Overview Medical Cannabis Insurance Coverage

Looking for clarity on insurance coverage for medical cannabis? Our Insurance Coverage Overview table below can bring you up to speed on how your group benefits could help alleviate the cost of your prescription.

Due to the nature and recentness of cannabis as medicine, coverage with insurance providers can be limited.

Most Health Care Spending Accounts (HCSAs) will cover medical cannabis, along with any other products needed for medicating ( e.g. vaporizers, pipes, replacement syringes). In addition to most HCSAs, some benefit providers also offer extended coverage for medical cannabis that your employer can opt-in to.

The minimum and maximum coverage for individuals and HCSAs are determined by your employer and the benefits package(s) chosen. Our recommendation is that you contact your HR Representative and discuss what kind of coverage your company offers. If you’re told there is no coverage, we strongly suggest having a conversation about changing that. The best course of action for this would be to contact your Union or Employee Representative.

Prior authorization on a case by case basis my be required.
May be covered by Health Care Spending Account (HCSA).

Information is currently limited. For now, it’s best to contact Alberta Blue Cross.

Included in supplementary health care coverage (some expenses that aren’t covered by public healthcare).

Expenses related to the treatment of illnesses and the relief of a number of symptoms. Namely, pain related to cancer, chemotherapy, refractory neuralgia, and multiple sclerosis or a lesion of the spinal cord.

Members and their dependents must be 21 years of age or older.

Desjardins will apply a pre-authorization process to any request for coverage related to these diseases and symptoms.

Case by case basis.

May be considered with non-smoker rates if there is no use of e-cigarettes, tobacco or nicotine in the last 12 months.

From their website:

“A smoker is considered someone who, in the past 12 months, has used more than 12 large cigars, or used any other tobacco, cigarette, e-cigarette, cigarillo, a pipe, chewing tobacco, nicotine patches or gum or betel nuts.”

Coverage is currently limited to chronic neuropathic pain, spasticity due to multiple sclerosis (MS), nausea, and vomiting due to cancer chemotherapy
From their website:

“A smoker is considered someone who, in the past 12 months, has used more than 12 large cigars, or used any other tobacco, cigarette, e-cigarette, cigarillo, a pipe, chewing tobacco, nicotine patches or gum or betel nuts.”

Coverage through HCSA.

Employers can choose to opt-in Manulife’s Medical Marijuana Program as part of the group insurance policy.

In this program, any requests for coverage will go through a prior authorization process, confirming the member has tried other appropriate treatment options, but hasn’t responded well to them.

Medical cannabis is currently eligible for coverage under a Health Care Spending Account (HCSA).

Requests for coverage are approved with a valid medical cannabis prescription.

Patients will receive ongoing case management services from our network of clinics, which includes: education, adherence management, side-effect management, counselling, and both phone and email support.

Patients must obtain their medical cannabis through BuyWell Care in order to be covered.

SSQ

Covered only when used to treat or relieve chronic neuropathic pain, cancer related pain, spasticity secondary to MS or spinal cord injury, nausea and vomiting caused by chemotherapy.
Effective January 1st, 2019.

Prior authorization from SSQ Insurance will be required.

Coverage through HCSA, regardless of the condition.

Optional medical cannabis coverage is now available to plan sponsors to opt-in where prescriptions will be reimbursed under its Extended Health Care (EHC) plan for cancer with severe or refractory pain, or with nausea or vomiting associated with treatments; MS with neuropathic pain or with spasticity; rheumatoid arthritis with pain that failed to respond to standard therapy; HIV/AIDS; anorexia; or with neuropathic pain; or palliative care.

Medical cannabis is eligible for coverage under a Health Care Spending Account (HCSA) for all members.

Updated: December 3, 2019

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