Does Medicare Cover Medical Marijuana?

Some Medicare Advantage plans (Medicare Part C) that include Medicare Part D plans along with some standalone Medicare Part D prescription drug plans may cover cannabinoid-based medications. Cannabinoids are types of chemicals that are found in marijuana.

More than 31 states allowing the use of marijuana for medicinal purposes in 2018.¹ So what does this mean for your coverage options as a Medicare beneficiary?

Learn more in this guide about how a Medicare plan could help cover the cannabinoids you need.

Why doesn’t Original Medicare cover medical marijuana?

The biggest reason why medical marijuana is not covered by Original Medicare is that marijuana is not approved for medicinal use by the Food and Drug Administration (FDA).

A second reason is because marijuana remains federally classified as a Schedule I drug, meaning it is not recognized by the federal government as having any medicinal value.

Though some Medicare Advantage plans with Part D coverage and some Medicare Part D plans may cover cannabinoid-based medications, Original Medicare (Medicare Part A and Part B) does not.

Some Medicare plans may cover other cannabinoids

Dronabinol is a synthetic form of cannabis that is used to treat the loss of appetite and weight loss suffered by some people with AIDS, Dronabinol can also be used to help treat the nausea and vomiting associated with cancer chemotherapy.

Dronabinol is the active ingredient in brand name drugs Syndros and Marinol, and both drugs may be covered by some Medicare Advantage plans with prescription drug coverage as well as some Medicare Part D plans.

Syndros comes in a liquid form while Marinol comes in the form of a gel capsule. Dronabinol also comes in capsule form as a generic drug that may also be covered by some Medicare Advantage plans and Medicare Part D plans.

Syndros and Marinol are both approved by the FDA and are both classified as Schedule II drugs.² This category features drugs with accepted medicinal use that are considered to carry a high risk of addiction or abuse and includes such drugs as oxycodone, fentanyl, morphine and methadone.

Check with your Medicare Advantage or Medicare Prescription Drug Plan carrier to determine if this type of medication (or any others you may need) is included in your plan’s formulary. A formulary is a plan’s list of covered medications.

Are you looking for Medicare prescription drug coverage?

You can compare Part D plans available where you live and enroll in a Medicare prescription drug plan online in as little as 10 minutes when you visit MyRxPlans.com.¹

How much do cannabinoids cost?

The average retail price of 60 capsules of Dronabinol is reported to be $257.⁴ A Medicare Advantage plan or a Medicare Part D plan that covers Dronabinol could help alleviate some of that cost. 

Medicare Advantage and Part D plans are sold by private insurance companies, so premiums, deductibles and coinsurance amounts can vary from one plan to the next.

Find a Medicare Advantage plan that offers prescription drug coverage

Are you looking to find a Medicare Advantage plan with Part D coverage that covers prescription drugs, such as cannabinoids that are similar to medical marijuana?

Not all plans in all locations offer the same benefits, so it can help to work with a licensed insurance agent to find out more about the plans that are available where you live.

Or call 1-800-557-6059 (TTY: 711) 24/7 to speak with a licensed insurance agent.

About the author

Christian Worstell is a senior Medicare and health insurance writer with MedicareAdvantage.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

Christian has written hundreds of articles for MedicareAvantage.com that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@tzhealthmedia.com.

 

 

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