Medicare CBD Oil

CBD is becoming more and more popular across the United States as a natural remedy for the symptoms of many common conditions from headaches and anxiety Does Medicare cover CBD oil? Medicare can only cover federally legal and FDA-approved drugs. Learn more about cannabis products for medical use here. Medicare still does not provide coverage for medical marijuana. So, what are your options, if there are any?

Does Medicare Cover CBD Oil?

CBD is becoming more and more popular across the United States as a natural remedy for the symptoms of many common conditions from headaches and anxiety to epilepsy and cancer. CBD, or Cannabidiol, is the name of a chemical compound that is in the cannabis (Cannabis sativa) plant, which is more commonly known as marijuana.

Unlike THC (Tetrahydrocannabinol), the chemical compound in the same cannabis plant, CBD does not get you high when you take it. THC is psychoactive but CBD is not.
Manufacturers produce CBD oil that is either edible or safe for use on the skin or other parts of the body by diluting Cannabidiol with another oil like hemp seed or coconut oil.

Scientific evidence has shown that CBD oil may be effective when used to relieve pain, reduce depression and anxiety, relieve symptoms related to cancer, provide benefits for neurological disorders, boost heart health, and help prevent diabetes, among others.

Today in the United States, CBD that comes from hemp plants is legal in all 50 states. CBD that comes from marijuana plants is not legal in every state. Hemp contains more of the CBD compound than the THC compound, and the reverse is true for marijuana plants. This makes hemp more efficient in providing CBD oil for the U.S. markets.

Even though all 50 states allow the sale of products containing CBD, some states are more accepting than others. Depending on the state where you live, your health care provider may be more willing to suggest using CBD oil for diverse reasons. If your physician thinks that CBD oil is something you should try, you may wonder if your Medicare benefits cover the cost. Here is some information on the topic of Medicare and CBD oil.

The Benefits of Using CBD Oil
While CBD oil is not right for everyone, many people are finding it effective as a treatment for some common ailments. Some of the reasons people use CBD oil are:

• For relief of muscle pain due to inflammation
• To ease muscle soreness and help muscles relax
• To fall asleep easier and sleep better
• To relieve anxiety
• To treat PTSD
• To help with depression
• To reduce acne
• To assist with substance abuse treatment
• To help prevent diabetes
• To help prevent the development of social recognition deficit in patients in the early stages of Alzheimer’s
• General pain management

Today, many people are using CBD oil to successfully treat symptoms caused by certain health conditions. Medical professionals are not all on the same page when it comes to recommending CBD oil to their patients. If your health care provider thinks that it may work for you, it might be worth your time and money to check CBD oil out.

Does Medicare Cover CBD Oil?
Unfortunately, Medicare does not offer coverage for CBD oil at the present time. This is due to the fact that it has not been legalized at the federal level yet. It is possible that when the FDA legalizes CBD oil and other products that contain CBD, Medicare may help pay for these products when they are medically necessary.

However, the drug Epidiolex, which contains CBD, is an FDA-approved treatment for seizures that are associated with the syndromes Lennox-Gastaut and Dravet for patients that are older than two years. Dravet and Lennox-Gastaut are two forms of epilepsy that are extremely rare.

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If you have a Part D prescription drug plan together with your Medicare benefits, or a Medicare Advantage plan that includes prescription drug coverage, you may have coverage for Epidiolex. Your coverage depends on whether your insurance policy’s formulary (list of covered drugs) includes Epidiolex. If it is included on the formulary, your final cost depends on your policy’s copayment, coinsurance charges, and your deductible.

Will Medicare pay for CBD oil?

Neither CBD oil nor medical marijuana is a drug covered by Medicare. While CBD oil and medical marijuana can be prescribed by a doctor and obtained at dispensaries, it’s not a legalized drug federally. For a drug to qualify for Medicare, it must be legal and FDA approved.

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Chelsey Tucker graduated with a Bachelor of History degree from Metropolitan State University in 2019. She now writes about insurance with her specialty being life insurance and has been quoted on Help Smart Phone and MEL Magazine.

Written by Chelsey Tucker
Insurance Expert

Dan Walker graduated with a BS in Administrative Management in 2005 and has been working in his family’s insurance agency, FCI Agency, for 15 years. He is licensed as an agent to write property and casualty insurance, including home, auto, umbrella, and dwelling fire insurance. He’s also been featured on sites like Reviews.com.

Reviewed by Daniel Walker
Licensed Auto Insurance Agent

UPDATED: Jun 28, 2022

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  • CBD oil is not federally legal if derived from marijuana
  • Cannabis for medical use is legal in 36 states
  • CBD is being researched to treat Parkinson’s disease and Alzheimer’s disease, among others

CBD oil is a wave that’s capturing the healthcare industry. It’s being studied as a treatment for many diseases and ailments such as Parkinson’s disease, Alzheimer’s disease, and even mental health disorders such as schizophrenia and anxiety.

By definition, CBD oil is derived from cannabis and is a type of cannabinoids. However, it does not create the psychoactive “high” effect like Tetrahydrocannabinol (THC). Cannabinoids are the chemicals naturally found in marijuana plants.

Even though its uses in health care are being studied, CBD oil and other products like it are not legal in most states or federally. Because it’s not federally legalized, does Medicare cover CBD oil?

What are the parameters of Medicare insurance ?

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Table of Contents

Does Medicare cover CBD oil?

Is CBD oil covered by Medicare?

At this time, Medicare does not cover CBD oil under Medicare Plan D or drug coverage. CBD oil has not been legalized at the federal level and Medicare coverage is a federal benefit.

Do other medical insurance providers cover CBD oil or does medical insurance cover medical marijuana? The answer remains the same. Cannabis products aren’t federally legal and can’t be covered by any type of health insurance provider whether private or public.

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Is medical marijuana covered by Medicare? Is medical marijuana covered by insurance?

Does Medicare cover medical marijuana or any other type of cannabis product?

No, like CBD oil, no cannabis-related drugs are covered by Medicare.

As previously mentioned, Medicare Plan D typically covers any drug, prescription, or medical device-related claims for Medicare recipients. For a drug to be covered under Medicare, it must meet the following requirements:

  • Approved by the Food and Drug Administration (FDA)
  • Available by prescription
  • Medically necessary

While cannabis products may be legal in some states, it’s not legal federally and the same rules that apply to Medicare apply to standard private health insurance.

Do CBD dispensaries accept insurance?

Dispensaries are set up to offer cannabis products for medical use much like a pharmacy is set up to offer prescriptions.

Even though a dispensary setup may look similar to a pharmacy, it is quite different. Dispensaries can’t accept insurance even when CBD oil or medical marijuana is prescribed by a doctor.

Cannabis products are legal in 36 states for medical purposes. In these 36 states, CBD oil and medical marijuana can be obtained with a medical marijuana card. To receive a card, you must have a prescription from a doctor and qualify for a listed condition such as anxiety or epilepsy.

What’s the difference between CBD oil and medical marijuana?

CBD oil and medical marijuana are both a type of cannabinoid. The main difference between CBD oil and medical marijuana is the psychoactive effect of Tetrahydrocannabinol or THC. CBD oil derived from hemp generally contains only a trace amount of THC (0.3%), but not enough to create a “high”.

Both cannabis products may be used medicinally but only the products that include THC will produce the feeling of being “high”.

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CBD oil and Medical Marijuana Insurance Coverage

These questions have become common for those seeking to use cannabis products like CBD oil for medical use:

  • Does Medicare cover CBD oil?
  • Does Medicare pay for medical marijuana?
  • Does insurance cover CBD oil?
  • Does insurance cover medical marijuana?

Although each question is somewhat different, the answer is the same for each. CBD oil and medical marijuana are both cannabinoid products that are not covered by any health insurance — private or public — including Medicare.

The primary difference between CBD oil and medical marijuana is the inclusion of THC, which creates the psychoactive effect.

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Does Medicare Cover Medical Marijuana or CBD Products? No – But There Are Some Options!

As of February 2022, 37 states have legalized comprehensive, publicly available medical marijuana/cannabis programs and 10 have approved use of “low THC, high cannabidiol (CBD)” products for medical reasons in limited situations.

With this widespread adoption of using marijuana for health conditions, including pain management, alleviating anxiety, and improving sleep, it’s become a viable alternative to pharmaceuticals, especially for people with chronic conditions, mental illness, or undergoing chemo.

It’s especially attractive to older Americans who are in constant pain due to arthritis or other conditions, who have trouble sleeping, or are battling mental health issues.

All that said, this leaves the question of how accessible medical marijuana is to Medicare beneficiaries. We’ll dive into the specifics in this piece, including whether or not Medicare provides coverage, the associated costs, and options available.

Does Medicare Cover Medical Marijuana?

As of July 2022, Medicare does not provide coverage for medical marijuana because it is still a federally controlled substance. In order for a medication to be covered by Medicare, it must have FDA approval. But because marijuana is not authorized on a federal level, Medicare will not cover it even if you buy a Part D plan.

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So far, the only FDA-approved marijuana-based drug is Epidiolex, which is a medication for children two years old or younger suffering from epilepsy.

Thus, even if your doctor believes marijuana is the best treatment choice for you and writes you a prescription, you will still be required to pay entirely out-of-pocket should you choose to move forward.

Will Medicare Advantage Cover Medical Marijuana?

Similar to Original Medicare, insurance carriers that sell Medicare Advantage plans need to abide by the federal guidelines, so they will not offer coverage for medical marijuana prescriptions. However, some Advantage plans may provide coverage for the use of cannabinoid-based medications such as Epidiolex.

What About Medigap?

Despite the wide array of benefits offered through Medigap plans, they too have to follow federal guidelines and will not provide coverage for medical marijuana.

So, What Are My Options?

Although Medicare does not cover marijuana, Part D may cover cannabis-based medications. Currently, there are four medications available that contain marijuana compounds and have FDA approval:

Marinol and Syndros

A synthetic version of the marijuana compound Dronabinol is contained in the brand-name medications Marinol and Syndros. If you pay out-of-pocket without any drug coverage, you could end up paying around $130 each month for Marinol and a whopping $1,300 for Syndros. Having a drug plan that covers these medications can be a massive benefit.

Cesamet

Cesamet is another medication that contains a synthetic compound similar to those in marijuana. The average out-of-pocket cost for Cesamet is more than $2,000 for a month’s supply.

Epidiolex

As mentioned above, Epidiolex has an ingredient derived directly from marijuana. Epidiolex has CBD in it, which can help reduce a plethora of symptoms. However, the average out-of-pocket price of Epidiolex is astronomical, costing more than $32,000 per year.

Does Medicare Cover CBD Oil?

Given the growing popularity of CBD or cannabidiol as a treatment for chronic pain, anxiety, and sleeplessness, it’s a great holistic solution for older adults. Moreover, it doesn’t have the psychotic effects of THC as CBD is typically sourced from industrial hemp plants as opposed to marijuana plants.

Yet, despite the availability of CBD products in health and wellness stores and its proven benefits for managing pain, anxiety, depression, insomnia, and many other unpleasant symptoms, Medicare will not provide coverage for it.

Unfortunately, just like marijuana, CBD is yet to be considered legal on a federal level. Until the FDA approves CBD oil, Medicare won’t help pay for it.

The upside here though is that CBD products are not nearly as expensive as medical marijuana. Depending on factors including strain, dosage, and dispensary you purchase from, the cost can range from $50–$1,500.

Do Your Research

While Medicare does not currently provide coverage for medical marijuana or CBD products, that’s not to say it never will, especially since more states are legalizing both recreational and medical marijuana use, and there’s a push to make it federally legal as well.

But for right now, my best advice is to listen to your doctor’s recommendations and do your research on benefits and costs associated with medical marijuana and CBD products to ensure you’re making a well-informed purchase.

Are medical marijuana and CBD legal in your state? Do you use such products? Why or why not? Do they help you with your particular health issues? What benefit have you noticed since you started using? How do you pay for this type of medication? Please share what you know in the comments below.

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