By Ford Carlisle
Jan 6, 2023
Medical marijuana is increasingly popular as a treatment option for various medical conditions and is now legal in many states.
However, medical marijuana remains illegal at the federal level. This might leave you wondering whether Medicare covers it as a treatment option.
This article will answer all your questions about medical marijuana: why it's used, how much it costs, and whether Medicare offers coverage.
Medical marijuana is a medical treatment derived from marijuana plants. These plants contain over 100 different chemical compounds called cannabinoids, which are believed to have potential therapeutic properties.
The two main cannabinoid compounds in the marijuana plant include:
Both compounds have unique benefits. CBD does not have the same psychoactive effects as THC, which is the compound more associated with feeling high on marijuana.
Medical marijuana is used to treat the following medical conditions:
Chronic pain — relieves neuropathic pain and pain caused by cancer
Multiple sclerosis — improves muscle spasms and spasticity
Epilepsy — reduces the frequency and severity of seizures in some people
Crohn's disease — reduces inflammation and improves symptoms
HIV/AIDS — relieves specific symptoms, including severe nausea, vomiting, and loss of appetite
The use of medical marijuana continues to be a topic of debate. Prior to FDA approval, there have not been largescale research studies to help fully understand its benefits and risks.
No. The Food and Drug Administration (FDA) does not yet recognize marijuana as a medication for any specific medical condition.
However, the FDA has approved certain prescription cannabinoids — products containing at least one plant-derived or synthetically manufactured cannabinoid. (These are available by prescription only).
The FDA-approved cannabinoid-based medications include:
Epidiolex (cannabidiol) — treats seizures associated with Lennox-Gastaut syndrome or Dravet syndrome, two rare and severe forms of epilepsy
Marinol (dronabinol) — treats nausea and vomiting in cancer patients; treats anorexia associated with HIV/AIDS
Syndros (dronabinol) — treats nausea and vomiting in cancer patients; treats anorexia associated with HIV/AIDS
Cesamet (nabilone) — treats nausea caused by chemotherapy
No, Medicare doesn't cover medical marijuana.
However, if you have Medicare Part D or a Medicare Advantage plan that covers prescription drugs, you might get coverage for FDA-approved cannabinoid-based medications (as mentioned above). In order to qualify for prescription drug coverage, your drug formulary must include your specific medication.
In other words, if your prescription drug plan covers FDA-approved cannabinoid-based medications and your medication is listed in its drug formulary, you might get coverage.
Contact your insurance provider to find out whether cannabinoid-based medications are included in your plan's drug formulary.
Why Doesn't Medicare Cover Medical Marijuana?
Despite being legal in many states, Medicare and Medicaid do not cover medical marijuana as a treatment option because marijuana is classified as a Schedule I Drug and it's not FDA-approved.
Will Medicare Cover Medical Marijuana in the Future?
Maybe! Marijuana legalization has passed in several states and has been up for debate at the federal level. So, there might be a day when it's federally legal, which could open the door to Medicare coverage of medical marijuana. We will be sure to keep an eye on this and update our blog accordingly.
The cost of medical marijuana depends on the following:
The product's quality
Medium-grade cannabis costs about $266 per ounce (in the U.S.)
High-quality cannabis costs about $326 per ounce (in the U.S)
The product's form
Inhalable, edible, topical, etc.
The location of purchase
States with stricter medical cannabis laws tend to have higher prices, while states with more liberal laws and higher production rates tend to have cheaper cannabis
The total expenses also include the following:
A healthcare provider's fee for determining your eligibility
A fee for the medical marijuana card — around $50–$200
A charge for using your medical marijuana card at a dispensary or other licensed establishment
No, you can't use your health savings account (HSA) to pay for medical marijuana.
Because marijuana is illegal under federal law, the Internal Revenue Service (IRS) considers marijuana an ineligible expense for health savings accounts (HSAs).
Since the federal government regulates HSAs, they must adhere to federal law. This means HSA funds can't be used to pay for marijuana, regardless of whether it's used for medical or recreational purposes.
A medical marijuana card (AKA a cannabis card or a marijuana card) is an identification card that shows you've been approved to use medical marijuana for medical purposes and allows you to buy and possess marijuana for medicinal use following state laws.
To obtain a medical marijuana card, you must:
Be a resident of the state where the card is issued
Have a diagnosed qualifying medical condition
Obtain a recommendation from a licensed healthcare provider
The healthcare provider must be registered with the state's medical marijuana program and certify that you would benefit from the use of medical marijuana
Once certified, you can apply for a medical marijuana card through the state's medical marijuana program.
Yes, it's generally a good idea to tell your healthcare provider if you're using medical marijuana, as it can affect how your body processes other medications and treatments.
Additionally, your healthcare provider can help you monitor any side effects or interactions with other medications.
It's important to have open and honest communication with your healthcare provider about all aspects of your healthcare, including any complementary or alternative treatments you may be using. This will help them provide you with the best possible care.
Although it's legal in many states, medical marijuana is not yet FDA-approved or covered by Medicare.
However, Medicare may cover FDA-approved cannabinoid-based medications if they're included in your prescription drug plan. Talk to your insurance provider to determine whether they cover specific prescription cannabinoids. You can also talk to your healthcare provider about a medical marijuana card.
If you have any questions, Fair Square Medicare is here to help. Medical marijuana laws and regulations can be confusing, but our team will gladly guide you through them. Call us at 1-888-376-2028.
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