Medical Marijuana Cards and the Health Insurance Question

healthA question we hear a lot from patients is whether or not health insurance will pay for a Medical Marijuana consultation. People want to know if their insurance will cover a visit to our clinic. In short, probably not. There are exceptions to the rule, but the vast majority of health insurance plans do not cover marijuana products or the visits required to obtain a Medical Marijuana Card.

Things will hopefully change in the future. We’ve heard rumors suggesting that some state legislatures will begin requiring insurance companies to cover certain Medical Marijuana related services. That would be awesome. And of course, Congress could decriminalize marijuana in 2021. But for now, Medical Marijuan Cards being covered by health insurance is off the table.

Avoiding the Liability

The difficulty with health insurance is liability. Marijuana is still a controlled substance under federal law. Health insurance companies have to walk that fine line between recognizing Medical Marijuana as legit and not creating problems with federal law. They are in the same position as banks. Even though most states and the District of Columbia recognize genuine medical reasons for using cannabis, insurance companies don’t want to risk the liability that comes with the Medical Marijuana territory.

Medical Cannabis could be decriminalized by Congress sometime in 2021. If so, there still is no guarantee health insurance companies will race to cover MMJ or clinical services. Insurance executives still debate whether or not Medical Marijuana is a good alternative to other drugs and therapies. It might take a while to convince them.

Options for Clinicians

Here in Utah, clinicians must be approved by the state to recommend the use of Medical Cannabis. In other words, you have to meet with an approved clinician, or Qualified Medical Provider (QMP), who can determine whether or not you would benefit from Medical Cannabis. Getting the okay means you can go ahead and apply for a Medical Cannabis Card.

Each state handles this in its own way. The one thing they all have in common is this: QMPs and dispensaries have to decide for themselves how they want to accept payment. Most don’t even try to go down the health insurance path. They require patients to pay with either cash or credit card.

Even if a QMP wanted to accept health insurance for a Medical Cannabis consultation, the consultation could not be primarily about using marijuana. It would have to be about something else that could be billed more easily. This creates problems.

Billing a consultation under an allowable category but still using the consultation to speak primarily about Medical Cannabis carries the risk of a QMP being dropped from the applicable insurance plan – in the event the insurance company found out about it. Doctors, physician assistants, etc. don’t want to take the risk any more than insurance companies want the liability of covering Medical Marijuana.

Changes Are Coming

The Medical Cannabis environment, in Utah and elsewhere, is not ideal right now. But it’s a lot better than where we were a decade ago. At least we’re now in the position of Medical Marijuana being recognized from coast to coast. Even though Washington still isn’t on board, the states are. It’s a good start.

More important is the fact that changes are coming. The evidence is all around us. It’s only a matter of time before marijuana is completely decriminalized at the federal level. Between now and then, Washington might take the step of recognizing Medical Marijuana as legitimate. When they eventually do, our industry can begin working with the insurance industry to cover consultations and Medical Marijuana products.

See our page on getting a Medical Marijuana card, to learn more about what you can expect with one. Also, feel welcome to reach out to us or visit one of our clinic locations. We’re always excited to help!

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Published December 21, 2020

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