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Does Medicare cover medical marijuana?

Even though medical marijuana is legal in more than three-quarters of states in the U.S., Medicare doesn’t cover medical marijuana because federal law classifies marijuana as an illegal Schedule 1 controlled substance.

But Medicare does make a slight exception. Part D prescription plans can cover some cannabis-derived drugs that the FDA has approved when a doctor prescribes them for certain medical uses.

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Does my state allow medical marijuana?

Even though the federal government classifies marijuana as an illegal substance, 38 states, the District of Columbia and the territories of Guam, Puerto Rico and the U.S. Virgin Islands allow the medical use of cannabis products, according to the National Conference of State Legislatures (NCSL).

Only Idaho, Kansas and Nebraska have no public access program, although Kansas enacted a law in 2019 that allows patients with a debilitating medical condition who encounter law enforcement to have as a defense a written recommendation from their doctor for qualifying CBD products. Nine states — Georgia, Indiana, Iowa, North Carolina, South Carolina, Tennessee, Texas, Wisconsin and Wyoming — don’t have medical cannabis laws but do allow certain CBD and low THC products, according to NCSL and the National Organization for the Reform of Marijuana Laws, better known as NORML.

Medicare doesn’t cover any of those uses even though they might be legal in your state.

What cannabis-derived drugs does Medicare cover?

Medicare Part D plans can cover two FDA-approved cannabis-derived drugs, cannabidiol and dronabinol.

Cannabidiol (CBD) is a chemical component of the cannabis plant. The FDA has approved the medication, brand name Epidiolex, to treat seizure disorders associated with three rare and severe forms of epilepsy — Dravet syndrome, Lennox-Gastaut syndrome and tuberous sclerosis. The majority of epilepsy patients for whom Epidiolex would be approved are children and young adults, according to the Epilepsy Foundation.

Epidiolex is an anticonvulsant, which is 1 of 6 protected classes of drugs that Part D plans must cover. Plans usually require prior authorization and information from your doctor about your condition and treatment plan before they’ll cover Epidiolex.

People with certain kinds of seizures may also be required to first try one or two types of antiepileptic drugs. Epidiolex is generally included in Part D Tier 5 plans, which include specialty drugs, and it can have high cost sharing, the Epilepsy Foundation says.


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Dronabinol, a synthetic form of the compound THC that gives pot its high, is FDA approved to help treat nausea and vomiting associated with cancer chemotherapy and for treatment of anorexia associated with weight loss in AIDS patients.

Most Part D plans cover the generic dronabinol, often a soft round gelatin capsule, but they usually don’t cover brand name Marinol unless a patient is unable to take dronabinol. Part D plans also require prior authorization, approve dronabinol coverage for only a limited time and may require you to try other medications first.

You can find out how Part D and Medicare Advantage plans in your area cover these drugs by using the Medicare Plan Finder. Contact the plan to find out more about prior authorization requirements.

Keep in mind

Approved uses for medical marijuana vary by state. If you meet certain requirements, it may be approved for conditions such as Alzheimer’s disease; amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease; cancer; chronic pain; Crohn’s disease; depression; epilepsy; glaucoma; HIV/AIDs; and multiple sclerosis.

As of Nov. 8, 2023, 24 states, the District of Columbia, U.S. Virgin Islands and Guam have passed laws that allow some marijuana possession for adult nonmedical uses, according to the NCSL and NORML.

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