Is Medical Marijuana Covered by My Health Insurance?

With more than half of the states and the District of Columbia now allowing the use of medical marijuana, America’s healthcare system is having to figure out what it is going to do with it. Right now, one of the biggest issues on the minds of patients is whether or not their prescriptions are covered by their health insurance.

Health insurance does not cover medical marijuana at this time. This is not to say it never will. In fact, the chances are good that health insurance coverage is right around the corner. But for now, patients hoping to obtain medical marijuana products have to pay out-of-pocket.

There are two issues at play. One is legal and the other is liability related. If you understand these two issues, you probably also understand that health insurance companies are in a tricky situation.

The Legal Issue

Marijuana is still a controlled substance under federal law. As a Schedule I drug, it is viewed as having no accepted medical uses, yet still with a high potential for addiction. An entire legion of medical marijuana experts would dispute this classification. And indeed, they do. But that does not change the fact that Washington has not taken the steps necessary to reschedule or decriminalize marijuana.

This puts health insurance companies in a precarious position. If they started covering medical marijuana prescriptions, they would be paying for an illegal drug. That presents too much of a risk. Health insurance companies do not want federal officials breathing down their necks. They don’t want the DEA or Justice Department investigating them for criminal activity, freezing their financial assets, etc.

The Liability Issue

The fact that Washington still views marijuana as a Schedule I substance adds liability concerns to the legal ramifications. If you are not sure why, step back and consider just how litigious modern society is. We are so litigious we are willing to sue fast food restaurants when customers spill hot coffee on themselves.

Health insurance companies are justifiably concerned about the liability of covering medical marijuana. Imagine a patient having some sort of adverse reaction to a medical cannabis product. It is very possible their lawyer would sue everybody involved in the process of getting the drug into their hands – including the patient’s insurance company.

There are also liability concerns in relation to health insurance companies working with doctors and pharmacists. If a doctor or pharmacist improperly prescribes medical marijuana and it causes problems for the patient, a health insurance company could be sued for being involved. After all, health insurance companies reimburse doctors and pharmacists for their services.

A Cash-and-Carry Business

As things currently stand, medical marijuana is a cash-and-carry business. Deseret Wellness in Provo, Utah is just one example of a medical cannabis dispensary that deals only in cash transactions. Patients bring cash with them, use an on-site ATM, or arrange a direct ACH transfer from their bank accounts.

While this is not necessarily optimal for dispensaries or patients, it is the way things must be for now. Cash-and- carry is the only way to protect health insurance companies against legal action and liability. It seems the only way things will change is if Washington either reschedules marijuana or decriminalize is it.

If you are a medical marijuana user, know that you are not alone. There are lots of forms of alternative medicine that are not covered by health insurance. It is just the way our insurance system works. Keep doing what you are doing for the time being. It could be that things will change in the next year or so.