Does Medicare Cover Medical Marijuana?
Fair Square Medicare

Does Medicare Cover Medical Marijuana?

Illustrated representation of medical marijuana, using a prescription bottle with a marijuana leaf on the front.

By Ford Carlisle

Jan 6, 2023

Medical Marijuana: Usage, Costs, and Coverage Options

Medical marijuana is increasingly popular as a treatment option for various medical conditions and is now legal in many states.

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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.

What Is Medical Marijuana?

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:

  • Cannabidiol (CBD)

  • Tetrahydrocannabinol (THC)

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.

What Is Medical Marijuana Used For?

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

  • Inflammation

  • Anxiety

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.

Is Medical Marijuana FDA-Approved?

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

Does Medicare Cover Medical Marijuana?

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.

How Much Does Medical Marijuana Cost?

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

Can I Use My HSA To Pay For Medical Marijuana?

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.

What's a Medical Marijuana Card? How Do I Get One?

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.

Do I Need To Tell My Healthcare Provider If I'm Using Medical Marijuana?

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.

Takeaway

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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