As of February 2022, 37 states have legalized comprehensive, publicly available medical marijuana/cannabis programs and 10 have approved use of “low THC, high cannabidiol (CBD)” products for medical reasons in limited situations.
With this widespread adoption of using marijuana for health conditions, including pain management, alleviating anxiety, and improving sleep, it’s become a viable alternative to pharmaceuticals, especially for people with chronic conditions, mental illness, or undergoing chemo.
It’s especially attractive to older Americans who are in constant pain due to arthritis or other conditions, who have trouble sleeping, or are battling mental health issues.
All that said, this leaves the question of how accessible medical marijuana is to Medicare beneficiaries. We’ll dive into the specifics in this piece, including whether or not Medicare provides coverage, the associated costs, and options available.
Does Medicare Cover Medical Marijuana?
As of July 2022, Medicare does not provide coverage for medical marijuana because it is still a federally controlled substance. In order for a medication to be covered by Medicare, it must have FDA approval. But because marijuana is not authorized on a federal level, Medicare will not cover it even if you buy a Part D plan.
So far, the only FDA-approved marijuana-based drug is Epidiolex, which is a medication for children two years old or younger suffering from epilepsy.
Thus, even if your doctor believes marijuana is the best treatment choice for you and writes you a prescription, you will still be required to pay entirely out-of-pocket should you choose to move forward.
Will Medicare Advantage Cover Medical Marijuana?
Similar to Original Medicare, insurance carriers that sell Medicare Advantage plans need to abide by the federal guidelines, so they will not offer coverage for medical marijuana prescriptions. However, some Advantage plans may provide coverage for the use of cannabinoid-based medications such as Epidiolex.
What About Medigap?
Despite the wide array of benefits offered through Medigap plans, they too have to follow federal guidelines and will not provide coverage for medical marijuana.
So, What Are My Options?
Although Medicare does not cover marijuana, Part D may cover cannabis-based medications. Currently, there are four medications available that contain marijuana compounds and have FDA approval:
Marinol and Syndros
A synthetic version of the marijuana compound Dronabinol is contained in the brand-name medications Marinol and Syndros. If you pay out-of-pocket without any drug coverage, you could end up paying around $130 each month for Marinol and a whopping $1,300 for Syndros. Having a drug plan that covers these medications can be a massive benefit.
Cesamet
Cesamet is another medication that contains a synthetic compound similar to those in marijuana. The average out-of-pocket cost for Cesamet is more than $2,000 for a month’s supply.
Epidiolex
As mentioned above, Epidiolex has an ingredient derived directly from marijuana. Epidiolex has CBD in it, which can help reduce a plethora of symptoms. However, the average out-of-pocket price of Epidiolex is astronomical, costing more than $32,000 per year.
Does Medicare Cover CBD Oil?
Given the growing popularity of CBD or cannabidiol as a treatment for chronic pain, anxiety, and sleeplessness, it’s a great holistic solution for older adults. Moreover, it doesn’t have the psychotic effects of THC as CBD is typically sourced from industrial hemp plants as opposed to marijuana plants.
Yet, despite the availability of CBD products in health and wellness stores and its proven benefits for managing pain, anxiety, depression, insomnia, and many other unpleasant symptoms, Medicare will not provide coverage for it.
Unfortunately, just like marijuana, CBD is yet to be considered legal on a federal level. Until the FDA approves CBD oil, Medicare won’t help pay for it.
The upside here though is that CBD products are not nearly as expensive as medical marijuana. Depending on factors including strain, dosage, and dispensary you purchase from, the cost can range from $50–$1,500.
Do Your Research
While Medicare does not currently provide coverage for medical marijuana or CBD products, that’s not to say it never will, especially since more states are legalizing both recreational and medical marijuana use, and there’s a push to make it federally legal as well.
But for right now, my best advice is to listen to your doctor’s recommendations and do your research on benefits and costs associated with medical marijuana and CBD products to ensure you’re making a well-informed purchase.
Are medical marijuana and CBD legal in your state? Do you use such products? Why or why not? Do they help you with your particular health issues? What benefit have you noticed since you started using? How do you pay for this type of medication? Please share what you know in the comments below.
