Incremental Change in Insurance Reimbursement for Medical Cannabis

We in the cannabis industry are used to small, incremental steps towards normalization. We believe it’s these small steps that eventually compound and result in lasting changes in mindset. Insurance reimbursement for medical cannabis is one area where we are seeing this incremental change.

While adult use gets the headlines, the medical use case almost always comes first and builds the pathway for adult use. Once a market graduates to adult use, medical use usually drops off as medical patients no longer bother with certifying, seeing a doctor for recommendations and other key elements to a successful medical cannabis program. Why? Because they don’t see the benefit. They can go to an adult use dispensary, get a recommendation from a budtender and buy the same medicine. So even if I am medical patient, why bother? I would argue that adhering to the medical program and working with a physician is a good reason. But fair point, that’s a little weak for the everyday medical user. When a market legalizes adult use, we’ve seen a few ways that medical patients can and should receive priority in order to receive uninterrupted, frictionless access. Such as medical patient only store hours or priority access to specific pain focused products. But what if your medical cannabis was treated like other medicines and all of a sudden you could possibly get reimbursed for that medicine?

Many states are not waiting on federal action and are passing state-level statutes that require or enable insurance carriers to reimburse patients for medical cannabis expenses. Now before everyone with a medical card and “chronic pain” gets excited, most of these state level bills come with caveats to make sure the casual adult use weed smoker is not being reimbursed for medicine. For example, here on the east coast:

1. New York lawmakers approved a bill that would require public health insurance providers in the state to include medical marijuana as a covered prescription drug and authorize private insurers to do the same (so no guarantee for private insurers).

2. A Pennsylvania appeals court ruled that the state’s medical marijuana law does not prohibit insurers from reimbursing injured workers for medical marijuana in cases where the drug is used to treat accepted work injuries.

As we’ve seen medical cannabis can be a viable option for patients with various conditions, we believe as the New York bill states, “Access to medical marijuana should not be limited to those who can pay out of pocket.”