Medicare does not cover cannabis for medical use. Some Part D and Medicare Advantage plans may cover cannabinoid-based medications approved by the FDA, but coverage can vary.
More states are legalizing medical cannabis with each passing year. That may make you wonder whether Medicare will cover the cost of medical cannabis in your state.
Federally, cannabis remains a controlled substance. It’s illegal to possess or use the drug under federal law. However, individual states have passed laws allowing distribution and sale within their state boundaries.
Medicare won’t cover medical cannabis because it’s considered a Schedule I controlled substance. In fact, doctors cannot even legally prescribe it.
Some people may use medical cannabis to manage symptoms like:
- pain
- nausea
- seizures
If you’ve received a doctor’s recommendation and your state has legalized medical cannabis, read on to learn what you need to know about coverage, how and why it’s used, and more.
Medicare doesn’t cover drugs that are illegal according to the federal government. This includes cannabis for medical use.
The Food and Drug Administration (FDA)
What about Medicare prescription drug plans?
Medicare Part C, or Medicare Advantage, is health insurance offered by private insurance companies that provides additional coverage beyond Original Medicare (parts A and B).
Extra coverage may include:
- dental care
- vision care
- some prescription drugs
Medicare Part D is medical insurance that’s also offered through private companies and covers prescription drugs. It doesn’t, however, cover medical cannabis.
Parts C and D could cover the cost of cannabinoid medications that have been approved by the FDA and are available without restriction. This is where some flexibility exists.
Cannabinoid medications may be covered by Medicare drug plans for their intended uses because they’re approved by the FDA. These can include:
- Epidiolex
- dronabinol (Marinol, Syndros)
- nabilone (Cesamet)
If you’re unsure what your plan covers, contact your Medicare prescription drug plan directly. They can help you understand whether you have coverage for any cannabinoid medication and how to fill a prescription.
Some people recommend medical cannabis to ease symptoms like:
Medical cannabis is often suggested to treat the symptoms of stage 3 HIV or cancer.
If you have multiple sclerosis (MS), medical cannabis may help ease pain and reduce muscle stiffness.
Cannabinoid-based medications
Dronabinol (Marinol, Syndros) can be used to ease nausea and vomiting from cancer treatment and increase appetite in people with stage 3 HIV.
Nabilone (Cesamet) can improve appetite and weight maintenance in people with stage 3 HIV.
Epidiolex can help prevent seizures and is used as a treatment for epilepsy. The FDA has approved these medications for these uses.
The federal government considers cannabis illegal and holds strict control over it and any cannabinoid-based products. That means research on the possible benefits or even the side effects of cannabis use is limited.
Without data from clinical research, the FDA won’t be able to update its position on the safety or effectiveness of its medical uses.
As of 2023, 39 states and Washington, D.C., have approved the sale and use of medical cannabis. Some of those states have also approved cannabis products for recreational use.
In states where only medical cannabis is legal, you’re required to get a medical cannabis card.
The rules and steps for getting a medical cannabis card may vary from state to state, but here are the basics:
- Make an appointment with your primary healthcare professional: Your doctor will likely give you a full physical exam and review your medical history. If your doctor thinks medical cannabis might help, they may approve you for a medical cannabis card.
- Renew your cannabis card annually: This may require follow-up visits. Ask your doctor if there are any other additional steps you’ll need to take. Most cannabis cards are registered with the state government.
- Your doctor can’t prescribe cannabis products directly: Federal law prevents doctors from prescribing substances that are illegal. Cannabis remains illegal under federal law. Instead, your doctor may suggest you may benefit from it.
Even though all types of cannabis are illegal at the federal level, the federal government hasn’t taken steps to prosecute those who use it within a state with legal cannabis trade.
However, it’s still possible to face prosecution under federal law under certain circumstances.
Cannabis contains several dozen active chemicals. The two most well known are cannabidiol (CBD) and delta-9-tetrahydrocannabinol, also known as THC.
CBD’s potential benefits include:
- improved relaxation
- pain reduction
- lowered anxiety
THC is the chemical responsible for the psychoactive effects of cannabis.
In recent years, CBD has been isolated from THC and is sold even in states that don’t allow medical cannabis. In states where medical cannabis is legal, both CBD and THC products are available for a variety of health issues.
Like medical cannabis, individual states have their own legislation regarding legal levels of CBD. Check your state’s legislation for specific information, and be mindful of other state laws when traveling with CBD.
How medical marijuana may affect the opioid crisis
Limited research suggests the use of cannabis is reducing the use of opioids and pain medications with high addiction potential. Because cannabis may help relieve some of the same symptoms as opioids, doctors may not prescribe pain medications if cannabis is an option.
With better processing equipment, medical cannabis producers and distributors have created a variety of cannabis-infused products. Common forms of consumption include:
Talk with your doctor if you’re not familiar with how to use medical cannabis or aren’t sure which method of consumption might work best for your condition. They can help connect you with resources for understanding proper usage.
Medical cannabis cards aren’t usually free. Cards generally cost about $50 or more when you first apply. You may also have to pay annual renewal fees.
If medical cannabis is approved in your state, check your state government’s website for specific cost information.
For each renewal, you’ll visit your doctor to discuss whether you still need medical cannabis for your condition. This office visit may or may not be covered by your particular Medicare plan.
Contact your plan ahead of time to find out if:
- the visit will be covered
- there’s a copay and, if so, how much it is
- you’ll need to pay the full bill out of pocket
In some states, a medical cannabis card gives discounts on cannabis products you purchase. Discounts may cover the cost of the card, depending on the frequency and amount you use.
Your Medicare prescription drug plan may cover FDA-approved cannabinoid-based medications like dronabinol (Marinol, Syndros), nabilone (Cesamet), and Epidiolex, at least in part. Prices vary.
Check with your doctor for availability and pricing options. You can check your plan’s list of covered medications, called a formulary, before filling a prescription or contact your plan directly to ask about coverage.
Medicare won’t cover the cost of medical cannabis because it’s federally illegal and not approved by the FDA. However, Medicare may pay for cannabinoid-based medications.
You must obtain a medical cannabis card before you can buy cannabis products, even in states where it’s available recreationally. A medical cannabis card may provide discounts.
If you’re curious whether medical cannabis is an option for you, talk with your doctor. Together you can review your symptoms and look for alternatives if your doctor doesn’t think cannabis products are the right choice for you.