AARP Hearing Center
Kiersten Essenpreis
Key takeaways
- Medicare doesn’t cover marijuana but has CBD pilot program.
- Eligible CBD products must be OK’d. Most people ineligible.
- Older adults show high interest in CBD. Risks being studied.
- Pilot program faces legal challenge. Reclassifying pot is key.
- Medicare covers FDA-OK’d CBD, THC. Only 1 state forbids it.
Medicare’s budding relationship with medical marijuana and hemp-derived products took some small steps forward this month.
Although legal in more than 40 U.S. states, the District of Columbia, Guam, Puerto Rico and the U.S. Virgin Islands, Medicare doesn’t cover medical marijuana because federal law classifies cannabis as an illegal, Schedule I controlled substance.
In December 2025, President Trump issued an executive order directing the Justice Department to begin efforts to reclassify marijuana as a Schedule III substance, meaning it has lower potential for abuse and physical and psychological dependence, the federal Drug Enforcement Administration (DEA) says.
That change has not yet happened, but last week, acting U.S. Attorney General Todd Blanche jump-started the process with an order that moves state-licensed medical marijuana to Schedule III, a drug classification that is less stringently regulated and doctors can prescribe. However, marijuana sold for recreational purposes, even in states that legally allow it, will remain a Schedule I drug.
The Justice Department has scheduled a hearing June 29 to consider a general reclassification of marijuana to Schedule III.
Medicare tests use of CBD products
Also in April amid the regulatory flux, Medicare began allowing some enrollees, including cancer patients, access to doctor-recommended products containing cannabidiol — better known as CBD. This doesn’t include medical marijuana, neither buds for smoking nor any inhalable products like vaporizers.
A chemical found in both hemp and marijuana, CBD, is now a key ingredient in cosmetics, creams, foods, lotions, oils and other products. Cannabidiol is used for general wellness and to treat anxiety, chemotherapy side effects, nausea, pain, sleeplessness and other ailments.
The Food and Drug Administration (FDA) has approved CBD in a high-dose liquid, Epidiolex, to treat seizure disorders related to three rare, severe forms of epilepsy. Most patients who would be approved for the anticonvulsant are children and young adults, the Epilepsy Foundation says.
But most of CBD’s presumed therapeutic benefits haven’t been confirmed through solid clinical research, says Kent Vrana, founding director of the Center for Cannabis and Natural Product Pharmaceutics at Pennsylvania State University School of Medicine in Hershey, Pennsylvania. Possible interactions with prescription medications and the mislabeling of some CBD products, particularly their THC levels, have also raised concerns.
THC, or tetrahydrocannabinol, is the chemical compound that gives marijuana its high.
“Pure CBD is not inherently dangerous,” Vrana says. “The bad news is the stuff that is out there is unregulated. We don’t know what’s in it.”
Eligible CBD products will be restricted
CBD products eligible for Medicare’s trial program cannot exceed a 0.3 percent level of THC, the Centers for Medicare & Medicaid Services (CMS) says. The products must meet all federal, state and local standards and come from a “legally compliant source and high-quality farm.”
And they also must undergo third-party testing for potency, accuracy of cannabinoid levels and contamination. Vrana says those requirements are appropriate and necessary.
Products that exceed 3 mg per serving of orally administered THC - such as brownies, gummies and teas - are also excluded from the program, which is run by the Centers for Medicare & Medicaid Innovation at CMS. CBD products with cannabinoids that are not naturally produced are also excluded.
An estimated 8,000 to 12,000 Medicare enrollees could take part this year, says Charlotte’s Web, a CBD product manufacturer based in Louisville, Colorado, that could supply some physicians and clinics in the test. The company estimates nearly 20 percent of older people now use CBD for medical reasons.
“Pure CBD is not inherently dangerous. The bad news is the stuff that is out there is unregulated. We don’t know what’s in it.”
CMS says it can’t verify third-party estimates on beneficiary participation nor project how many will receive CBD products. That depends on how many provider organizations are approved to offer CBD and how many doctors and their patients decide to use the products, a CMS spokesman said.
The pilot program allows eligible Medicare beneficiaries who meet certain health requirements to access up to $500 a year in approved CBD products from their physicians at no charge.
Medicare won’t cover the cost. Provider organizations participating in the test pay for the products that physicians and clinicians provide directly to patients.
Next in Series
Medicare Coverage for Medical Equipment
Yes, but most of it has to be prescribed and durable