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When will insurance companies start to cover medical marijuana?

November 2, 2016

Medical marijuana has become a hot topic in Canada over the past few years and since its status and the regulations around it keep changing, the information here may be obsolete as soon as we post it! But we’ll do our best to bring you up to date on the current status of medical marijuana and why it’s not currently covered under most benefits plans.

First, let’s backtrack a bit and look at medical marijuana’s complicated and confusing history… 

2001: Health Canada introduced the Medical Marihuana [sic] Access Regulations (MMAR) to enable legal access to marijuana for medical use for patients with terminal or severe illnesses. Based on documentation from a physician that conventional treatments aren’t working, Health Canada would then consider licensing the patient to possess marijuana for medical purposes. Licensed patients had three choices to access marijuana: buy it from Health Canada, grow it themselves (Personal-Use Production License), or designate a grower (Designated-Person Production Licence).

April 2014: Health Canada introduced new Marihuana for Medical Purposes Regulations (MMPR) replacing the MMAR. The MMPR implemented some major changes: Health Canada no longer licensed users – patients now go to their physician for approval rather than Health Canada. Health Canada no longer sold marijuana or allowed personal “homegrown” production; the patient had to buy it from one of Health Canada’s licensed producers.

August 2016: The MMPR is replaced by the Access to Cannabis for Medical Purposes Regulations (ACMPR) as a result of a court ruling in a case called Allard v. Canada. The ACMPR restored the right for patients to produce their own supply of marijuana. Patients who were previously licensed to grow their own under MMAR can continue to do so, new patients can apply for registration with Health Canada to grow a limited amount of marijuana. Or patients can designate someone to produce it for them. Health Canada’s licensed producers continue to be the only recommended source of marijuana for patients not growing their own.

Yes, complicated and confusing…

So, what about your benefits plan? If your coverage includes a health care spending account (HSCA), you’re in luck. Medical marijuana is an eligible expense under HCSAs because the Canada Revenue Agency (CRA) allows it to be claimed as a medical expense on income tax returns. Note that only marijuana is eligible under CRA medical exempt items not vaporizers or other items used to consume it.

But here’s the bad news: Although physicians are prescribing it, and people are using it for medical reasons, marijuana is not currently covered under traditional drug benefits. That’s because Health Canada hasn’t reviewed it for safety and effectiveness or approved it for therapeutic use the way it reviews and approves all other prescription drug products. This means marijuana hasn’t been assigned a drug identification number, which the insurance industry usually requires before a drug can be covered. In fact there is a lack of rigorous clinical research on the effectiveness and safety of marijuana or even to definitively identify the active ingredients – the evidence thus far is weak and largely anecdotal. Until there is research that can be reviewed by Health Canada, marijuana will remain an unapproved drug and unlikely to be covered by your plan.

And a word about those marijuana dispensaries and compassion clubs popping up in neighbourhoods across the country…they’re illegal.