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Will Your Insurance Cover Medical Marijuana?

By George Khoury, Esq. on May 17, 2017 | Last updated on March 21, 2019

Medical marijuana has been hailed as a wonder drug. Doctors frequently prescribe or recommend it to patients on opiates as it has potential to provide effective pain relief without the negative side effects of opiates.

Although marijuana can be used to safely treat a variety of ailments, illnesses, and diseases, health insurance companies do not currently provide coverage for it. Even in states where medical marijuana is legal, because the federal Controlled Substances Act (CSA) puts marijuana on the same level as heroin, most health insurance companies' policies require denying coverage. However, other types of insurance may actually be available.

Health Insurance Policies Require Denial

Most health insurance companies require that all medical treatment be FDA approved in order to provide coverage. Since the FDA is a federal agency, and marijuana is classified as a drug with no possible medical uses under the CSA, marijuana won't be approved by the FDA until it gets reclassified.

While there are many prescription drugs covered by the Controlled Substances Act, the law distinguishes between drugs that have a medical application and those that don't. Unfortunately for medical marijuana patients, despite the vast support and increased acceptance of medical marijuana nationwide, under the current administration, any change in classification may not be on the horizon for several more years.

What About Workers' Comp Insurance Providers?

This past January, a New Jersey workers' compensation judge ruled that a workers' comp insurer must pay for an injured worker's medical marijuana. The judge specifically found convincing the argument that marijuana was effective in providing pain relief and weaning a patient off dangerous opiates.

In addition to the recent New Jersey case, a few years back, a New Mexico workers' comp judge reached a similar decision. In both cases, the judges found that medical marijuana was an effective treatment, and was reasonable and necessary for the injured employees' medical care.

However, in California and other states, laws specifically allow workers' compensation, and other, insurers to deny coverage for medical marijuana claims. As such, before seeking to claim reimbursement from an insurer for medical marijuana, it's probably a good idea to read through your policy and check your state's laws to see if it is specifically excluded.

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