Health insurers in the United States won’t pay for anything that’s technically illegal. Most health insurance policies include an illegal acts exclusion saying that health issues occurring due to or in association with your voluntary involvement in an illegal act are not covered (some states limit or prohibit these sort of exclusions ). Even though medical marijuana has most likely been legalized in the state where you live, it’s still classified by the federal government as a schedule I controlled substance as defined by the Controlled Substances Act. It’s still illegal to use marijuana in terms of federal law.
In addition to health plan illegal acts exclusion clauses, another issue arises due to marijuana’s Schedule I designation. Schedule I controlled substances can’t be prescribed by physicians the way other medications are.
Medical Marijuana Is a Schedule I Drug
Physicians who prescribe controlled substances must be registered with the Drug Enforcement Administration and have a DEA number. Prescribing a Schedule I drug, even in a state where medical marijuana has been legalized, would place a physician at risk of having his or her DEA registration revoked. Even if medical marijuana has been legalized in your state, as long as it’s considered a Schedule I drug by the federal government, prescribing it would put your physician at risk of losing his or her ability to prescribe even simple controlled substances like sleeping pills and cough syrup with codeine.
If you think it costs a lot now, wait until Pfizer, Merck, AstraZeneca or another big pharma company gains the exclusive right to bring marijuana to market in the United States.
In summary, there’s more than one reason why your health plan won’t pay for medical marijuana. Even if marijuana were to be reclassified to a lower schedule or congressional action removed it from the list of controlled substances altogether, that wouldn’t be like waving a magic wand. Your health plan wouldn’t magically start paying for your medical marijuana a month or two later. Instead, it would be the beginning of a long, slow, process.
It is not only the average consumer who is becoming more aware of the health-related properties of CBD oil. Many physicians have begun to notice as well, seeing their patient’s symptoms improve for various ailments. These products have scientific research behind the claims of their medicinal properties and yield almost no side effects in a majority of patients.
As a result, some doctors are starting to recommend CBD oil as a treatment—often in combination with other conventional medications. And they’re being asked by their patients if it’s covered by health insurance.
Will Health Insurance Agencies Pay for CBD Oil?
At the present time, the answer to this question is unfortunately no. There are no health insurance companies in the United States that will cover CBD oil or even medicinal marijuana, even if it’s prescribed by a doctor. Health insurance will not cover the costs even when a patient hands over a prescription at a dispensary.
The other obstacle to health insurance coverage for CBD oil is because it’s classified as a Schedule 1 controlled substance. This classification typically applies to marijuana, but laws in the U.S. state that any product containing the cannabidiol compounds found in marijuana must also fall under the classification.
Additionally, there could also be changes to the scheduling classification of the compound—ultimately leading to health insurance companies embracing CBD oil’s potential health benefits for patients.
As with most medical benefits there is a limit on the cost Veterans Affairs Canada will reimburse per gram of cannabis. A maximum rate of $8.50 per gram of cannabis is covered and medical users must pay the rest out of pocket. However, many reputable LPs will adjust the cost accordingly specifically for veterans.
If you need any paperwork filled out by your doctor, please contact Apollo and we will be happy to assist you*.
More than 17 years after cannabis was first legalized in Canada for medical use, some insurers are just beginning to cover the cost of the medication. Slowly things are changing for the better as companies are being given the option from insurers to include medical cannabis. However, many plans limit coverage to just a handful of medical conditions that qualify and do not cover the cost of medical cannabis for most users.
But don’t fret – if your health insurance plan includes a Healthcare Spending Account (HCSA or HSA), you are likely able to claim medical cannabis under this category. Be sure to chec k the details of your insurance plan to see what is and is not covered. The Canada Revenue Agency lists medical cannabis as an eligible medical expense . Your proof of purchase (receipts) that include your prescription information, can be found online under your personal account with each Licensed Producer (LP) on their respective websites.
If you have any questions about your prescription, your apollo educator is here to assist you free of charge, 7 days a week.
Veterans Affairs: A Pioneer in Coverage
Many Licensed Producers (LPs) also offer compassionate pricing to low-income individuals, seniors, and those on ODSP. Medical cannabis users should work with a patient educator who can help them determine if they qualify for compassionate pricing or other benefits. Patient educators are also able to recommend Licensed Providers who offer compassionate pricing, as not all LP’s offer this benefit. Apollo Cannabis Clinics employ patient educators to work with each individual after they receive a medical cannabis recommendation. Patient educators are committed to helping medical cannabis users understand what benefits certain Licensed Producers may offer. They also work to help individuals select LPs who carry the product they require.
Veterans Affairs Canada reimburses eligible medical cannabis users, those with a K# and Awarded Conditions, for up to three grams of dried cannabis or equivalent in oils/edibles per day. If there is a need for additional daily dosage of cannabis, Apollo can help complete all necessary paperwork allowing veterans to receive more than 3grams a day to be covered. Eligible cannabis must come from a medical Licensed Producer with whom a patient is registered through an authorized medical document (prescription). Grey market and recreational cannabis purchases are not reimbursable.
Veterans Affairs Canada was the first Canadian institution to cover medical cannabis and has a revised coverage policy since November 22, 2016 through Medavie Blue Cross. The Veterans Affairs Canada website states “the health and well-being of Veterans is a top priority for the Government of Canada. This was the fundamental consideration in the development of VAC’s reimbursement policy for cannabis for medical purposes”.
If you would like to book a free virtual/telephone appointment, we assist our patients 1-on-1 with any insurance questions as well as assisting in finding you the best LP that suits your needs and budget.
You can fill out a form here and someone from our bookings team will give you a call or you can reach us directly toll-free at 1-877-560-9195.