Why Doesn’t Health Insurance Cover My Medical Cannabis?

For many medical cannabis users, one of the most challenging aspects of getting treatment isn’t finding access to safe, validated cannabis medications; it’s negotiating the complicated world of health insurance.

Because cannabis is classified as a Schedule I Drug by the Controlled Substances Act, insurance companies won’t cover costs associated with its use, even if that use occurs in a state in which cannabis is legal for medicinal use.

Many policy and industry observers anticipate that cannabis will in the future be decriminalized on the federal level, but that leaves many patients out in the cold for the time being. Where does this vitally important issue currently stand? Let’s start with a brief rundown of the situation.

Canadian Health Insurance Covers Cannabis; Why Not Here?

Many Americans are asking why their health insurance won’t cover the cost of medical cannabis when Canadian insurers do.

Some policymakers here in the U.S. have been looking north for clues as to how to integrate cannabis into healthcare. In a Canadian court case in early 2017, a Nova Scotia man successfully argued that his health insurance provider had discriminated against him by refusing to reimburse him for the cost of his medical cannabis.

Since then, Canadian Prime Minister Justin Trudeau sidestepped further such suits by fulfilling a campaign pledge to legalize cannabis for both medical and recreational use, though hashing out the details of just how, or even when, this will occur has proved to be an elusive target.  

Here in the United States, the Department of Justice—the agency which oversees the DEA—has taken a hardline stance towards rescheduling cannabis. Attorney General Jeff Sessions is notoriously opposed to cannabis; in a hearing before the Senate in 2016, he flatly stated: “good people don’t smoke marijuana.”

The federal government’s take on cannabis is remarkably at odds with public opinion—which overwhelmingly supports the decriminalization of cannabis—but many believe that there’s little chance of legalization as long as the current administration is in office.

For medical cannabis patients, there’s some small hope that fiscal relief is on the way: In a small but closely watched case similar to the Canadian example, a New Jersey judge ruled that a man’s insurance company must reimburse him for the cost of his treatment with medical cannabis.

Ironically, health insurance companies already typically cover Marinol, a synthetic form of marijuana produced in the lab. But the actual, all-natural marijuana plant? Nope.

Talking to Your Health Insurer

Interacting with your health insurer can be intimidating in the best of circumstances. Add in the complications of cannabis’ messy legal status and it can feel downright threatening.

Many advise patients to be truthful with your insurer if you’re asked about medical cannabis use as making statements you know to be untrue to your insurer could constitute fraud, and you could lose your insurance. While your admission could potentially have an impact on your policy, health insurers are typically not in the business of reporting cannabis users to the federal government.

If you’re concerned that your cannabis use could lead to a higher premium, that could be a possibility, depending on the insurer. They may classify your cannabis use as a risk factor, much as they would smoking cigarettes.

Health Insurance: The Financial Angle

If we’re not exactly holding our breath waiting for a change in the Federal stance on cannabis, there is some hope that the sheer weight of numbers—the dollars-and-cents kind—will win the day. Research indicates that cannabis could have a very significant effect on national health spending, which now accounts for nearly 20% of national spending.

An article published earlier in 2017 on forbes.com suggested that, had all states legalized medical marijuana in that year, Medicare would have saved at least $1 billion, and perhaps as much as $3.89 billion.      

And that’s only the tip of the iceberg; the study referenced in the article points out that, had other state-to-state variables remained consistent, the dollar amount could be greater, as in “multiple billions” greater.

In October 2012, the United States Court of Appeals for the District of Columbia dismissed a case brought by Americans for Safe Access against the DEA in an attempt to force them to reclassify cannabis. But the cultural landscape has evolved since then; remember those two little court cases from earlier in the article?

There’s a good chance you’ll start to see more of these successful suits as acceptance of medical cannabis increases. And while we’d all love to see sweeping, history-making change come down from the Federal level, patience and persistence pay off. As the proverb goes: “Water wears away stone” (Job 14: 19).