Medical cannabis can be pretty expensive medicine depending on how often a person uses it. It wouldn’t be so bad from a financial perspective if health insurance covered it. But that’s not the way it works. To date, no big-name insurers pay for medical cannabis products. Note that there are legitimate reasons for this. It is not just insurance companies being greedy.
Regardless of your personal opinions about health insurance companies and their practices, the fact remains that their hands are pretty much tied when it comes to covering medical cannabis. Even if some insurance companies want to provide coverage, ongoing conflicts between federal and state laws make it nearly impossible.
There are exceptions to the rule. For example, the NAIC estimated in 2023 that there were perhaps 30 very small health insurance companies offering limited coverage for related services and certain cannabinoid medications. But those companies still did not cover whole-plant products.
Still Federally Illegal
A lack of health insurance coverage is directly tied to the fact that cannabis remains federally illegal. Marijuana and its derivatives were classified as Schedule I control substances back in the 1970s. They remain on Schedule I even today.
Insurance companies cannot cover medical cannabis products without running afoul of federal regulations. Given the highly regulated nature of health insurance, insurers do not want to take the risk.
The Medicare and Medicaid Problem
Another factor to add to the mix is the Medicare and Medicaid problem. Combined, the two federal health insurance programs constitute the largest insurer in the United States. For all intents and purposes, their administrator – the Department of Health and Human Services (HHS) – sets the bar for all health insurance products.
Whatever HHS decides to do with coverage is pretty much mimicked by private insurers. And right now, HHS is prohibited by law from covering medical cannabis products. No insurance company is going to buck HHS and risk the likely consequences.
Along with that is the reality that so many healthcare institutions either receive federal funding or accept Medicare and Medicaid patients. Getting mixed up with medical cannabis could mean a significant loss of funding.
The Potential to Reschedule
The potential to reschedule cannabis to Schedule III is out there thanks to actions taken by the By the administration a couple of years ago. But rescheduling still hasn’t happened. It may not happen under the current administration. There is no way to know for sure. We just need to let things play out.
If cannabis is rescheduled, the conflict between state and federal law would be partly addressed. At the very least, it will allow health insurance companies to provide coverage the same way they cover other Schedule III drugs.
It’s Self-Pay, For Now
For now, however, medical cannabis is a self-pay option. When a patient visits the Beehive Farmacy medical cannabis dispensary and Salt Lake City, Utah, he pays for his medications out of pocket.
Beehive personnel recognize that some patients spend considerable amounts on their medications. They say having access to health insurance coverage would make medical cannabis more accessible to more people. Will it ever happen? Probably. The more important question is how long it will take to get there.
Insurance companies not covering medical cannabis are not simply being greedy. Maybe some of them will not cover it even when they can. But for the time being, offering coverage simply isn’t possible. Insurance companies are up against federal regulations that essentially tie their hands. Perhaps their hands will be untied sooner rather than later. When the day arrives, it will be interesting to see what insurers do.
