No mainstream health insurance company in the United States offers a policy that covers medical marijuana use. The reason for this situation is the same reason Medicare and Medicaid do not include medical marijuana as part of their coverage: the U.S. Food and Drug Administration (FDA) has not approved any drug containing or derived from botanical marijuana. Health insurance companies do not cover drugs not approved by the FDA.
Interestingly, the FDA has approved a “drug containing a synthetic version of a substance that is present in the marijuana plant and one other drug containing a synthetic substance that acts similarly to compounds from marijuana but is not present in marijuana.” Why would synthetic marijuana be available and not the real thing? Although the FDA website does not so explicitly state, the reason is the most-often-cited fact on our Canna Law Blog: Marijuana is a Schedule 1 drug and is still illegal under federal law.
Whether consumer-directed healthcare plans or CDHPS (Health Savings Accounts, Health Reimbursement Accounts, and Flexible Spending Accounts) cover cannabis is a bit more complicated. A CDHP is part of a standard health insurance plan whereby the insured has a personal healthcare account that can be sued for copays or deductibles, where the patient has discretion in how to spend the funds for his/her own medical needs. Funds are deposited into a CDHP tax-free and are withdrawn tax-fee or tax deductible. Since, by definition, the patient has discretion in how CDHP funds shall be spent, it would logically follow that CDHP funds could be used to purchase medical marijuana in a state with legalized medical marijuana.
But, so far, this has not been the case.
The first problem with CDHPs and medical marijuana is tax deductibility. According to the IRS, federally illegal controlled substances are not a tax-deductible medical expense. Even if one were not concerned with tax deductibility, private insurance companies will not cover medical marijuana as part of a CDHP because of another technicality. Doctors do not issue prescriptions for medical marijuana, but rather recommendations. The list of reimbursable medical expenses from an insurance company chosen at random illustrates the specification that an expense must be a prescription in order for the insurance company to cover the cost. Needless to say, neither medicare nor medicaid provide coverage for cannabis either.
This overall lack of health insurance coverage makes it tough for low income patients to use cannabis as medicine and is yet another reason why state by state legalization is not enough when it comes to effective health care and marijuana consumption.