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Will Insurance Companies Offer Coverage for Medical Marijuana?

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Many Canadians are favouring the use of medical marijuana as a more ‘natural’ medication over ‘conventional’ opioids. They take it as an anti-inflammatory or anti-depressant, and use it as a medication for the treatment of pain, anxiety, post-traumatic stress disorder and sleep disturbances. Unfortunately, insurers are still hesitant to provide widespread coverage for those individuals prescribed medical pot.

The experience at Veterans Affairs Canada

Part of the hesitation insurers have comes from lax prescribing practices. Many doctors who regularly prescribe pot don’t do proper patient examinations or follow-ups, according to Veteran Affairs Canada’s chief medical officer. The benefit plan for Veteran Affairs Canada has allowed medical marihuana (the spelling used in medical circles) since 2009.

Costs are another cause for concern. Mirroring the experience of agencies that cover pot in other countries, Veterans Affairs Canada saw costs explode from $19,088 in fiscal year 2009 to $62.7 million in the year ending March 2017. After that time coverage was restricted to 3 grams a day at $8.50 per gram and reimbursements reduced to $51 million for the plan year ending in 2018.

Information is still lacking

Before an insurer provides a benefit they analyze the risk factors. Currently, insurers feel that they do not have enough information to include medical marijuana as a covered prescribed medication on individual health insurance plans. There are some group benefit insurers that provide very limited coverage under employer sponsored plans.

What insurers do know is that pot is often costlier than pharmaceuticals. For example, a 10-day supply of Baclofen, a muscle relaxant used to treat muscle spasms and feelings of stiffness, costs $28.82. Health Canada estimates the cost of medical marijuana at $8.00 per gram. When used as a substitute for Baclofen, a patient must take an estimated average dose of 0.68 grams to 1.5 grams of marijuana each day. The comparison cost for that 10-day supply? About $80.00, or four times more expensive.

Even the Canadian Medical Association has asked members to proceed cautiously with pot prescriptions.

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You can still depend on your health insurance

Today and tomorrow your private health insurance will provide coverage for the out-of-pocket cost for most prescription drugs not covered by your government health plan.  You can claim whenever you need to — just once for that prescription for your lingering cold or flu, or much more frequently if you are like many Canadians and suffer from a chronic condition that needs continuous treatment.

Remember, sudden healthcare expenses can put added pressure on an already-stretched financial budget, especially where families are involved. Your health insurance plan is designed to ensure that you and the rest of your family are covered for day-to-day health maintenance as well as medical emergencies.

What does the future hold?

Who knows, maybe medical marijuana will one day become a regular component of covered services under individual health insurance plans. One thing you can be certain of is that health insurance works to ensure your current and future health needs are covered. Contact us today for a no-obligation quote to help you decide on what’s right for you and your family.

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