Does Insurance Cover Medical Marijuana Evaluation?
Emmanuel Foret
Writer, Editor, Social Media Manager
February, 3 2025
Photo credit: iStock
Key Takeaways:
- Insurance Does Not Cover Medical Marijuana Evaluations – Due to federal restrictions, most insurance companies do not cover the cost of medical marijuana doctor visits or prescriptions, leaving patients to pay out-of-pocket.
- There Are Ways to Save on Costs – While insurance won’t cover evaluations, patients can reduce expenses through discounts, telemedicine options, and state-specific financial assistance programs.
As medical marijuana gains traction as a viable treatment option for various medical conditions, many patients wonder: Does insurance cover medical marijuana evaluation? The short answer is no, but the reasoning behind it is complex. While medical marijuana is legal in Florida and numerous other states, insurance providers—including private insurers, Medicaid, and Medicare—do not cover medical marijuana evaluations or the cost of medical cannabis itself. However, the landscape of medical marijuana policy is constantly evolving, and there is potential for future changes.
Why Doesn’t Insurance Cover Medical Marijuana Evaluations?
One of the main reasons insurance does not cover medical marijuana evaluations is that cannabis remains classified as a Schedule I drug under the U.S. Drug Enforcement Administration (DEA). According to the DEA, Schedule I substances have “no currently accepted medical use and a high potential for abuse.” Because of this classification, insurance companies are legally prohibited from covering cannabis-related expenses, including doctor evaluations required to obtain a medical marijuana card.
Additionally, insurance companies typically only cover FDA-approved treatments, and as of now, the Food and Drug Administration (FDA) has not approved whole-plant cannabis for medical use. While certain cannabis-derived medications, such as Epidiolex, Marinol, and Cesamet, have received FDA approval, medical marijuana itself remains unapproved, preventing insurers from covering related costs.
Will Health Insurance Ever Cover Medical Marijuana Evaluations?
Although medical marijuana remains ineligible for insurance coverage today, there is hope for change in the future. Recently, there has been significant momentum toward rescheduling cannabis from Schedule I to Schedule III, which would acknowledge its medical benefits and allow more extensive research and regulation.
If cannabis is moved to Schedule III, it could open the door for the FDA to approve more cannabis-based treatments. As more cannabis-derived medications receive FDA approval, insurance companies may begin covering medical marijuana in some form—including the cost of evaluations required to obtain medical marijuana recommendations.
Additionally, some states are pushing for expanded coverage. For example, New York lawmakers recently passed a bill requiring certain insurance providers to cover medical cannabis, which may encourage similar efforts in other states, including Florida.
Medicaid and Medicare: Do They Cover Medical Marijuana Evaluations?
Because Medicaid and Medicare are federally funded, they adhere to federal guidelines that currently classify cannabis as an illegal drug. This means neither Medicaid nor Medicare covers medical marijuana evaluations, nor do they cover the cost of purchasing medical cannabis.
However, some FDA-approved cannabis-derived medications may be covered under Medicare Part D or Medicaid prescription drug programs. For example:
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Epidiolex, a cannabidiol (CBD) oral solution approved for treating severe epilepsy, is covered by some Medicare and Medicaid plans.
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Marinol (Dronabinol) and Cesamet (Nabilone), synthetic THC medications used for chemotherapy-induced nausea and appetite loss, are also covered in certain cases.
While these medications are not the same as medical marijuana, their FDA approval makes them eligible for insurance coverage.
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Private Health Insurance and Medical Marijuana Evaluations
Private health insurance companies follow similar restrictions as federal programs, meaning most private insurance plans do not cover medical marijuana evaluations or cannabis purchases. The main barriers include:
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Federal illegality: Until cannabis is reclassified, insurers are unlikely to cover any related costs.
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Lack of FDA approval: Since most medical marijuana products are not FDA-approved, they are not included in insurance drug formularies.
However, some flexible spending accounts (FSA) and health savings accounts (HSA) may reimburse the cost of a medical marijuana evaluation if deemed a qualified medical expense. Patients should check with their insurance providers to determine if they can use FSA or HSA funds for their medical marijuana doctor visit.
Are There Alternative Ways to Reduce Costs?
Since insurance does not cover medical marijuana evaluations, patients must pay out-of-pocket for their doctor visits and medical marijuana cards. However, there are ways to save money, such as:
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Seeking clinics with risk-free assessments: Some medical marijuana doctors offer refunds if a patient does not qualify for a medical card.
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Using discount programs: Some dispensaries and clinics provide discounts for veterans, seniors, and low-income patients.
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Checking for payment plans: Some medical marijuana doctors allow patients to pay for evaluations in installments.
“Most insurance companies won’t cover medical marijuana evaluations, leaving patients to pay out-of-pocket.”
Final Thoughts: The Future of Insurance Coverage for Medical Marijuana Evaluations
At present, insurance does not cover medical marijuana evaluations, but ongoing legal and policy changes may shift this stance in the coming years. With the DEA considering cannabis reclassification and more states advocating for insurance coverage, there is a possibility that medical marijuana evaluations could become an eligible medical expense in the future.
Until then, patients seeking medical marijuana in Florida must budget for their evaluations and treatment costs independently. If you are considering medical cannabis, consult with a qualified medical marijuana doctor to explore your options and ensure you receive the best possible care.
Need a Medical Marijuana Evaluation in Florida?
If you’re ready to see if medical marijuana is right for you, schedule an appointment with a certified Florida medical marijuana doctor today. Many clinics offer risk-free consultations, ensuring that you only pay if you qualify for treatment.
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