Patients seeking CBD products need to make sure they’re purchasing them from a reputable company. It is critical that you do your research and examine the authenticity of the brand.
There are two primary obstacles preventing health insurance companies from offering to cover CBD oil or similar treatment options such as medicinal marijuana.
The first obstacle is the U.S. Food and Drug Administration (FDA). When a new drug is released on the market, it must first be approved by the FDA before doctors can legally prescribe it to their patients.
CBD Oil and Health Insurance: What the Future May Hold
The FDA focuses its attention on pharmaceutical products and has little interest in products that are primarily made from natural sources—so CBD products don’t get approved and, in turn, health insurance companies are not obligated to cover them. According to state laws, these agencies are only required to provide coverage for drugs that are FDA approved.
Even though health insurance companies don’t currently cover the cost of CBD oil, this doesn’t mean there will never be such coverage.
While many scientific studies have backed up the claims about the benefits of CBD oil, and many people have already started to use it, the relatively high prices of CBD oil remain a concern. Many consumers opt for cheaper products only to find they yield ineffective results, as they contain dosages of the cannabidiol compound that are insufficient to produce the potential health benefits.
Even though there is plenty of evidence regarding the medicinal uses for CBD oil—and even though doctors are already prescribing these oils to their patients—health insurance plans do not offer to cover the costs. This brings up the question of why, especially when there are a significant number of other pharmaceutical drugs that are covered— sometimes with similarly high or even higher price tags.
Health insurers in the United States won’t pay for anything that’s technically illegal. Most health insurance policies include an illegal acts exclusion saying that health issues occurring due to or in association with your voluntary involvement in an illegal act are not covered (some states limit or prohibit these sort of exclusions ). Even though medical marijuana has most likely been legalized in the state where you live, it’s still classified by the federal government as a schedule I controlled substance as defined by the Controlled Substances Act. It’s still illegal to use marijuana in terms of federal law.
If you live in a state where medical marijuana use has been legalized (35 states and DC as of late 2020), it’s tempting to assume that your health insurance will pay for it like other drugs prescribed by your physician. However, you’d be wrong; health insurance won’t pay for medical marijuana even in states where its use has been legalized. Why won’t health insurance pay for medical marijuana when it will pay for all sorts of other drugs, many arguably more dangerous and prone to abuse?
Medical Marijuana Is a Schedule I Drug
Without FDA approval, it won’t get on your health plan’s drug formulary, so your health insurance won’t pay for medical marijuana. The process of getting marijuana approved would almost assuredly involve big pharma, exclusive marketing rights, and exorbitant costs. You can read more about this in an article about marijuana that the FDA published.
In this situation, patients who would benefit from using marijuana would be able to buy it over-the-counter like any other herbal remedy. As they are now, those patients would be highly motivated to find a way to pay for it themselves. Why would your health insurance want to set a precedent of paying for over-the-counter drugs or herbal remedies that you’re willing to pay for yourself?
James Lacy, MLS, is a fact checker and researcher. James received a Master of Library Science degree from Dominican University.