Does Medicare Cover Medical Marijuana?

Even though medical marijuana is 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 it because federal law classifies marijuana as an illegal, Schedule 1 controlled substance.

Medicare does make a slight exception. Some Part D prescription plans may cover some federal Food and Drug Administration (FDA)–approved drugs derived from cannabis when a doctor prescribes them for certain medical uses.

But marijuana’s Schedule I designation — alongside ecstasy, heroin and LSD — has slowed the medical community’s embrace because it’s viewed as a drug with “no currently accepted medical use and a high potential for abuse,” according to the U.S. Drug Enforcement Administration (DEA).

The president’s executive order issued Dec. 18 is expected to change the federal government’s overall legal classification of marijuana and pave the way for increased research and expanded medical use of cannabis in Medicare.

The order directs the Justice Department to begin efforts to move marijuana from its Schedule I designation to Schedule III, a drug tier for substances with lower potential for abuse and physical and psychological dependence, the DEA says. Doctors are able to prescribe Schedule III drugs.

The Justice Department had begun this same process in 2024 after an August 2023 Department of Health and Human Services recommendation that the federal government fully recognize marijuana’s accepted medical use. But federal rulemaking and legal challenges prevented the move from becoming final before the change in administrations.

Executive order opens Medicare to medical cannabis

The White House initiative also will include a pilot program in which Medicare, for the first time, will cover beneficiaries’ purchase of physician-recommended medical products containing cannabidiol, better known as CBD. This chemical found in marijuana can be used to treat pain, side effects of cancer treatments and other ailments.

The Center for Medicare and Medicaid Innovation within the Centers for Medicare & Medicaid Services (CMS) will run the trial project.

Pilot program participants could receive up to $500 a year in Medicare coverage of products that use compounds derived from hemp “at no charge if their doctors recommend” the items, Dr. Mehmet Oz, CMS administrator, said during a White House ceremony announcing the executive order.

Although CMS has not provided details about the model program, the concepts typically are tested for five to 10 years.

April 2026 targeted for access to CBD products

The pilot demonstration will “allow millions of Americans on Medicare to become eligible to receive CBD as early as April of next year,” Oz said. Eligible products must meet state and local quality and safety standards and come from legitimate sources.

CMS will collect data on patients in the program who receive the products. If the results are promising, the pilot program could be expanded among Medicare and Medicaid beneficiaries, he said.

“If you can hear my voice and you’re over 65, you should pay attention to this executive order because it’s going to touch your life,” Oz said. As part of the CMS effort, Medicare Advantage insurers are “agreeing to consider CBD” for use among their 34 million enrollees.

About 30,000 licensed health professionals are already authorized to recommend medical marijuana for more than 6 million patients who have at least 15 medical conditions, the White House fact sheet says.

“Rescheduling marijuana corrects the federal government’s long delay in recognizing the medical use of marijuana and will vastly improve research on safety and efficacy,” the White House says.

An FDA review found credible scientific support for use of marijuana to treat “anorexia related to a medical condition, nausea and vomiting, and pain,” the fact sheet says. One in 10 older adults have used marijuana in the past year, the agency found, and “evidence shows improvements in … health-related quality of life and pain with medical marijuana use.”

Older adults’ cannabis use may be higher, according to a University of Michigan National Poll on Healthy Aging, partly sponsored by AARP. The question, asked in February and March 2024, found that more than 1 in 5 of adults 50 and older had used cannabis in beverages, edibles, flowers or vapes in the past year — often to relax or help with sleep more than pain relief.

One caution: A study published in 2024 in the Journal of the American Heart Association found a higher risk of heart attack or stroke among users of cannabis products.