December 19th 2023
By Ari Parker
Medicare does not provide coverage for medical marijuana, but there are certain situations where Medicare drug plans could cover the cost of cannabinoid-based medications.
By Ari Parker
Medical marijuana has become more popular to treat conditions like chronic pain and alleviate side-effects from cancer treatments. With its increased popularity, you might be curious about whether or not Medicare covers medical marijuana
The short answer is no—Medicare does not cover medical marijuana. This is because it is illegal on a federal level. While 37 states, 3 territories, and the District of Columbia have legalized marijuana, the federal government classifies it as a Schedule I controlled substance. As a federal program, Medicare can’t pay for anything that the federal government deems illegal.
Medicare does not cover medical marijuana because, at the federal level, it’s illegal to possess the drug.
As an alternative, there are cannabinoid-based FDA-approved drugs that your Medicare prescription drug plan could cover. Every plan is different, so check with your insurance policy about whether or not Medicare can pay for the medication.
Despite its controversies in the last century, marijuana has been used for medicinal purposes for thousands of years. Also known as cannabis, the plant contains chemical compounds called cannabinoids that many people have found to have therapeutic benefits. The two most well-known cannabinoids are THC and CBD. THC has psychoactive properties and CBD has a non-psychoactive, body-relaxing effect.
The most common uses for medical marijuana are:
Chronic pain management (including treating conditions like fibromyalgia, arthritis, and neuropathic pain)
Treating symptoms associated with chemotherapy like nausea and vomiting
Calming muscle spasms
Increasing appetite in cancer and HIV/AIDs patients
Treating anxiety
Treating seizures
Despite the legalization of marijuana in many states and territories across the US, the federal government defines marijuana as a Schedule I substance, making it illegal for anyone to possess or consume it on a federal level. This classification means that the federal government believes marijuana has a high potential for abuse and does not have medical value. For this reason, the FDA is unable to approve medical marijuana for medical treatment.
Even if the state you live in has legalized marijuana, it’s unlikely that even private insurers would cover the drug as long as it maintains its status as a Schedule I drug under federal law. Private insurance companies that offer Medicare Advantage plans also rely on the FDA to decide what medications to cover. If the FDA continues to exclude medical marijuana as an approved treatment, your Medicare Advantage plan won’t cover it.
If you live in a state where only medical marijuana is legal (vs.recreational marijuana), you’ll need to get a medical marijuana card, which can cost from $50 to $200. You’ll likely need to pay annual renewal fees as well.
The requirements around getting a medical marijuana card varies from state to state, but you usually need to book an appointment with your healthcare provider to get the process started. Keep in mind, doctors are prohibited from prescribing medical marijuana directly because it is not legal under federal law. Instead, your doctor can suggest or recommend the use of cannabinoids.
Medicare covers FDA-approved cannabinoid-based medications under certain circumstances and for certain health conditions. The FDA has not approved medical marijuana as a whole, but it has approved certain drugs with cannabinoids as an active ingredient. Some common medications include:
Epidiolex: approved for the treatment of seizures
Marinol and Syndros: approved to treat nausea and vomiting caused by chemotherapy
Your Medicare prescription drug plan may cover these FDA-approved medications, but it’s important to check with your insurance policy for specific details on what drugs it covers.
While Medicare does not cover medical marijuana, there may be other alternatives for you that your plan does cover. Talk to your doctor about the right prescriptions and treatment plan for your health conditions. If you have any questions about Medicare coverage for any prescriptions and services, we’re here to help! Call us at (855) 900-2427 or schedule a consultation to get free Medicare information and support.
