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Will Using Medical Marijuana Affect My Health Insurance?

With the rising cost of healthcare in this country, medical marijuana users are concerned about higher insurance rates.

Medical marijuana is enjoying soaring popularity in the U.S. According to the Washington Post, 80 percent of doctors support the use of medical marijuana, while over 90 percent of medical marijuana patients claim it works for their particular condition.

Regardless of this shift in public opinion, the medical use of cannabis remains federally prohibited, creating a myriad of policy issues, including whether or not it should be covered by health insurance.

Benefits of Medical Marijuana on Healthcare Costs

Legalizing medical marijuana has reduced healthcare costs in states across the U.S., yet cannabis products can’t be paid for using public or private health insurance. This means medical marijuana patients are shouldering the burden of the insurance providers’ reduced medical costs, which the patients alone are creating.

According to NPR, states that have legalized medical marijuana have seen a drop in overall prescription medication use, saving Medicare $165 million in 2013 alone. According to the study cited, if medical marijuana were extended nationwide, that number would reach closer to $470 million.

Despite these benefits, insurance companies in the U.S. still refuse to cover the cost of medical marijuana. Part of this stems from the fact that cannabis, including its medical use, is still classified as Schedule I by the federal government. Drugs listed under this classification are recognized to have high potential for abuse and no medical uses. Of course, there is a body of research available online that says otherwise.

On top of the fact that medical marijuana patients can’t use health insurance to help cover the costs of their treatments, in some markets, medical marijuana is taxed on either the state or local level – sometimes both – meaning that patients who choose medical marijuana as their preferred treatment often pay extreme costs to do so.

You can read more about the taxing of medical marijuana patients HERE.  

Negative Effects of Medical Marijuana Use on Insurance Rates

Because the federal government maintains that cannabis has no medicinal benefit, insurance companies are able to use the Schedule I listing for cannabis as a reason to avoid paying for its costs. This is especially true for government covered health care, like Medicare and Medicaid.

If patients do not want to pay out of pocket or cannot afford the price of medical marijuana in their state, the other option is exploring cannabis-based drugs that health insurance does cover. There are currently a number of legal, FDA-approved synthetic cannabinoids that have been used to develop new pharmaceuticals. These alternatives to medical marijuana include Marinol (dronabinol) and Cesamet (nabilone). However, these synthetic cannabinoids carry more potent side effects than phytocannabinoids and are often prescribed only after all other options have been exhausted.

There has been some progress gaining coverage for medical marijuana patients; though specifically, it has been through workers’ compensation. Already workers’ comp plans have been directed to cover medical marijuana in some cases. This might be the first place we see widespread coverage of medical marijuana.

One example of this came at the beginning of 2017. A New Jersey judge made a landmark ruling in a workers’ compensation case concerning a lumber worker who testified on his legal use of medical marijuana to treat neuropathic pain in one of his hands. The judge in the case ruled that workers’ compensation would have to cover the costs of the worker’s medical marijuana treatment. Rulings like this continue to open the door for insurance to one day cover medical marijuana.

If patients could use their insurance to help pay for their medical marijuana, however, there would be other issues to consider. Insurance companies would have the ability to raise premiums significantly, citing the cost of covering a patient who needs an expensive drug for higher rates.

Some advocates worry this is already taking place and medical marijuana users may currently be paying higher premiums just for choosing cannabis as part of their treatment, despite the fact that insurance companies don’t cover these costs.

Because of this, it might be better to keep your medical marijuana use off your medical records. Many medical marijuana states have specialized doctors that work solely in the cannabis space. Since these doctors don’t take insurance and expenses are paid out of pocket, your medical marijuana use is likely to remain off your record.

When applying for new health insurance policies, though, providers often check with agencies like the Medical Information Bureau (MIB) for medical backgrounds. Withholding the fact that you are a medical marijuana patient may not be a solution on these applications. Insurance companies who discover you lied about being a medical marijuana patient, either through a urine drug screen or medical records, are likely to deny coverage outright. They may also report you to the MIB, leading to you from getting banned by other providers as well.

This problem extends to life insurance as well, where cannabis users are nearly always classified as “smokers”, getting rates on par with cigarette smokers. Depending on the insurance company, you may even be denied coverage altogether.

For now, health insurance and medical marijuana don’t mix. As public perception continues to shift in favor of cannabis, research reveals ever more benefits to medicinal cannabis use, and marijuana legalization spreads across the U.S., conditions may lead insurance providers to finally cover the costs of medical marijuana patients. Until then, patients will need to cover the cost of their medical cannabis products out of pocket.

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