Does Medicare Cover Medical Marijuana or CBD Products? No – But There Are Some Options!
As of March 2020, 33 states have legalized comprehensive, publicly available medical marijuana/cannabis programs and 13 have approved use of “low THC, high cannabidiol (CBD)” products for medical reasons in limited situations.
With this widespread adoption of using marijuana for health conditions, including pain management, alleviating anxiety, and improving sleep, it’s become a viable alternative to pharmaceuticals, especially for people with chronic conditions, mental illness, or undergoing chemo.
It’s especially attractive to older Americans who are in constant pain due to arthritis or other conditions, who have trouble sleeping, or are battling mental health issues.
All that said, this leaves the question of how accessible medical marijuana is to Medicare beneficiaries. We’ll dive into the specifics in this piece, including whether or not Medicare provides coverage, the associated costs, and options available.
Does Medicare Cover Medical Marijuana?
As of July 2020, Medicare does not provide coverage for medical marijuana because it is still a federally controlled substance. In order for a medication to be covered by Medicare, it must have FDA approval. But because marijuana is not authorized on a federal level, Medicare will not cover it even if you buy a Part D plan.
So far, the only FDA-approved marijuana-based drug is Epidiolex, which is a medication for children two years old or younger suffering from epilepsy.
Thus, even if your doctor believes marijuana is the best treatment choice for you and writes you a prescription, you will still be required to pay entirely out-of-pocket should you choose to move forward.
Will Medicare Advantage Cover Medical Marijuana?
Similar to Original Medicare, insurance carriers that sell Medicare Advantage plans need to abide by the federal guidelines, so they will not offer coverage for medical marijuana prescriptions. However, some Advantage plans may provide coverage for the use of cannabinoid-based medications such as Epidiolex.
What About Medigap?
Despite the wide array of benefits offered through Medigap plans, they too have to follow federal guidelines and will not provide coverage for medical marijuana.
So, What Are My Options?
Although Medicare does not cover marijuana, Part D may cover cannabis-based medications. Currently, there are four medications available that contain marijuana compounds and have FDA approval:
Marinol and Syndros
A synthetic version of the marijuana compound Dronabinol is contained in the brand-name medications Marinol and Syndros. If you pay out-of-pocket without any drug coverage, you could end up paying around $130 each month for Marinol and a whopping $1,300 for Syndros. Having a drug plan that covers these medications can be a massive benefit.
Cesamet is another medication that contains a synthetic compound similar to those in marijuana. The average out-of-pocket cost for Cesamet is more than $2,000 for a month’s supply.
As mentioned above, Epidiolex has an ingredient derived directly from marijuana. Epidiolex has CBD in it, which can help reduce a plethora of symptoms. However, the average out-of-pocket price of Epidiolex is astronomical, costing more than $32,000 per year.
Does Medicare Cover CBD Oil?
Given the growing popularity of CBD or cannabidiol as a treatment for chronic pain, anxiety, and sleeplessness, it’s a great holistic solution for older adults. Moreover, it doesn’t have the psychotic effects of THC as CBD is typically sourced from industrial hemp plants as opposed to marijuana plants.
Yet, despite the availability of CBD products in health and wellness stores and its proven benefits for managing pain, anxiety, depression, insomnia, and many other unpleasant symptoms, Medicare will not provide coverage for it.
Unfortunately, just like marijuana, CBD is yet to be considered legal on a federal level. Until the FDA approves CBD oil, Medicare won’t help pay for it.
The upside here though is that CBD products are not nearly as expensive as medical marijuana. Depending on factors including strain, dosage, and dispensary you purchase from, the cost can range from $50–$1,500.
Do Your Research
While Medicare does not currently provide coverage for medical marijuana or CBD products, that’s not to say it never will, especially since more states are legalizing both recreational and medical marijuana use, and there’s a push to make it federally legal as well.
But for right now, my best advice is to listen to your doctor’s recommendations and do your research on benefits and costs associated with medical marijuana and CBD products to ensure you’re making a well-informed purchase.
Are medical marijuana and CBD legal in your state? Do you use such products? Why or why not? Do they help you with your particular health issues? What benefit have you noticed since you started using? How do you pay for this type of medication? Please share what you know in the comments below.
Does Medicare Cover Medical Marijuana or CBD Products? No – But There Are Some Options! As of March 2020, 33 states have legalized comprehensive, publicly available medical marijuana/cannabis
Medical Marijuana and Medicare Coverage
Medicare wonвЂ™t cover medical marijuana since it remains a controlled substance federally. So what does this mean? If your doctor decides that marijuana is the best treatment for you, youвЂ™ll pay out of pocket.
Your doctor might decide to prescribe your marijuana for several reasons. The most common symptoms that cannabis may help treat are pain, nausea, or anxiety.
Below, weвЂ™ll go over why Medicare doesnвЂ™t cover medical-grade marijuana.
Medical Marijuana and Medicare Coverage
Your medication must have FDA approval to gain coverage from Medicare. Since marijuana doesnвЂ™t yet have authorization on a federal level, Medicare wonвЂ™t cover it.
Part A and B benefits seldom include coverage for medications. When you need medication, itвЂ™s best to buy a Part D plan.
But, your medication must have FDA approval to gain coverage. The FDA approved its first marijuana-based drug called Epidiolex.
The medications help treat patients that are two years old or younger with epilepsy.
Medigap and Medical Marijuana Coverage
While these comprehensive plans tend to include plenty of benefits, youвЂ™ll have to pay out of pocket for this prescription.
Like both Medicare and Medicare Advantage plan, Medigap policies donвЂ™t cover marijuana.
Medicare Advantage Plans and Medical Marijuana
Medicare Advantage plans wonвЂ™t offer coverage for medical marijuana prescriptions. Insurance carriers that sell Advantage plans must still work within the federal guidelines.
But, your Medicare Advantage plan may cover the use of other cannabinoid-based medications like Epidolex.
Cannabinoid-Based Medications and Medicare Coverage
While Medicare wonвЂ™t cover marijuana, Part D may cover prescriptions derived from cannabis. Currently, there are four medications available that have approval through the FDA.
The four medicines all contain compounds that are present in marijuana are the following:
Marinol and Syndros
Both these prescriptions are brand-name medications. Marinol and Syndros both contain a synthetic version of the compound from marijuana, called Dronabinol. If you pay out of pocket without any drug coverage, you could end up paying around $130 each month for Marinol.
Hold on to your seat as we dive into the average cost of Syndros. YouвЂ™ll likely pay more than $1,300 for a Syndros prescription if your insurance doesnвЂ™t help cover any cost. A drug plan could be a massive benefit to you with high prices like these.
Cesamet is another medication that contains a synthetic compound like whatвЂ™s in marijuana. The average out of pocket cost for Cesamet is more than $2,000 for a monthвЂ™s supply.
Unlike the other three medications, Epidiolex has an ingredient derived directly from marijuana. Epidiolex has CBD in it, which can help reduce a plethora of symptoms.
The average cost of Epidiolex annually is more than $32,000 per year. Yes, you read that right.
Learn How to Lower Your Medicare Costs
Medicare will cover many of your medical expenses, but not all of them. Thankfully, Medicare Supplement plans can help cover these expenses that Medicare doesnвЂ™t cover.
While your medical marijuana may not receive coverage, many other health care treatments will. Here at MedicareFAQ, weвЂ™ll compare plan rates from the top carriers in your area. OR, if you prefer, complete our online rate form for a quote in minutes.
View Comments (5)
Very expensive. I have many health issues ex. Wires in my head and stimulator in my chest, autoimmune disease no cure to name a couple.. when I go to the airport I have medical ID and go through pat down. what is disturbing which I find out when my mother and I had to make an emergency trip to her IвЂ™ll brother is that even though you have medical ID for medical marijuana, you can not take it out of state so for however period of time youвЂ™re gone.. you have to stop taking it. why canвЂ™t you use your ID and take the medical marijuana with you.. and if they consider that it may be given to someone else, just place a limit on what you can bring. just like with any drug, you canвЂ™t just stop taking your medicines immediately cause it can cause more health issues, even death. maybe if this was approved by Medicare, and covered. this world would be a better place than to have overdosed and deaths occurring because they are picking stuff off the streets that are laced with things like ex. Fentanyl or whatever. And they get it cheaper not knowing whatвЂ™ they are getting and where it originated from. thank you for allowing me to voice my opinion..
It’s rediculous that the FDA won’t declassify mmj for patient use. You can get a mmj card but not be able to afford to get it to use it.
If the government isnвЂ™t going to cover medical marijuana then they shouldnвЂ™t be able to collect the taxes on it! Period we cannot get pain meds because of the new laws, and being in chronic pain for more than 20 years! without a doctors prescribed pain meds I really cannot function but they donвЂ™t care if you are in pain! ItвЂ™s cruel u wouldnвЂ™t let an animal suffer would you?
Why is it called вЂњMedical MarijuanaвЂќ if medical insurance doesnвЂ™t cover it? Sounds like Uncle Sam just wants more money if you ask me!
Hi Kenny! You’re not the first person to ask that! There’s a lot of prescriptions out there that health insurance doesn’t cover at first. However, that doesn’t mean one day it won’t be covered!
The legalization of medical Marijuana has been a hot topic over the last 20 years. Learn the facts on Medicare coverage for medical Marijuana.