Insurance Issues in the Medical Marijuana Debate in Canada

Featured image of the SBIS tree logo set on a solid green background
Currently, almost 30,000 Canadians are authorized to grow and consume marijuana. While still quite controversial, marijuana is used to treat a variety of health conditions such as glaucoma, depression, anxiety, the after-effects of chemotherapy, and many other ailments.

On April 20, 2017, the Canadian Federal Government announced that recreational use of marijuana (also known as cannabis) will be legal in Canada by Canada Day 2018. For many Canadians, this settles a longstanding matter, and yet we have no idea yet how it will play out.

How will this affect those who take marijuana for medicinal purposes?

The coming legislation will most certainly affect the production and sale of marijuana. It’s no longer a matter of “if” it should be legal, but rather “when”. What happens to the current model of distribution for medical marijuana?

Health Claims of Medical Marijuana Proponents

Thankfully, we’re getting past the Cheech and Chong stoner counterculture that painted marijuana users as slacker hippies. Today, a more accurate picture shows that users of medical marijuana come from all walks of life.

It’s important to clarify that there are two types of marijuana. There is recreational marijuana, which is self-explanatory, and then there is medical marijuana. The latter requires proof of the need, in the way of a diagnosis, and must be approved by Health Canada. It also has a different dosage than your run of the mill recreational strains.

More and more people are speaking out to dispel the misconceptions about marijuana use, and urging others to do their research. The most common symptoms of a host of medical conditions that benefit from marijuana include:

  • Seizure disorders such as epilepsy
  • Cancer symptoms and the after-effects of chemotherapy
  • Digestive disorders such as IBS, ulcerative colitis and Crohn’s disease
  • Glaucoma
  • Chronic pain
  • Stress, depression and anxiety disorders
  • Post-Traumatic Stress Disorder

Researchers are developing new treatments using marijuana, now that the criminal fog is slowly being lifted. With the pending legislation, the research field is bustling; everyone wants a piece of the potential cash crop.

Well, maybe not everyone. As is the case with many new explorations in marijuana, there are still many critics standing by. The Jama Network posted on its website a meta-analysis of 79 different trials that evaluated the efficacy of marijuana in treating several different ailments, stating that the benefits could be overstated.

There will always be someone refuting the benefits of what they believe should be a controlled substance. It may take some time for cannabis to be proven as the best possible treatment for certain illnesses.

Current State of Legalized Marijuana for Medical Use in Canada

Do you know the difference between marijuana and marihuana? It goes beyond the letter “h”. The latter spelling indicates that the substance is considered medical cannabis, and not the regular recreational weed.

medical marijuana prescription with bottle and stethoscope.

Almost as soon as the government began communications that marijuana would be legalized, dispensaries started to pop up all over the place. Despite not having any authorization to do so, many of these dispensaries have turned up in the dozens around Toronto and Ottawa.

Indeed, there are raids and crackdowns occurring weekly, since these businesses are not yet legally allowed to sell cannabis. There are processes in place, applications that need to be filed in order to be licenced to sell.

Health Canada’s mission is to be responsible for helping Canadians maintain and improve their health. This extends to the regulation of marijuana. The process for approval to sell marijuana for medical use is very involved.

There are preliminary and enhanced screenings to ensure that producers are supplying safe, efficacious substances as appropriate under their provincial and municipal laws. (The municipal aspects include zoning, fire regulations and proper waste management.)

The process is involved but not for the sake of making it difficult to supply medical marijuana, but rather to ensure public safety. Under the Access to Cannabis for Medical Purposes Regulations (ACMPR) patients must go through a four-step process. To see the regulations, visit Justice Canada’s website.

The four-step process includes:

  • Seeing your medical doctor or authorized health care practitioner
  • Obtaining medical documentation authorizing the use of cannabinoids
  • Registering with a licenced producer
  • Taking delivery via courier or Canada Post

The process does not allow for the old fashioned handoff with a marijuana dealer off the street, obviously. The current process involves Health Canada telling you who to buy from. Another option is to go through a dispensary but as we touched on earlier, finding a legally authorized place may present a challenge.

Do Insurance Companies Offer Coverage for Medical Marijuana?

The short answer to this is not yet. While insurance companies are in the business of helping Canadians obtain the best treatments and medications for their illnesses, sometimes the legislation and regulations aren’t caught up.

There are some company group plans that offer medical marijuana coverage to their employees, so perhaps there is hope for broader coverage in the future.

There simply isn’t enough information on marijuana’s safety at this time. With the new legislation, the interest is definitely there to learn more, but clinical trials and data compilation take time. Once the data is there, insurance companies will be better placed to decide whether or not they can include coverage for medical marijuana.

The Absence of a DIN

A Drug Identification Number (DIN) is an eight-digit code that is assigned by Health Canada to a drug prior to marketing. This code is crucial for insurance companies, as information on the drug is usually attributed to this. The insurance company searches a DIN to find information on the type of drug it is and whether it is qualified for coverage.

Marijuana currently does not have a DIN. Until it does, it poses a problem in being covered by insurance companies. At this time, marijuana still falls under the purview of the Controlled Drugs and Substances Act.

If you need to use marijuana for medical reasons, don’t despair—the legislation is coming. In the meantime, it’s important that you get your voice heard. Talk to your insurance provider and give feedback on the exclusion of coverage for medical marijuana. If enough people speak up and make it known that this is a substance that they rely on, more industries will recognize it.

That’s not to say that you should petition to get your insurance to cover marijuana, but your opinions do matter and the health concerns of Canadians are important to insurance professionals.

What Will Legal Marijuana in Canada Mean for Medical Users?

The new legislation is aimed to legalize marijuana for recreational use. This will be a challenge both legally and in terms of logistics. How and where will it be sold? What qualifications will the buyer be required to have?

How does this affect those who take it for medicinal purposes? Will they still need to go through the processes that are in place right now, or will all marijuana be sold the same way?

In one scenario the implementation could be similar to prescription drugs, where there are “regular” and “prescription” doses for the same type of product. For example, codeine usually requires a prescription for higher doses, but in some provinces it can be sold over the counter at lower doses.

Until the legislation is ready, we won’t know exactly how it will be handled. Medical marijuana users will certainly be affected, as how they will be able to access their proper therapeutic dosages still needs to be determined.

male medicine doctor hand holding and offering to patient medical marijuana in jar.

It will also affect producers of marijuana. Their work will most certainly be affected, but only time will really tell just how big an impact the legislation will have on the industry. It’s an emerging topic that we’re keeping a close eye on.

Ideas in the Midst of Confusion

One of the advantages of working with an industry professional is being able to access their knowledge and expertise about the legislative processes around drug approvals, and how they relate to insurance coverage.

Call an insurance broker today and learn as much as you can to ensure your current and future health needs are covered. Who knows, maybe medical marijuana will one day become a regular component of covered services under insurance plans.

Contact us today for a no-obligation quote to help you decide on what’s right for you and your family.

6 Responses

  1. My wife has been taking Hybrid Cannabis Oil for pain after her MD cut her Hydro Morph Cont pain killer to the point that she has been left in chronic pain from a stomach surgery and migraine headaches. She also has arthritis and nerve pain from her Diabetes which the HMC helped alleviate. BUT, since she is on provincial government disability assistance, her only medical coverage is NS Pharmacare, which has stated they WILL NOT cover medical marijuana. Although in the recent past the cost of it was covered for many chronic pain patients by Pharmacare. Those who were covered will continue to be covered but there will be no coverage for new patients requests. Financially we are running up the credit card to cover the cost of $300-$400 monthly. It has helped relieve some of her pain at a low dose of 1/2 gram = 4ml of oil daily. Financially we can’t afford to increase the dose as the current cost is beyond what we can actually afford. So the high cost of Medical Marijuana is more than many can afford to pay for. My wife knows she will have to stop taking the Oil at some point because we can’t continue to pay for it. With the cutback to non cancer patients who have been taking Opiate pain killers for several yrs, many, like my wife, have been left in chronic pain. Her MD suggested that Cannaboids many be an alternative to replace the cut back of her pain meds. But he doesn’t want to get involved in prescribing Medical Marijuana.
    The question is, What coverage is there that will help patients such as my wife? Even with the Compassionate Pricing by the LPS, the Hybrid Oil is still expensive and causing a financial burden for us. Her MD has refused to increase her Hydro Morph Cont back to a dose that helped to relieve her chronic pain, even though she was on a dose well below that recommended by the NS Physicians and Surgeons.
    In such cases Pharmacare should cover the cost since we are not in a financial position to continue paying the cost of the Medical Cannabis Oil.
    It seems that this will only be available to those who can afford it. Patients like my wife will be left in pain due to the cut back in prescribing Opiate pain killers and the high cost of the Medical Marijuana that has helped at a low dose. But we can’t afford to increase her daily dosage.
    It doesn’t seem logical or fair that Health Canada and the Government have approved the use of Medical Marijuana yet neither will list it with a DIN number and have it covered by Pharmacare and other medical insurance companies.

    1. Hi Bryon. We only know that once the Medical Marijuana receives a DIN number it will be treated like any other prescribed drug, but until then at this point none of the plans we offer will pay for medical marijuana.

  2. I currently spend around $500 a month on cbd products that have helped me greatly improve the quality of life every day for me. I wear knee braces and suffer from PTSD, I use it strictly for medicinal purposes and can’t believe there is no government assistance to help specially since it’s medicinal. I hope when it becomes legal that the government or whatever out there will help people like me, which I do not work I am on disability. The cbd products I use, have enabled me to now take of my knee braces more as my knees don’t seem to be hurting as much, also my PTSD almost never shows, this has been great as it has helped me get off pain meds such as morphine also as most pain meds do not work for me. I have called around and emailed numerous places to see if they would help with costs and sadly not, I really hope this will change as I don’t want to have to go back to pain meds again but the costs is starting to take its toll.

    1. Once the marijuana becomes legal and has a drug identification number then insurance companies should include it in their plans.

  3. How many years is this going to take? Cannabis still doesn’t have a DIN number, and while apparently some insurance companies and plans cover this expense, most still do not — even though it is apparently contrary to the law. How are insurance companies continuing to break the law? How many years will this continue?

    1. Thank you for your comment Derek, as a broker we unfortunately do not have any say in when the insurance companies add Medical Marijuana to their formulary prescription lists. I do know that one of our plans through Manulife currently covers up to $500 in lifestyle prescriptions which would include medical marijuana. Hopefully in the future the proper DIN’s are created to allow all insurance companies the option to include it in their plans.


Your email address will not be published. Required fields are marked *

Related posts