Does Medicare Cover Medical Marijuana?
Some Medicare Advantage plans (Medicare Part C) and some Medicare Part D prescription drug plans may cover other cannabinoid-based medications, however. Cannabinoids are types of chemicals that are found in marijuana.
More than 31 states allowing the use of marijuana for medicinal purposes in 2018. 1 So what does this mean for your coverage options as a Medicare beneficiary?
Learn more in this guide about how a Medicare Advantage plan could help cover the cannabinoids you need.
Why doesn’t Original Medicare cover medical marijuana?
Though some Medicare Advantage plans and some Medicare Part D plans may cover cannabinoid-based medications, Original Medicare (Medicare Part A and Part B) does not.
The biggest reason why medical marijuana is not covered by Original Medicare is that marijuana is not approved for medicinal use by the Food and Drug Administration (FDA).
A second reason is because marijuana remains federally classified as a Schedule I drug, meaning it is not recognized by the federal government as having any medicinal value.
Some Medicare plans may cover other cannabinoids
Dronabinol is a synthetic form of cannabis that is used to treat the loss of appetite and weight loss suffered by some people with AIDS, Dronabinol can also be used to help treat the nausea and vomiting associated with cancer chemotherapy.
Dronabinol is the active ingredient in brand name drugs Syndros and Marinol, and both drugs may be covered by some Medicare Advantage plans with prescription drug coverage as well as some Medicare Part D plans.
Syndros comes in a liquid form while Marinol comes in the form of a gel capsule. Dronabinol also comes in capsule form as a generic drug that may also be covered by some Medicare Advantage plans and Medicare Part D plans.
Syndros and Marinol are both approved by the FDA and are both classified as Schedule II drugs. 2 This category features drugs with accepted medicinal use that are considered to carry a high risk of addiction or abuse and includes such drugs as oxycodone, fentanyl, morphine and methadone.
Check with your Medicare Advantage or Medicare Prescription Drug Plan carrier to determine if this type of medication (or any others you may need) is included in your plan’s formulary. A formulary is a plan’s list of covered medications.
Are you looking for Medicare prescription drug coverage?
You can compare Part D plans available where you live and enroll in a Medicare prescription drug plan online in as little as 10 minutes when you visit MyRxPlans.com. 1
Enroll in Medicare Part D at MyRxPlans.com
How much do cannabinoids cost?
The average retail price of 60 capsules of Dronabinol is reported to be $257. 4 A Medicare Advantage plan or a Medicare Part D plan that covers Dronabinol could help alleviate some of that cost.
Medicare Advantage and Part D plans are sold by private insurance companies, so premiums, deductibles and coinsurance amounts can vary from one plan to the next.
Find a Medicare Advantage plan that offers prescription drug coverage
Are you looking to find a Medicare Advantage plan that covers prescription drugs, such as cannabinoids that are similar to medical marijuana?
Not all plans in all locations offer the same benefits, so it can help to work with a licensed insurance agent to find out more about the plans that are available where you live.
Explore Medicare Advantage plan benefits in your area
Or call 1-800-557-6059 (TTY: 711) 24/7 to speak with a licensed insurance agent.
Compare plans today.
Join our email series to receive your Medicare guide and the latest information about Medicare and Medicare Advantage.
By clicking “Sign me up!” you are agreeing to receive emails from MedicareAdvantage.com.
- About Us
- By State
- Terms and Conditions
Copyright © 2020 TZ Insurance Solutions LLC. All rights reserved.
1 National Conference of State Legislatures. State Medical Marijuana Laws. (Nov. 8, 2018). Retrieved from www.ncsl.org/research/health/state-medical-marijuana-laws.aspx.
2 Ellis, Lisa. FDA Approves Syndros, First Liquid Form of Cannabinoid Dronabinol. (Aug. 9, 2017). Practical Pain Management. Retrieved from www.practicalpainmanagement.com/resources/news-and-research/fda-approves-syndros-first-liquid-form-cannabinoid-dronabinol.
3 10-minute claim is based solely on the time to complete the e-application if you have your Medicare card and other pertinent information available when you apply. The time to shop for plans, compare rates, and estimate drug costs is not factored into the claim. Application time could be longer. Actual time to enroll will depend on the consumer and their plan comparison needs.
4 GoodRx. Donabinol. Retrieved Nov. 9, 2018 from www .goodrx.com/dronabinol.
MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts; enrollment in any plan depends upon contract renewal.
The purpose of this communication is the solicitation of insurance. Callers will be directed to a licensed insurance agent with TZ Insurance Solutions LLC, TruBridge, Inc. and/or a third-party partner who can provide more information about Medicare Advantage Plans offered by one or several Medicare-contracted carrier(s). TZ Insurance Solutions LLC, TruBridge, Inc., and the licensed sales agents that may call you are not connected with or endorsed by the U.S. Government or the federal Medicare program.
Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
Medicare has neither reviewed nor endorsed this information.While Medicare does not cover medical marijuana, some Medicare Advantage plans may cover other cannabinoids. Learn more about your coverage options.
Does Medicare Cover Medical Marijuana?
More states are legalizing medical marijuana with each passing year. That may make you wonder whether Medicare will cover the cost of medical marijuana in your state.
Federally, marijuana 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 marijuana because it’s considered a Schedule I controlled substance. In fact, doctors can’t even legally prescribe it.
Marijuana is usually suggested to treat symptoms like pain, nausea, and seizures. If you’ve received a doctor’s recommendation and your state has legalized medical marijuana, read on to learn what you need to know about coverage for medical marijuana, how and why it’s used, and more.
Medicare doesn’t cover drugs that are illegal according to the federal government. This includes marijuana.
The Food and Drug Administration (FDA) hasn’t cleared marijuana as a safe and effective treatment for any medical use. That’s true even if you live in a state where it’s medically legal. This is another reason Medicare won’t cover medical marijuana.
What about Medicare prescription drug plans?
Medicare Part C, or Medicare Advantage, is health insurance offered by private insurance companies that offers additional coverage beyond original Medicare (parts A and B). Extra coverage may include dental care, vision care, and 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 marijuana.
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, like dronabinol (Marinol, Syndros) and Epidiolex, may be covered by Medicare drug plans because they’re FDA approved.
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.
Marijuana has been recommended to ease symptoms like:
Medical marijuana is often suggested to treat the symptoms of AIDS or cancer. Research has shown it can boost appetite and reduce nausea. If you have multiple sclerosis (MS), medical marijuana may help ease pain and reduce muscle stiffness.
Dronabinol can be used to ease nausea and vomiting from cancer treatments and increase appetite in people with AIDS.
Epidiolex can help prevent seizures and is used as a treatment for epilepsy. Both of these medications have been approved by the FDA for these uses.
The federal government considers marijuana illegal and holds strict control of cannabis and cannabinoid-based products. That means research on the possible benefits, or even the side effects, of marijuana use is limited.
Without data from clinical research, the FDA won’t be able to update its position on the safety or effectiveness of medical marijuana.
In 2020, 33 states and Washington, D.C., have approved the sale and use of medical marijuana. Some of those states have also approved marijuana for recreational use.
In states where only medical marijuana is legal, you’re required to get a medical marijuana card.
The rules and steps for getting a medical marijuana card may vary from state to state, but here are the basics:
- Make an appointment with your primary healthcare provider. Your doctor will likely give you a full physical exam and review your medical history. If your doctor thinks medical marijuana might help, they may approve you for a medical marijuana card.
- Renew your marijuana card annually. This may require follow-up visits. Ask your doctor if there are any other additional steps you’ll need to take. Most marijuana cards are registered with the state government.
- Your doctor can’t prescribe marijuana directly. Federal law prevents doctors from prescribing substances that are illegal. Marijuana remains illegal under federal law. Instead, your doctor may suggest you use it.
Even though all types of marijuana are illegal at the federal level, the federal government hasn’t taken steps to prosecute those who use it within a state with legal marijuana trade.
However, it’s still possible to face prosecution under federal law under certain circumstances.
Marijuana contains several dozen active chemicals. The two most well known are cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC).
CBD’s potential benefits include improved relaxation, pain reduction, and lowered anxiety. THC is the chemical responsible for the psychoactive effects of marijuana.
In recent years, CBD has been isolated from THC and is sold even in states that don’t allow medical marijuana. In states where medical marijuana is legal, both CBD and THC products are available for a variety of health issues.
Like medical marijuana, 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 marijuana is reducing the use of opioids and pain medication with high addiction potential. Because marijuana may help relieve some of the same symptoms as opioids, doctors may not prescribe pain medications if marijuana were an option.If you have a serious illness, marijuana is sometimes used to treat symptoms like pain, nausea, and seizures. If your doctor has diagnosed you with one of these conditions and your state has legalized medical marijuana, here’s what you need to know about using medical marijuana and how much it will cost. ]]>