Medicare does not cover CBD oil, but as research continues, that could eventually change. 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 Medicare still does not provide coverage for medical marijuana. So, what are your options, if there are any?
Why Medicare Still Doesn’t Cover CBD Oil, And How That May Change
Cannabidiol (CBD) is now decidedly mainstream. In fact, CBD-based products have flooded the shelves of many pharmacies and grocery stores in various states. But what about CBD and Medicare? Medicare doesn’t cover CBD, despite its growing popularity.
Who Uses CBD Oil, and What Can it Treat?
A 2019 Gallup poll found that 14% of Americans report using CBD products such as chocolates, oils, fragrances, bath products, capsules, and lotions.
Despite limited research on the benefits of CBD, CBD proponents and manufacturers claim it can treat everything from cancer to anxiety. 40% of CBD users say they seek relief from pain. Other popular uses include anxiety (20%), insomnia (11%) and arthritis (8%). These conditions are notoriously difficult to treat. Traditional prescription drugs may cause unpleasant side effects, and do not offer relief to all sufferers. So the promise of a natural substance offering relief for these symptoms is very appealing.
CBD does have one clear, proven benefit. It can treat seizures associated with two types of epilepsy—Dravet syndrome and Lennox-Gastaut syndrome. In 2018, the U.S. Food and Drug Administration (FDA) approved a CBD-based drug, Epidiolex, for the treatment of these severe, rare forms of epilepsy.
Why Doesn’t Medicare Cover CBD?
Original Medicare (Parts A and B) only covers treatment received in a medical facility such as a hospital or doctor’s office. Part B covers a very limited number of prescription drugs, and CBD medications are not on that list.
Medicare beneficiaries have the option to purchase a Part D prescription drug plan in order to expand their drug coverage. They may also opt for private insurance through a Medicare Advantage (Medicare part C) plan, many of which cover prescription drugs.
However, even with a prescription drug plan, you cannot get coverage for CBD oil and other over-the-counter products. There are at least two reasons for this:
- There are no drug products containing CBD, other than Epidiolex, that are approved by the FDA.
- According to the Centers for Medicare & Medicaid Services, Part D plans only cover drugs that have been approved by the FDA.
If you have a prescription for Epidiolex and your Medicare Part D or Medicare Advantage plan covers the drug, then you can use Medicare to access this one medication containing CBD. However, a recommendation from a doctor that you try over-the-counter CBD oil is not sufficient for using Medicare to pay for any other product containing CBD.
Will Medicare Cover CBD Oil in the Future?
With so many potential uses of CBD, research is ongoing. If scientifically-rigorous evidence finds support for other CBD uses, manufacturers could develop CBD-based drugs for many conditions.
If these future drugs receive FDA approval, they could also become medically-recognized prescriptions. That would open the door to Medicare coverage. No such drug approvals are on the immediate horizon, althoughsearch leaves open the possibility that Medicare may eventually cover other prescription forms of CBD.
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.
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.
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.
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 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.
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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