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Will insurers ever cover medical marijuana?


Can you imagine a time when you go to the doctor and he or she asks, "Would you like some weed to help ease your symptoms?"

That scenario isn't widespread, but it's possible that it will be a common conversation happening in doctors' offices in the near future--especially if insurers start covering medical marijuana.

There's already medical evidence showing that marijuana can help patients with glaucoma, cancer and about 35 other medical conditions. And both Washington and Colorado have now completely legalized the drug, while 21 states allow consumers to use marijuana for medical purposes.

Because of these states' actions, marijuana is becoming more accepted by mainstream society. But even if insurers are interested in pursuing coverage options for marijuana, they have to overcome some barriers, including:

  • Marijuana is still illegal on the federal level, despite states' legalization of the drug. Insurers will need to decipher all the laws surrounding marijuana, both for medicinal and recreational purposes.
  • Marijuana isn't approved by the Food and Drug Administration, and insurers rarely pay for medications that aren't FDA-approved. To be approved, however, the FDA must conduct extensive clinical studies on the drug's safety and efficacy.
  • There are already FDA-approved meds that are made with the marijuana plant on the market. For example, appetite stimulant Marino, which is often used for patients with AIDS, contains an active ingredient of marijuana.
  • Marijuana is categorized as a Schedule 1 controlled substance because it has a high risk for abuse.

But that's not all. Marijuana is expensive and its price isn't currently regulated, forcing some people to spend more than $100 per day on the drug. On the other hand, it would be replacing meds that are also pricey, and marijuana generally only needs small doses to be effective.

Despite these obstacles, the American Medical Association is becoming more receptive to the idea that marijuana could help patients with certain diseases. In fact, the doctor group asked to change marijuana's Schedule 1 classification so the drug can be studied to better determine whether it's safe and effective. And many physicians agree marijuana has clinical benefits, but need more information and training on the medical science of cannabis.

Other supports of covering the drug even believe that medical marijuana could prove a remedy to the country's ever-rising healthcare costs.

So will insurers be next to recognize the drug's health benefits and start covering it, at least for limited uses? There will surely need to be several steps in place before that happens, particularly since insurers aren't interested in coverage of any kind of medical service or drug without sufficient evidence of its efficacy.

But I would be willing to bet that if more states legalize marijuana and the drug becomes even more commonplace, we could very likely be receiving prescriptions and even filling them at our local pharmacies. - Dina (@HealthPayer)

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