FDA approval is a long and rigorous process, meaning it could take years for CBD-based drugs to reach the market even if the FDA changes its stance. In the meantime, standard CBD oil — the kind found in pharmacies, supermarkets, and medical cannabis dispensaries around the country — would still not be covered.
Though most people know that no health insurance plan will cover medical marijuana, many still have questions on whether such plans might cover CBD oil and CBD products. They don’t induce a high, after all, and since the federal government legalized hemp-derived CBD in the 2018 Farm Bill, it seems counter-intuitive to most that health insurance companies would be averse to a product that is both legal and wildly popular.
One of the main challenges that prevents CBD from being covered under insurance policies is the hostility of powerful government agencies to any cannabis-related product — a sentiment that insurance companies have noticed and respected.
Why Health Insurance Doesn’t Cover CBD Oil
This has remained a popular view among many federal authorities. In 2018, when U.S. Health and Human Services Secretary Alex Azar was asked about medical marijuana as a pain relief alternative to opioids, he responded by saying there is “no such thing as medical marijuana.”
And without FDA approval, insurance companies won’t approve of CBD, either. When the public relations manager of Humana, one of the country’s five largest insurers, told VICE why the company did not insure medical marijuana, he could just as easily have been talking about CBD. “As of right now, there is no FDA-approved marijuana product, and we therefore do not currently offer a prescription drug benefit for medical marijuana,” he said. “If there were to be an FDA-approved medical marijuana product in the future, it may be covered depending upon the terms of the individual member’s drug coverage.”
Barring an unexpected act of Congress, there are two potential ways in which CBD oil (or at least certain types of it) could be covered under health insurance plans, and neither of them are likely to be especially fast.
In its 2001 “Notice of denial of petition to reschedule marijuana,” the DEA emphasized that its main objection to the rescheduling of cannabis and its derivatives was not because of their potential for abuse, but rather for their lack of accepted use in medical treatment:
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Without FDA approval, it won’t get on your health plan’s drug formulary, so your health insurance won’t pay for medical marijuana. The process of getting marijuana approved would almost assuredly involve big pharma, exclusive marketing rights, and exorbitant costs. You can read more about this in an article about marijuana that the FDA published.
Medical Marijuana Is a Schedule I Drug
When a drug becomes available without a prescription, it’s removed from health plan drug formularies and you’re expected to pay for it yourself. Does your health insurance currently reimburse you for over-the-counter medications like Tylenol? Most don’t. Does it cover herbal remedies like St. John’s wort or echinacea? That’s unlikely.
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.
If marijuana was to be reclassified so that it wasn’t a controlled substance at all, it might become available without a prescription. However, those who think that’s the answer to getting medical marijuana covered by health insurance are misguided.
At the moment, patients interested in obtaining CBD oil for its medicinal properties must pay for it out of their own pockets. There is currently no financial assistance for a patient wanting to obtain CBD oil for any health reason—even with a doctor’s prescription.
With a rapidly growing body of scientific research showing just how powerful CBD oil is for treating depression, anxiety, pain, inflammation, acne, and many other conditions in the human body, the FDA certainly could consider reviewing these products in the future.
So far the FDA has approved only one drug containing CBD, for a rare form of epilepsy.
What Options Are There for Patients?
Patients seeking CBD products need to make sure they’re purchasing them from a reputable company. It is critical that you do your research and examine the authenticity of the brand.
The first obstacle is the U.S. Food and Drug Administration (FDA). When a new drug is released on the market, it must first be approved by the FDA before doctors can legally prescribe it to their patients.
There are two primary obstacles preventing health insurance companies from offering to cover CBD oil or similar treatment options such as medicinal marijuana.
The FDA focuses its attention on pharmaceutical products and has little interest in products that are primarily made from natural sources—so CBD products don’t get approved and, in turn, health insurance companies are not obligated to cover them. According to state laws, these agencies are only required to provide coverage for drugs that are FDA approved.