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Does Health Insurance Cover Medical Cannabis?

By March 23, 2020 August 13th, 2021 No Comments
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Medical Cannabis and Insurance

More than 17 years after cannabis was first legalized in Canada for medical use, some insurers are just beginning to cover the cost of the medication. Slowly things are changing for the better as companies are being given the option from insurers to include medical cannabis. However, many plans limit coverage to just a handful of medical conditions that qualify and do not cover the cost of medical cannabis for most users.
But don’t fret – if your health insurance plan includes a Healthcare Spending Account (HCSA or HSA), you are likely able to claim medical cannabis under this category. Be sure to chec
k the details of your insurance plan to see what is and is not covered. The Canada Revenue Agency lists medical cannabis as an eligible medical expense. Your proof of purchase (receipts) that include your prescription information, can be found online under your personal account with each Licensed Producer (LP) on their respective websites.
If you have any questions about your prescription, your apollo educator is here to assist you free of charge, 7 days a week.

Medical Cannabis Compassionate Pricing 

Many Licensed Producers (LPs) also offer compassionate pricing to low-income individuals, seniors, and those on ODSP. Medical cannabis users should work with a patient educator who can help them determine if they qualify for compassionate pricing or other benefits. Patient educators are also able to recommend Licensed Providers who offer compassionate pricing, as not all LP’s offer this benefit. Apollo Cannabis Clinics employ patient educators to work with each individual after they receive a medical cannabis recommendation. Patient educators are committed to helping medical cannabis users understand what benefits certain Licensed Producers may offer. They also work to help individuals select LPs who carry the product they require.

If you would like to book a free virtual/telephone appointment, we assist our patients 1-on-1 with any insurance questions as well as assisting in finding you the best LP that suits your needs and budget.
You can fill out a form here and someone from our bookings team will give you a call or you can reach us directly toll-free at 1-877-560-9195.

Claiming medical cannabis as a medical expense

One of the biggest benefits for medical cannabis patients and users is the ability to “write off” their medical cannabis medication on their yearly personal taxes as a medical expense. To be able to do so, the cannabis must have been purchased through a Licensed Producer, and have valid receipts of purchase.

How to claim medical cannabis on your insurance:

  • Ensure you can claim medical cannabis under your personal or workplace health insurance plan by reading the details of your plan coverage, or by inquiring directly with your insurance provider.
  • If the insurance provider requires any forms to be completed by the physician prescribing medical cannabis, please submit for review by your healthcare practitioner at Apollo Clinics*.
  • If and when you are approved for medical cannabis coverage through your health insurance plan, inquire with your LP about direct billing.

How to claim medical cannabis under your Healthcare Spending Account

  • Ensure you have a health spending account through your personal or workplace insurance plan. HSA claims are out-of-pocket expenses that you are reimbursed for after the purchase. 
  • Check with your plan administrator to ensure medical cannabis is something that can be claimed. 
  • Make sure you have all of your receipts from your personal account with your LP and a registered medical document (your prescription). You can request this from your LP.
  • Inquire with your insurance provider about the submission process.

If you need any paperwork filled out by your doctor, please contact Apollo and we will be happy to assist you*.

Insurance companies currently offering medical cannabis coverage inclusion

  • Sunlife Financial
  • Co-Operators Life Insurance
  • Desjardins Insurance
  • Green Shield Canada
  • Great West Life
  • Manulife
  • Alberta Blue Cross
  • Medavie Blue Cross
  • SSQ Insurance
  • The Great-West Life Company 

Source from: https://www.marijuanamedinfo.ca/health-benefits-coverage-for-medical-marijuana/insurance-providers

Employers that have included medical cannabis coverage as a listed benefit under their employee health plan include:

  • Laborers’ International Union of North America (LiUNA) – Local 625
  • Loblaw Companies Limited
  • Ontario Public Service Employees Union (OPSEU)
  • The Arthritis Society

Source from: https://www.marijuanamedinfo.ca/health-benefits-coverage-for-medical-marijuana/employer-unions

Veterans Affairs: A Pioneer in Coverage

Veterans Affairs Canada was the first Canadian institution to cover medical cannabis and has a revised coverage policy since November 22, 2016 through Medavie Blue Cross. The Veterans Affairs Canada website states “the health and well-being of Veterans is a top priority for the Government of Canada. This was the fundamental consideration in the development of VAC’s reimbursement policy for cannabis for medical purposes”.

Veterans Affairs Canada reimburses eligible medical cannabis users, those with a K# and Awarded Conditions, for up to three grams of dried cannabis or equivalent in oils/edibles per day. If there is a need for additional daily dosage of cannabis, Apollo can help complete all necessary paperwork allowing veterans to receive more than 3grams a day to  be covered. Eligible cannabis must come from a medical Licensed Producer with whom a patient is registered through an authorized medical document (prescription). Grey market and recreational cannabis purchases are not reimbursable.

As with most medical benefits there is a limit on the cost Veterans Affairs Canada will reimburse per gram of cannabis. A maximum rate of $8.50 per gram of cannabis is covered and medical users must pay the rest out of pocket. However, many reputable LPs will adjust the cost accordingly specifically for veterans.

Ongoing Advocacy

Current medical cannabis users are hopeful that private insurers will begin to recognize cannabis as medicine and cover the expenses. There is a large push to see cannabis covered the same way as any other prescribed medication, as well as better access for those who are on ODSP or a fixed income. There are advocacy groups & nonprofits that work with patients to discuss coverage with their employers and private insurers while showing supporting medical evidence of your prescription such as a doctor’s letter alongside the request. Currently, this is generally done on a case-by-case basis on whether or not the coverage will be approved. 

Apollo Cannabis Clinics Can Help

Apollo Cannabis Clinics employ a team of health care providers to help individuals gain access to medical cannabis and best utilize their medication. Patient educators are available to assist clients in choosing an appropriate Licensed Producer who may offer additional assistance, such as compassionate pricing or money towards vaporizers.

Book Your Appointment

More Resources:
What to expect from an online/virtual appointment
Eligible conditions
5 reasons to have a prescription

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