Medicare won’t cover medical marijuana since it remains a controlled substance federally. So what does this mean? If your doctor decides that marijuana is the best treatment for you, you’ll pay out of pocket.
Your doctor might decide to prescribe your marijuana for several reasons. The most common symptoms that cannabis may help treat are pain, nausea, or anxiety.
Below, we’ll go over why Medicare doesn’t cover medical-grade marijuana.
Medical Marijuana and Medicare Coverage
Your medication must have FDA approval to gain coverage from Medicare. Since marijuana doesn’t yet have authorization on a federal level, Medicare won’t cover it.
But, your medication must have FDA approval to gain coverage. In 2018, the FDA approved its first marijuana-based drug called Epidiolex.
The medications help treat patients that are two years old or younger with epilepsy.
Medigap and Medical Marijuana Coverage
While these comprehensive plans tend to include plenty of benefits, you’ll have to pay out of pocket for this prescription.
Like both Medicare and Medicare Advantage plan, Medigap policies don’t cover marijuana.
Medicare Advantage Plans and Medical Marijuana
Medicare Advantage plans won’t offer coverage for medical marijuana prescriptions. Insurance carriers that sell Advantage plans must still work within the federal guidelines.
But, your Medicare Advantage plan may cover the use of other cannabinoid-based medications like Epidolex.
Cannabinoid-Based Medications and Medicare Coverage
While Medicare won’t cover marijuana, Part D may cover prescriptions derived from cannabis. Currently, there are four medications available that have approval through the FDA.
The four medicines all contain compounds that are present in marijuana are the following:
Marinol and Syndros
Both these prescriptions are brand-name medications. Marinol and Syndros both contain a synthetic version of the compound from marijuana, called Dronabinol. If you pay out of pocket without any drug coverage, you could end up paying around $130 each month for Marinol.
Hold on to your seat as we dive into the average cost of Syndros. You’ll likely pay more than $1,300 for a Syndros prescription if you need to pay out of pocket. A drug plan could be a massive benefit to you with high prices like these.
Cesamet is another medication that contains a synthetic compound like what’s in marijuana. The average out of pocket cost for Cesamet is more than $2,000 for a month’s supply.
Unlike the other three medications, Epidiolex has an ingredient derived directly from marijuana. Epidiolex has CBD in it, which can help reduce a plethora of symptoms.
The average cost of Epidiolex annually is more than $32,000 per year. Yes, you read that right.
Learn How to Lower Your Medicare Costs
Medicare will cover many of your medical expenses, but not all of them. Thankfully, Medicare Supplement plans can help cover these expenses that Medicare doesn’t cover.
While your medical marijuana may not receive coverage, many other health care treatments will. Here at MedicareFAQ, we’ll compare plan rates from the top carriers in your area. OR, if you prefer, complete our online rate form for a quote in minutes.