in your state or not.
Still, there is a catch – Medicare Advantage and Medicare Part D can pay for some medications that are based on cannabinoid products. The condition is for the product to be approved by the FDA, but a prescription from your medical provider is also required. The drug formulary you were given is necessary to have that specific medication added to the list.
Where is medical marijuana legal?
As of 2023, medical marijuana was approved in a total of 38 states, with patients requiring a special card to obtain the product. Oklahoma is the state that sees the most common use, with about 9.1% of the population being the owners of a medicinal marijuana card. Oklahoma is followed by Maine and Pennsylvania, with 7.66% and 4.78% respectively owning such a card.
Some states have also legalized marijuana for recreational use, with some notable examples being Arizona and Maryland. Other states such as Arkansas and Florida allow only medical use, whereas states like Hawaii and Louisiana have decriminalized it entirely.
The states where it is still illegal include Georgia, Idaho, Indiana, Iowa, Kansas, South Carolina, Tennessee, Texas, Wisconsin, Wyoming, and American Samoa.
However, it is important to remember that even if you live in a state that has legalized medical marijuana, Medicare will not cover it because it has not been deemed legal on a federal level. The only exceptions are cannabis-based products that have been approved by the FDA, for which you may potentially obtain Medicare coverage.
What medications are covered?
Since the FDA has not approved cannabis for effective or safe use, it seems that Medicare has its hands tied on the matter.
However, early in 2018, the FDA approved several medications based on cannabinoid-active ingredients for certain conditions. One of them is prescription medicine, whereas the others are non-prescription medications. These are the only drugs for which you could obtain Medicare coverage, should your medical provider prescribe them to you. We’re talking about:
1. Epidiolex
Epidiolex has a purified version of CBD listed as an active ingredient, which has been obtained from cannabis. The drug was approved to treat two rare, yet severe forms of epilepsy called Davet Syndrome and Lennox-Gastaut Syndrome.
2. Syndros and Marinol
Syndros and Marinol contain dronabinol, which is a synthetic version of THC. The products are used to treat weight loss and loss of appetite in patients with anorexia or AIDS/HIV. They can also be used to treat nausea symptoms caused by chemotherapy.
3. Cesamet
Cesamet features nabilone, which is also a synthetic substance similar to THC. Like Syndros and Marinol, the medicine is used to treat vomiting and nausea induced by chemotherapy in cancer patients.
Do medical marijuana dispensaries take insurance?
Technically speaking, since marijuana is not yet legal on a federal scale, insurance companies cannot cover this type of medicine. However, the good news is that marijuana dispensaries offer the alternative of a loyalty program when you use your medical marijuana card.
Does Medicare offer coverage for CBD oil?
While CBD oil is an extract obtained from medical marijuana, Medicare does not cover its use. Still, one thing to note is that CBD oil is an active ingredient found in Epidiolex, which has been approved by the FDA. In this case, if you have been prescribed to take Epidiolex, you can obtain the much-wanted compensation from Medicare.
The bottom line
For the most part, Medicare and medical marijuana do not see eye to eye. Since it has not been approved by the FDA, you cannot get coverage for medical marijuana throughout the USA, regardless of its legal status. The only exceptions are the four drugs that have obtained FDA approval.
