A lot of questions come up when you consider using medical marijuana to relieve pain or treat a condition. One of the most important: will my health insurance plan cover medical weed?

Unfortunately, the answer to that query is no. Health insurance does not cover medical pot.

If you’re thinking of turning to weed, pot, bud, kush — whatever you want to call it — to combat muscle stiffness, nausea, lack of appetite and more, don’t expect your health plan to pay for it.

At the moment, no health insurance covers medical marijuana. Not the kind of health insurance you get from an employer. Not the kind of health coverage you get from the Obamacare marketplace. Not the kind you get from Medicare or Medicaid.

We answer a bunch of other questions related to health insurance and medical marijuana in this article, including:

Why doesn’t health insurance cover medical marijuana?

In 1996, Californians voted to legalize the use of “medical weed” in their state.

Since then, 28 other states, plus Washington D.C., have followed suit. As have the U.S. territories of Guam and Puerto Rico.

Given that, you might think at least some health insurance plans would cover medical cannabis. But that’s not the case.

The biggest reason for that: federal law. You can “blame” the Controlled Substances Act.

As of now, marijuana is a “Schedule 1” drug under the law. This class of drugs — heroin and ecstasy are two other examples — has “a high potential for abuse” and “no currently accepted medical use.”

That means, according to federal law, Americans who use pot to treat health issues can’t legally possess, sell, give away or grow it. Even if they’re living in one of the states or territories mentioned earlier.

It also means doctors, physicians and other healthcare providers can’t prescribe marijuana to patients. (Though they can recommend or authorize it thanks to the First Amendment.) And it means insurance companies and plans can’t — or won’t — cover it.

Federal law isn’t the only thing keeping insurers from covering medical weed. The FDA and the lack of clinical research play important roles, too.

All three of those “culprits” are intertwined.

You see, insurance companies rarely cover drugs the FDA hasn’t approved. And the FDA won’t approve marijuana until research proves it’s a safe and effective medical treatment. But that research can’t be done if growing, possessing and using weed is federally illegal.

Even if weed becomes federally legal and the FDA eventually approves the drug for medical use, that may not lead to health insurance coverage of it.

Unless all, or at least most, health insurers agree to cover medical cannabis, none of them may cover it. Or it may take them a long time to start covering it. It’s a big risk for insurers. And insurance companies don’t want to be known as the one that covers patients who use the substance.

Do any health plans cover CBD oil or synthetic marijuana?

Not everyone who uses pot for medical reasons smokes it. Some cook with it and then eat the resulting dish or food item. Some brew it into tea and drink it. Some vaporize it, spray it under their tongues, or apply it to their skin.

And some don’t use “real” marijuana at all. That is, the green bud that is commonly associated with marijuana. They use cannabidiol or CBD oil. Or they use one of the synthetic forms of marijuana that have popped up in recent years.

Cannabidiol is a compound extracted from the cannabis plant. It isn’t the compound that causes people to feel “high” after using weed, though. That compound is tetrahydrocannabinol, also known as THC. So, what does CBD do for folks who use it? First, it’s non-intoxicating, so users don’t experience the high associated with weed. Second, Leafly states that people use CBD to treat several issues:  

  • Pain and inflammation
  • PTSD and anxiety
  • Crohn’s disease
  • Multiple sclerosis
  • Opioid withdrawal
  • Epilepsy and seizure disorders

At the moment, only that last form of treatment has any scientific support. An FDA advisory panel just recommended approval of an epilepsy drug, Epidiolex, that contains CBD. If the FDA approves, it would become the first cannabis-derived prescription medication in the US, according to The New York Times.

As for synthetic weed, the FDA has approved three prescription drugs that contain synthetic forms of marijuana compounds or chemicals.

One example is Cesamet. Its active ingredient is nabilone, which the FDA says “has a chemical structure similar to THC.” Unlike THC, nabilone is synthetic. Physicians prescribe Cesamet to cancer patients who struggle with nausea and vomiting following chemotherapy treatments.

Marinol and Syndros are the two other FDA-approved synthetic forms of marijuana on the market. They’re used to treat nausea and vomiting, too, but they also can help improve the appetite of people who have AIDS.

That’s all well and good, of course. Except for one thing: many people who’ve used actual pot as well as these substitutes swear the synthetics aren’t as good as the real deal. For starters, it can take the “fake” drugs a long time to kick in; plus, they’re apparently linked to an increased risk of depression and anxiety.

Regardless, the FDA’s approval of these drugs means your health insurance plan should cover them, right? Actually, that is the case when it comes to Cesamet, Marinol and Syndros. And it’ll probably be the case if the agency approves Epidiolex.

Even then, don’t assume your health coverage will help you pay for these medications. It may or it may not. It’s not illegal for it to do so, however — which isn’t the case for medical marijuana.

You can assume that your health insurance policy won’t cover CBD or synthetic cannabis products beyond Cesamet, Marinol and Syndros. In other words, it won’t cover CBD oil you buy at a local dispensary. And it won’t cover the “K2” or “Spice” you purchase online.

The most likely reason for that lack of coverage is both types of products are unregulated. And in the case of CBD oil, there’s the added problem of some of it being illegal, too. CBD oil made from industrial hemp isn’t because it contains almost no THC. CBD oil made from marijuana, however, is because it can contain quite a bit of THC (and can make you feel high).

Will health insurance ever cover medical marijuana?

Health insurance policies may someday cover medical marijuana. And CBD oil, too. Right now, though, that day seems far off.

Why? The federal government doesn’t appear to be in a hurry to legalize pot for medical use. Or any use, for that matter.

You never know, though. This situation could change. Especially considering how many Americans use weed for help with various ailments, and how many of them support legalization. As more and more states legalize marijuana — for medical or recreational use — we could see a snowball effect.  

And a 2017 Yahoo News and Marist University survey found that more than 55 million Americans currently use weed. Thirty-five million are monthly users. And 83% of Americans support legalizing medical pot.

Still, changing the law won’t immediately change how health insurance plans treat the drug. It is the first step, though. Beyond legalization, insurers will require more clinical trials to establish marijuana’s medical uses. Then, the FDA has to approve it for medical use.

Even after all of that comes to pass, insurance companies will have to decide to cover it. And that’s far from a sure bet.

Most marijuana-friendly states

America is getting more and more marijuana-friendly every year. As of April 2021, 17 states have fully legalized marijuana, 27 states have decriminalized it and 36 states have laws allowing the use of medical marijuana. Legalization looks like the future, so our team of analysts took a look at which states are leading the charge.

Key findings:

  • Marijuana sales in fully legalized states passed $10 billion in 2020.
  • The number of marijuana-related jobs increased by more than 20% in 2020.
  • Colorado, Alaska and Nevada are the most marijuana-friendly states.

To find the most marijuana-friendly state in the nation, we ranked states based on current laws, job growth, taxes and sales per capita. With strong laws, nearly 5,000 new marijuana-related jobs and nearly $1.6 billion in sales, we found that Colorado is the most 420 friendly state in the nation.

Most Marijuana Friendly States
State Legal and decriminalized Job growth rank Sales per capita rank Tax revenue per capita rank
1. Colorado Yes 10 1 1
2. Alaska Yes 7 4 5
3. Nevada Yes 8 5 4
4. Washington Yes 11 3 2
5. Oregon Yes 9 2 7
6. Montana Yes 2 8 6
7. Michigan Yes 3 7 8
8. California Yes 5 10 9
9. Massachusetts Yes 1 12 12
10. Arizona Yes 6 9 10
11. Vermont Yes 14 11 3
12. Illinois Yes 4 14 13
13. Maine Yes 13 6 14
14. New Jersey Yes N/A Just approved in 2021
15. New York Yes N/A Just approved in 2021
16. New Mexico Yes N/A Just approved in 2021
17. Virginia Yes N/A Just approved in 2021

Methodology: We used several different data sources to create this report. For jobs, we compared Leafly job reports for 2019 and 2020. Sales, tax and per capita information was sourced from the Tax Foundation, Cannabis industry.org, United States Census Bureau and the Motley Fool.

To determine the most marijuana-friendly state, we ranked each state from one to 14 in the categories of job growth, sales per capita and tax revenue per capita. We then added up the rankings and divided them by the number of categories to produce an aggregate number. States were ranked from lowest to highest aggregate number.

Job growth in the marijuana industry

Marijuana is literally and figuratively a growing industry. According to Leafly, the United States now supports 321,000 full-time jobs. To put that in perspective, there are only 201,000 dentists in the U.S.

Job growth in the marijuana industry, however, isn’t spread evenly across the legalized states. We found that while states like Washington and Oregon added thousands of jobs, others like California and Michigan saw significant unemployment in the last year.

Marijuana industry job growth
State 2019 jobs 2020 jobs Job growth
Massachusetts 3,029 13,255 337.6%
Montana 871 1,800 106.7%
Michigan 8,862 18,078 104.0%
Illinois 8,489 16,837 98.3%
California 34,263 57,970 69.2%
Arizona 15,080 20,728 37.5%
Alaska 2,810 3,559 26.7%
Nevada 11,766 14,305 21.6%
Oregon 17,294 19,981 15.5%
Colorado 31,201 35,532 13.9%
Washington 19,349 19,873 2.7%
New Jersey 2,350 2,356 0.3%
Maine 400 400 0.0%
Vermont 335 266 -20.6%

Marijuana sales and taxes

States track and report marijuana sales differently, but overall the numbers are clear: 2020 was a very good year for the marijuana industry nationwide. Looking at the fully legalized states alone, we found over $10 billion in total sales and $3 billion in tax revenue.

Marijuana sales and taxes in 2020
State Total sales Sales per capita rank Tax revenue Tax revenue per capita rank
Alaska $163,000,000 4 $24,213,296 5
Arizona $587,000,000 9 $183,169,705 10
California $2,470,000,000 10 $1,031,879,926 9
Colorado $1,630,000,000 1 $387,480,110 1
Illinois $137,000,000 14 $52,783,471 13
Maine $221,800,000 6 $3,709,440 14
Massachusetts $156,000,000 12 $81,734,083 12
Michigan $984,600,000 7 $288,183,493 8
Montana $95,000,000 8 $35,142,502 6
Nevada $608,000,000 5 $105,180,947 4
New Jersey $121,000,000 13 $158,974,353 11
Oregon $1,110,520,723 2 $133,150,349 7
Vermont $17,000,000 11 $27,313,974 3
Washington $1,735,000,000 3 $469,200,000 2

Medical marijuana and the future

Colorado may be the most marijuana-friendly state but the U.S. is increasingly becoming more 420 friendly. New York, New Mexico, New Jersey and Virginia legalized marijuana already this year and Connecticut, Rhode Island and Delaware seem poised to do the same. Medical marijuana sales are also booming. And all together, more than $17.5 billion worth of marijuana was sold in 2020. With several states still banning marijuana entirely, it’s unclear if cannabis will ever be fully legalized, however, the future looks increasingly green.

Can medical marijuana make health insurance more affordable?

QuoteWizard’s team of data analysts found that people in states where marijuana is illegal shop for health insurance at twice the rate of people in legalized states. Moreover, research shows that some health insurance costs are lower in states with legal cannabis. Why is that? While it’s hard to draw firm conclusions from the data, there are a few possibilities:

  • People who have legal access to weed are less reliant on regular health care.
  • Using legal pot is a viable alternative to some types of prescription medication.
  • People in states with legal cannabis are more open to alternative forms of medication which often aren’t covered by insurance.

A study by Health Affairs, a “leading journal of health policy thought and research,” recently looked at medical marijuana and Medicare. The study found that Medicare users in states with medical marijuana rely considerably less on certain prescription drugs. Specifically, prescription drugs “of which marijuana could serve as a clinical alternative.” With patients choosing marijuana instead of prescription medications, the study estimates that Medicare saved $165.2 million thanks to medical marijuana.

Health Affairs published another study focusing on Medicaid with similar findings. Medicaid prescription drug use dropped in states with medical marijuana. The study concludes that “if all states had had a medical marijuana law in 2014, we estimated that total savings for fee-for-service Medicaid could have been $1.01 billion.”

It’s too early to make any firm conclusions, but early signs are promising. If this trend continues, medical marijuana will have a major impact on the healthcare industry, and help make health insurance cheaper. Twenty-three states and the District of Columbia have legalized marijuana. Here is a list of the states where marijuana is fully legal and the states that have mixed laws.

Mixed laws signify that the state approved medicinal use of marijuana, decriminalized medicinal marijuana use or both. Medicinal usage means that personal usage is dedicated to treatment for medical purposes. Decriminalized laws mean no arrest, prison or criminal records for first-time possession of small amounts of marijuana for personal use. Twenty-seven states mix laws between allowing medicinal or decriminalized usage of cannabis products.

Marijuana legality status by state
State Legal Status Medicinal Decriminalized
Alabama Fully Illegal No No

Alaska

Fully Legal

Yes

Yes

Arizona

Fully Legal

Yes

Yes

Arkansas

Mixed

Yes

No

California

Fully Legal

Yes

Yes

Colorado

Fully Legal

Yes

Yes

Connecticut

Mixed

Yes

Yes

Delaware

Mixed

Yes

Yes

District of Columbia

Fully Legal

Yes

Yes

Florida

Mixed

Yes

No

Georgia

Mixed

CBD Only

No

Hawaii

Mixed

Yes

Yes

Idaho*

Fully Illegal

No

No

Illinois

Fully Legal

Yes

Yes

Indiana

Mixed

CBD Only

No

Iowa

Mixed

CBD Only

No

Kansas

Fully Illegal

No

No

Kentucky

Mixed

CBD Only

No

Louisiana

Mixed

Yes

No

Maine

Fully Legal

Yes

Yes

Maryland

Mixed

Yes

Yes

Massachusetts

Fully Legal

Yes

Yes

Michigan

Fully Legal

Yes

Yes

Minnesota

Mixed

Yes

Yes

Mississippi

Mixed

Yes

Yes

Missouri

Mixed

Yes

Yes

Montana

Fully Legal*

Yes

Yes*

Nebraska

Fully Illegal

No

Yes

Nevada

Fully Legal

Yes

Yes

New Hampshire

Mixed

Yes

Yes

New Jersey

Fully Legal*

Yes

Yes*

New Mexico

Mixed

Yes

Yes

New York

Mixed

Yes

Yes

North Carolina

Fully Illegal

No

Yes

North Dakota

Mixed

Yes

Yes

Ohio

Mixed

Yes

Yes

Oklahoma

Mixed

Yes

No

Oregon

Fully Legal

Yes

Yes

Pennsylvania

Mixed

Yes

No

Rhode Island

Mixed

Yes

Yes

South Carolina

Fully Illegal

No

No

South Dakota

Fully Legal*

Yes*

Yes*

Tennessee

Fully Illegal

No

No

Texas

Mixed

CBD Only

No

Utah

Mixed

Yes

No

Vermont

Fully Legal

Yes

Yes

Virginia

Mixed

CBD Only

Yes

Washington

Fully Legal

Yes

Yes

West Virginia

Mixed

Yes

No

Wisconsin

Mixed

CBD Only

No

Wyoming

Fully Illegal

No

No

Marijuana legality status was sourced from DISA.  *States with a “*” are pending enactment.

Are there special health insurance plans that cover medical marijuana?

At the moment, there are no special health insurance plans that cover medical marijuana.

Federal law that makes it illegal to use cannabis in any way. There is no FDA approval for medical marijuana. And there is a lack of clinical research and trials that prove marijuana is safe and effective to treat various medical problems.

It’s easier to find a company that will insure your medical weed business than it is to find an insurer that will help you buy the drug for personal medical use.

Are you looking for health insurance coverage? Before you spend too much time shopping around, figure out which type of health insurance plan is right for you.

Other frequently asked questions

Can you use flexible spending accounts or health savings accounts to pay for medical marijuana?

Both flexible spending accounts (FSAs) and health savings accounts (HSAs) allow people to pay for medical treatments, services and products their health insurance plans won’t cover. Given that, you might think you could use them to buy medical marijuana. Unfortunately, you can’t.

Why? Pot is federally illegal even if you use it to treat a medical problem. And you can’t use either of these spending and savings accounts to purchase illegal substances.

Something you may be able to use your FSA or HSA funds for: Cesamet, Marinol or Syndros prescriptions. Granted, physicians only prescribe these medications to people in rare situations (and often after they’ve exhausted their treatment options), but at least it’s a possibility.

You also may be able to use your FSAs or HSAs to pay for doctor visits that relate to your medical marijuana recommendation or use. This isn’t always the case, though, so check with your HSA or FSA provider beforehand. After all, you’ll pay if you misuse this money. Even if it’s an accident. Not only will you pay taxes on that amount, but you’ll also pay a sizable penalty.

What can you do if you need medical marijuana and can’t afford it?

Here are a few options for people who need medical marijuana but can’t afford it:

  • Some states reduce their medical cannabis registration or “patient card” fee for people on government assistance. If you’re in that situation, contact your state’s program and see if you’re eligible for such a discount.
  • Make sure you register with your state’s medical marijuana program or get a patient card if you’re at all able to do so. This is a must if you want to buy marijuana from a medical dispensary. And you want to buy from a medical rather than a recreational dispensary, because the product sold by medical dispensaries tends to be cheaper.
  • In some states with recreational cannabis, medical patients qualify for a tax exemption. In other words, if you have medical authorization to use cannabis, you may not need to pay state taxes at a recreational cannabis store.
  • Just like shopping around is helpful when you’re looking for health insurance, it’s also helpful when you’re looking for medical pot. In other words, check out all the dispensaries in your area. Compare what they charge for what you need before making a purchase.

How much does medical marijuana, synthetic marijuana or CBD oil cost?

As you might imagine, pinpointing what you’ll pay for any of these products is not easy. Several factors determine the cost of cannabis and related products.

According to marijuanadoctors.com, how much you spend on medical marijuana depends on:

  • Where you buy it.
  • How much competition there is in your area.
  • How much you purchase.
  • What kind of weed you purchase (the higher the quality, the higher the price).
  • When you buy it (you may pay less if you buy it right after it’s harvested in the fall).

In general, you should expect to pay around $40 for an eighth of an ounce of marijuana, according to forbes.com. That’s just an average, though. You may well spend more than that in a city like San Francisco, while you’ll spend less in, say, Portland or Denver.

Also, that figure represents the average cost of recreational pot. In many areas, medical marijuana costs less than recreational. So, it might be worth your while to get a recommendation from a doctor so you can buy medical rather than recreational cannabis.

Figuring out what you’ll pay for synthetic weed or CBD oil is just as difficult.

A leafly.com article from 2017 suggests you can spend from as little as five cents to as much as 60 cents per milligram for CBD oil. That adds up to anywhere between $30 and more than 150 per bottle. (Depending on how much oil the bottle in question contains, of course.)

Again, though, a number of factors determine how much CBD oil costs in your area, including where you buy it and what kind you buy.

Synthetic marijuana (the gas station stuff, not the doctor prescribed kind) costs a lot less than medical pot or CBD oil. Before you go down that road, read up on the many problems associated with “fake weed.”

Why do people use medical marijuana? What health issues and conditions can medical marijuana help with or treat?

Some 55 million Americans use the substance either recreationally or to relieve health issues.

Those people do so to treat a lot of different issues or conditions. A few examples:

  • AIDS
  • Amyotrophic lateral sclerosis (also ALS or Lou Gehrig's disease)
  • Anorexia
  • Cancer
  • Crohn’s disease
  • Epilepsy
  • Multiple sclerosis

Many people use it in other, more general ways, too. Some use it to relieve pain if traditional pain relievers don’t work or come with harmful side effects. Some use it to relieve nausea or loss of appetite. Some use it to calm anxiety.

If you think you could benefit from medical marijuana, talk with your doctor or physician before you start using it. Weed interacts with many medicines, and some of those interactions can be dangerous.

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