Does Health Insurance Cover Medical Cannabis? [The Correct Answer]

Nicole Richter Nicole Richter / Updated on May 12, 2019

Does Health Insurance Cover Medical Marijuana

With medicinal marijuana becoming increasingly popular across the United States, one major question keeps popping up again and again among the thousands of would-be users: “Will my health insurance cover medical marijuana?”

Unfortunately, the answer is pretty much a resounding NO. Read on to find out why insurance companies are afraid (and even unable) to mingle with pot, and what the future is looking like in terms of any possible changes.

Why Doesn’t Health Insurance Cover Medical Marijuana?

On the surface of the argument, it seems a pretty straightforward scenario: you pay for your health insurance, which covers treatments that are recommended by the physician(s) that you see, right? So if a physician officially recommends you be treated with cannabis (as is actually required by law in any state where medical marijuana is legal), wouldn’t it seem that the insurance company has to pay for the recommended medication?

Well, not quite. One of the major reasons (actually pretty much THE reason) why health insurance companies are unwilling and unable to cover anything cannabis related, is because the herb is not approved by the Food and Drug Administration (FDA) as a medicine.

There are of course some exceptions and complex legalities that may act as loopholes, but in general, private health insurance companies, as well as Medicare (federal health coverage for senior citizens) and Medicaid (federal coverage for low-income citizens) are required by law to cover FDA-approved drugs. Since marijuana is not an FDA-approved drug, providers virtually are “not allowed” to cover it – even if they wanted to.

This brings about a whole other topic of discussion in terms of what power insurance companies have over managing drug prices, but as for medical marijuana, basically all it means is that patients are SOL in terms of having their insurance providers offer any cannabis-related coverage, or even reimbursements on money that is spent out of pocket. (If you’re unfamiliar with what SOL means, let’s just say it’s a nice way of saying you’re screwed).

Also, there is no ignoring the fact that marijuana is currently still classified as a Schedule I narcotic, according to the Drug Enforcement Administration (DEA). This means, among other things, that it has a “high risk for addiction and no recognized medical value. Crazy, right? Tell the idea that it has “no recognized medical value” to the literally thousands of scientific studies that have PROVED otherwise.

In any regard, there is no insurance company in the world that’s going to cover a medication that is defined by their government as having “no medicinal value” – it just wouldn’t make sense.

Again, this brings up another very relevant argument altogether: Why don’t insurance companies have more power over what they are able to cover? Or for that matter, what they’re NOT able to cover? A lot of people argue that the federal government telling a private organization (i.e. an insurance company) what they are and aren’t allowed to spend money on is a breach of the constitution, but for now, that’s just the way it goes.

does insurance cover medical marijuana

In reality, the whole FDA/insurance relationship is actually quite a complicated situation, at least in terms of simplicity for the average patient. On the one hand you definitely need a trusted organization (i.e. the FDA) that oversees the drugs that are available to citizens, but on the other hand, if said organization essentially mandates that health insurers have to provide coverage for approved medications, all that really happens is the majority of the power gets put into the hands of the drug manufacturers – in other words, into the hands of Big Pharma. However, that’s a discussion for another time and another place.

Other Reasons Why Health Insurance Won’t Cover Medical Marijuana

Like we said, the fact that marijuana is not recognized or approved by the FDA is pretty much the sole reason why insurance providers don’t cover it. However, here’s a few more reasons why their hands are tied in terms of giving patients money to buy weed:

  • Lack of Clinical Research: Health insurance companies do have somewhat of a say in terms of what products/drugs they will and won’t cover, but generally what they want to see are drugs that have been rigorously tested through multiple clinical trials. And more importantly, through double-blind studies.

However, for all of the positive research that has been done on marijuana and other cannabis-related products, data is still severely lacking in terms of actual clinical evidence. For this reason (and until large-scale clinical data IS available for marijuana as a medication) insurance companies aren’t going to touch it.

  • “Researchable Product” is Unavailable (and/or Illegal): Of course, the major issue of the aforementioned problem (i.e. the lack of clinical trials and double-blind studies), is that researchers can’t get ahold of the appropriate amounts of marijuana that would be required to even think about doing a large-scale clinical trial. This is directly due to the fact that cannabis is a Schedule I substance — no money is going to be available to research a drug that is illegal, and even if it WERE available, conducting the research in itself would be illegal without proper authorization (which is difficult and costly to get). Quite the catch-22 type situation, if there ever was one.

So Do We Have Any Hope of Health Insurance Covering Marijuana in the Future?

As it looks right now, the long-term future of marijuana legality is still pretty bleak, at least on the federal level. Things are obviously on the uptrend within individual states, but marijuana reform activists are still treading water in terms of trying to get the Feds to acknowledge our beloved cannabis.

One thing that does have a possibly brighter outlook than whole-plant marijuana, however, is CBD oil, and other CBD-based products.

is medical marijuana covered by insurance

We won’t go into much detail in this article (you can check out a much more thorough discussion on the subject here), but basically CBD is a compound in marijuana that offers loads of therapeutic benefits without the high. Most people use it as an infused oil tincture, and there have been dozens and dozens of reputable studies done showing that it has an extremely positive safety profile, and that it is virtually non-existent in terms of addiction. For that reason, there has been talk of the FDA looking into approving CBD as a medication, but again, this is still a ways off – if it even happens at all.

Are Synthetic Marijuana Drugs Covered by Health Insurance?

Of course, there have been a few synthetic forms of marijuana that have been approved by the FDA over the years. Marinol is probably the most famous one, as it’s been an approved medication for over 30 years — since 1985. However, most real cannabis users will tell you that it’s far from the “real thing” in terms of effectiveness – it takes forever to take effect, and it poses a fairly high risk of promoting states of depression and anxiety.

Syndros is a much more recent synthetic marijuana drug that has been approved by the FDA (in liquid format, the first of its kind) and like Marinol/Dronabinol (Dronabinol is the generic name), is classified federally as a Schedule III substance, which means it has an “accepted medical use and low to moderate potential for abuse.”

So what about these – are synthetic marijuana drugs covered by health insurance, considering that they’re FDA-approved?

In fact, yes they are. Marinol is a fairly commonly-prescribed medication for chemotherapy patients that’s used to improve appetite and reduce nausea and vomiting, and it is routinely covered by health insurance providers, as are the other two forms of FDA-approved synthetic cannabinoids.

However, like we said, most patients who use these drugs will tell you that they’re not quite the real thing – they would much prefer to be able to smoke actual cannabis.

Final Thoughts: Is Medical Marijuana Covered by Health Insurance


Like we said, until medical marijuana is approved by the FDA and is able to be legally prescribed by physicians, it will not be available for coverage by any health insurance providers. Until that day comes (or if it EVER comes), patients will continue to be forced to pay for their cannabis meds out of pocket, with no potential for deductions or reimbursements.

There are a few synthetic marijuana drugs that are FDA-approved and available for health insurance coverage, but as we mentioned these medications are not quite the same thing in terms of the whole-range therapy (and minimal side-effects) that real cannabis provides.

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  1. Lindsay Burrows
    Do not disclose.

    I don’t think even the ones who do, very rare though, will give you some claim in the end. They have a thousand loop holes to escape, so better research carefully before you buy some policy. In fact it can hamper your claim for other diseases as well, if you disclose you are on weed.

  2. StonerDave
    I truly believe Jeffery ^ is STONED ..also, as a medical marijuana patient in NJ for the past 2 years...

    I truly believe Jeffery ^ is STONED ..also, as a medical marijuana patient in NJ for the past 2 years, I’ve seen how this is a BIG BUSINESS first and foremost and the truth is nobody in the government, the medical community, the corporate dispensaries, and the general (non-consuming) public cares about the patient or the plant. After paying $250 to the state, 300 to the dr, $420/oz OR MORE to the crooked corporate dispensary… I have concluded without question that this is a money grab. Just for reference… the average cost of grade AAA pot on the black market here is $250/oz …so let’s look at math: adding the $100/3mos recertification dr visits, plus the monthly cost of my “prescription” (2oz/month) at dispensary pricing… $$250/2yr state fee + $1000 dr fee + 2oz x $440 x 24mos ($21,120) = $22,370 // comparison to black market price? ($250 x 2 x 24mos = $12,000) THE DIDFERENCE IS CLEARLY DOUBLE THE PRICE …all this for the “conconvienience” of not being arrested …afain its a money grab and “a pay to play” scenario that discriminates against poor people and prays on the sick. The whole moral compass is lacking. Obviously I’m stoned too Jeffery hit me up let’s smoke together bro!

  3. Jeffrey
    What needs to be said

    We’re coming for you pharmaceutic’cists you think you can take on the whole world and up till now you have been able to but I’m calling out to all true free people to go to battle as a United force every race kreed and color its time to kick ‘butt sh_t’ out of our way ! And a return to real health with the natural things that should never have been made illegal by the evil doers “Pharmaceutical companies” and these Liers this Federal Government useing it’s “Big Clout” we have to come together onthis or they will just keep poisoning us our children and our children’s children

  4. Anonymous
    You are STUPID!!

    Dear ana from july 16,

    The insurance companies, big pharma, and government officials already do tell us what ehere and when.

    Your comment is completely IGNORANT!

    As a person who lives with Degenerative Disc Disease, Severe Spinal Stenosis, Extreme Blood pressure issues, and anxiety from all of these illnesses and the fact that after 31 years of employment I am having to ask my 73 year old mother for financial support because i am unable to work due to my pain medication making me sick, weak and dizzy. I am looking forward to making the change yo medical marijuana.

  5. kathleen

    I have a friend who asked her doctor about trying the Marj. oil for her pains. The Doc said he would suggest it bc if she developes any ills from using the oil the insurance company would not cover her. Is this true

    1. Adam

      Most insurance companies won’t cover MJ related products

  6. Ray
    Methadone versus medical marijuana

    Why do they have methadone clinics that are free and they give out free needles but we can’t get medical marijuana Covered on our insurance. That makes no sense

    1. Dylan

      Couldn’t agree more Ray. Hopefully one day cannabis will get its due credit.

  7. Yvette

    Interesting conversation, however, I think medicare and medicaid should at least pay for office visits. In my opinion.

    1. Marie E. Shriner
      Lack of equal medical care for medicaid patient compared to private paying patients.

      Absolutely Medicaid should cover dr and prescriptions! The ONLY reason marijuana was deemed illegal way back when is because Big Pharma could not cash in on it! The way I have been treated from ER to specialists is disgusting and demeaning! I know for a fact, that every medcaid patient is considered a drug seeker until the patient proves otherwise. In addition, I waited 45 minutes for my appt with an orthopedic Dr and once I got into the room, the Dr. NEVER once even touch my back or neck. He told me point blank…I know you are having serious pain from stenosis, but medicaid will not approve surgery and treatment because I smoke cigs (nooo live with a smoker!) In addition, our lawyers forbid prescribing any pain meds! I am not often speechless but I couldnt believe what I was hearing! I asked him why did I bother even to see you…evidently insurance and lawyers are making my treatment decisions!? The Dr. Then said well I could order a cat scan! Are you kidding me!? You just walked in the room and informed me I wont get help for an obvious medical issue no matter what tests are done! Clearly, he was trying to pad his billing by ordering more tests, knowing damn well no matter what may show up beyond what was clear from the xrays was only helpful for his bank account! That entire “dr visit” last 10-15 minutes max! I have no options for medical treatment that will help me and Ill be damned he was going to order unecessary tests to make a bit more money from medicaid! When I had no choice but to get medicaid which was so embarrassing and so demoralizing for a person with 2 master degrees and has worked since the age of 12, having to even ask for help was so diffcult! The fact I now get viewed as a drug seeker and/or worth so little as a human with a clear and painful medical condition, no Dr. Is going to truly going to help me. I guess the sad truth is….yes, I got medical coverage but they didnt say I would have GOOD medical care! Imo, Drs accepting medicaid have no desire to do any more than necessary to get pocket change and because medicaid pays them a far lower reimbursement, the patient gets far lower treatment! If medical marijuana helps my pain and condition, WHY cant they cover the bills? If they wont approve procedures to fix or help me, the least they can pay for the medicine that helps my pain? Its almost insane the reality for me and others having to get medicaid cant and dont receive treatment to fix my condition but they wont even pay for having even one day witn no pain and get back to having some quality of life beyond my bed!

  8. Lori Barham

    It’s natural and better than all these meds I’m on. I’d rather smoke and get relief than take 8 man made chemical drugs everyday.

  9. Ana

    I’m really glad it isn’t covered.. I don’t want companies telling me what where and when..

  10. Marsha White

    I think if your state is recognizing marijuana as a medicine, your insurance should cover it. It is recommended and dosed by a licensed physician!

  11. Margaret Simmons

    Medical insurance and marijuana, great topic.

    1. Adam

      Wish Medicare would pay for this stuff. It could help so many people

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