Does Medicare cover medicinal marijuana? The answer is currently “no,” and it will likely remain that way for some time to come. Original Medicare is divided into Part A (hospital insurance) and Part B (general medical insurance), but neither covers legal medical marijuana treatments. Medicare Part C, sometimes called Medicare Advantage, likewise omits marijuana treatments. The same is true for the 10 Medigap plans currently standardized by the United States federal government and sold by private insurance providers.
Medicare specifies what treatments, equipment, and specialists qualify for coverage or reimbursement under its program umbrella. The criteria that the federal government uses to determine whether or not a treatment is valid has to do with whether it is deemed “medically necessary” by a physician and documented as such.
Marijuana is legal in some states
Medical marijuana has been legalized in 23 states and the District of Columbia. It is used by cancer patients, epileptics, and people with chronic pain in place of more traditional pain management drugs. A recent University of Georgia research effort concluded that medical marijuana use saves state and federal governments millions of dollars on both Medicare expenses and prescription drug use. Specifically, the states that have legalized medical marijuana use have seen a sharp decline in the demand for prescription painkiller drugs.
Despite these statistics and studies, Medicare isn’t alone in its refusal to cover medical marijuana use. Health insurance providers don’t pay for it, either.
Marijuana is classified as a Schedule I controlled substance, and the Federal Controlled Substances Act puts it in the same category as cocaine, heroine, and other so-called hard and illegal drugs. This means that US lawmakers view it as a substance with high potential for abuse. This makes it almost impossible for marijuana to undergo the clinical studies necessary for it to become approved by the Food and Drug Administration.
Calls to reclassify the drug
The American Medical Association has called for marijuana’s classification to be changed so that clinical trials may be performed. The AMA cites research showing that the drug is safer than both alcohol and tobacco. The Brookings Institution, a Washington, D.C. think tank, states that marijuana reclassification is unlikely to happen anytime soon because of the politics and bureaucratic red tape surrounding the initiative.
Meanwhile, medical marijuana is quite expensive due to its status as a controlled substance. Some estimates place daily user costs upwards of $1000 per month. Low-income patients may qualify for a price break on medical marijuana registration depending on which state they live in. New Mexico even requires worker’s compensation benefits that cover medical cannabis.
While it’s currently unlikely that marijuana will be included under Medicare’s coverage umbrella, it’s not impossible due to the money involved. Medicare cost the federal government roughly $550 billion in 2015. If medical marijuana use is proven to reduce costs as the aforementioned research study indicates, the government will be forced to consider it.