Despite a growing body of scientific research that shows marijuana offers health benefits, the United States remains conflicted over whether the plant has beneficial uses or is an addictive substance. Currently, 36 states and the District of Columbia passed laws legalizing marijuana for medical or recreational use (or both). However, U.S. federal law calls marijuana a Schedule I Controlled Substance with no currently accepted medical use. 

So, which is it? There are many questions around the subject, including, “will insurance pay for medical marijuana?”

Is Medical Marijuana Legal in Florida?

Yes, Florida legalized medical marijuana in in 2016. It was the 22nd state in the nation to allow the use of this plant for medical care. Patients struggling with seizure disorders, cancer, or other illness could use medical marijuana when prescribed by a licensed physician. 

In fact, 71% of Florida voters approved a constitutional measure that allows seriously ill patients access to medical marijuana. This includes patients with illnesses such as HIV, cancer, PTSD, Parkinson’s, and epilepsy. 

Then, in 2017, the state legislature followed up with Senate Bill 8A, the Medical Use of Marijuana Act, which established many of the rules that govern how we distribute the plant within state lines. The Florida Department of Health established the Office of Medical Marijuana Use to regulate how we use these medications.

Will My Insurance Pay for Medical Marijuana?

Despite all of the legal rules that allow doctors to prescribe marijuana as medication in Florida, your health insurance provider will not pay for these drugs. Granted, they will probably pay for a host of other medications, including the highly-addictive class of opioids that have caused so many abuse problems, but not legally prescribed medical marijuana. Once medical marijuana becomes federally legal, insurance companies will begin to pay. 

The federal government still lists the plant as a controlled substance. This means doctors must be registered with the Drug Enforcement Administration (DEA) and have a DEA number to write a marijuana prescription. Even though the state legalized marijuana, your doctor could lose his or her license and go to jail if they fail to register with the DEA.

There is another complicating factor that keeps insurance companies from reimbursing expenses for medical marijuana: marijuana isn’t on the payer’s formulary. A drug formulary is the list of medications your insurance company will pay for. To change this list would require your health insurance carrier’s therapeutics and pharmacy committee to add marijuana to this list. The problem is that marijuana hasn’t been approved by the Food and Drug Administration (FDA). Before approving marijuana, the FDA would run a host of clinical trials to approve the safety and efficacy of the plant as medication. Without FDA approval, marijuana will never appear on the drug formulary.

Health insurance provider Cigna suggests there are four primary reasons why they will not cover medical marijuana:

  • It lacks FDA approval
  • Marijuana may impair your coordination, judgment, and memory
  • The smoke may harm your lungs
  • There are legal drugs that may work just as well

However, with that said, the FDA has approved some THC products for human consumption, including Marinol, Cesamet, and Syndros. THC stands for tetrahydrocannabinol, which is the natural substance that produces the “high” from the marijuana plant. All three of these FDA-approved medications contain a synthetic form of THC, and all three are covered under health insurance for the treatment of diseases like cancer and epilepsy.

One of the other active ingredients culled from the marijuana plant is cannabidiol or CBD. CBD does not produce the “high” that THC does, so these legal products are cropping up all over, from dietary supplements to pain relief. In 2018 the FDA approved Epidiolex to treat the severe seizures associated with certain types of epilepsy. This drug, being FDA approved, is also covered by many health insurance companies.

Is Medical Marijuana Safe?

Health insurance carrier Cigna says, “Marijuana is a drug that is made up of the leaves, flowers, and buds of the hemp plant.” They suggest marijuana can be used to treat symptoms such as pain, nausea, lack of appetite, and muscle stiffness caused by AIDS, cancer, multiple sclerosis, or other diseases.

The American Association of Retired Persons (AARP) compiled the data on medical marijuana and state that:

  • More than 600,000 Americans use marijuana for chronic pain
  • Randomized clinical trials show marijuana helps with everything from diabetes nerve pain, HIV, cancer, chemotherapy, rheumatoid arthritis, multiple sclerosis, and spinal cord injury
  • Marijuana appears to help with chronic insomnia
  • There appears to be the benefit of reducing anxiety, calming chronic tension, and PTSD

While AARP has endorsed the use of medical marijuana, they are careful to point out that more research needs to be done. There are also caveats in each of the studies, for example, the strain and dosage of marijuana seems to have an effect on the effectiveness of the treatment. 

WebMD suggests “Researchers are studying whether medical marijuana can help treat a number of conditions, including:

  • Alzheimer’s disease
  • Appetite loss and eating disorders
  • Cancer
  • Crohn’s disease
  • Epilepsy
  • Glaucoma
  • Immune system illness such as MS or HIV/AIDS
  • Mental health conditions
  • Multiple sclerosis
  • Muscle spasms
  • Nausea
  • Pain
  • Seizures
  • Wasting syndrome

Another new study seems to show promise that marijuana may lessen the memory loss and confusion associated with dementia. However, the highest volume of research to date focuses on the positive effects of marijuana for reducing chronic pain, muscle tremors from MS, and nausea and vomiting from chemotherapy to treat cancer.

Who is Eligible for Medical Marijuana in Florida?

To be eligible for medical marijuana in the state of Florida, you must first visit an approved clinical provider such as Martin Schnell, M.D., and the team at Rapha Wound Care. You must have been diagnosed with one or more of the following conditions by your primary physician:

  • ALS
  • Anxiety disorder
  • Cancer
  • Chronic nonmalignant pain
  • Crohn’s disease
  • Epilepsy
  • Glaucoma
  • HIV/AIDS
  • Insomnia
  • Parkinson’s disease
  • Post traumatic stress disorder 

To request an evaluation by Dr. Schnell and his staff, please call 352-409-4404 or click here to contact us online.

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