The never ending topic of insurance! It can be complicated to understand what is covered, how much of it is covered, and what you have to end up paying. As we look more into CBD and CBD oil offerings, it’s caused many of us to ask - “huh, is this covered?” And while the answer is probably a bit more complicated, the short of it is no, insurance does not cover CBD oil as of 2022. Don’t worry, we’ll explain and answer additional questions in this piece so you have a better idea of why insurance doesn’t cover CBD oil - even if you get a prescription from your doctor.
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Even if you have a prescription from your doctor to purchase medical cannabis from a dispensary, it still does not qualify to be covered by insurance. This is, in part, due to the legal status of marijuana in the U.S. While CBD is considered legal as long as it has under 0.3% THC, medical marijuana is still classified as a Schedule I controlled substance through the Controlled Substances Act. So while you may be able to obtain a medical marijuana card from your doctor in a state that it is legalized, the federal government’s classification prevents it from being covered.
If your healthcare provider prescribes medical marijuana (technically considered a controlled substance under the federal law) they must then be registered with the the Drug Enforcement Administration (DEA). Even if medical marijuana is legal in that state it must still be logged and registered with a DEA number to verify the healthcare provider’s ability to prescribe.
Despite having supported research on the potential benefits of using CBD oil, it is not recognized by the FDA or health insurance companies as something worth coverage. This means that you will have to pay out of pocket for any CBD products you purchase.
While CBD is not classified in the same way as medical marijuana, or marijuana in general, health insurance companies will only pay for items on the drug formulary. A formulary (also called a drug list) is generally just a list of prescription drugs that are covered within a drug or insurance plan. Since the FDA has not approved CBD products for prescription use or categorized it within the classification of drug schedules. The drug schedules listed by the DEA are as follows:
The only cannabis products covered by insurance are ones that are approved by the FDA. There is only one FDA-approved prescription CBD medicine, called Epidiolex. It is used to treat seizures associated with Lennox-Gastaut Syndrome (LGS), Dravet Syndrome, or Tuberous Sclerosis Complex (TCS) for patients 2 years or older. While this is the only direct cannabis-derived drug product, there are three synthetic cannabis-related products:
The benefits and uses for CBD oil range from:
Chronic Pain - A 2018 study found that 15 of 18 trials demonstrated a significant analgesic effect of cannabinoids when compared to a placebo. A portion of patients also self-reported a 30% reduction in pain intensity (based on a scale of 0-10).
Epilepsy - CBD has actually been approved for use with one medication for helping with seizures.
Anxiety - Existing preclinical evidence strongly supports CBD as a treatment for generalized anxiety disorder, panic disorder, social anxiety disorder, OCD, and PTSD when administered acutely. They mention that the research is lacking for chronic CBD dosing with more data suggesting that acute dosing may be successful for patients.
High Blood Pressure - In 2017, researchers found that an acute administration of CBD (600 mg of CBD) can reduce resting blood pressure and even blood pressure associated with stress and an increase in heart rate.
Perhaps one day health insurance companies will cover CBD products, but for now, this doesn’t seem immediate. However, this doesn’t mean that the cannabis world isn’t done changing. Individual states have recently changed their statuses of what is legal or illegal based on cannabis products. The varying degrees of status really depend on your individual state, so be sure to check before you order any new product, especially online or if you’re looking to purchase a product with a higher THC content (think delta-9 and delta-8 products).
As the landscape changes we will most likely see many more changes in the years to come. It’s best to stay up to date and continue researching on your cannabis journey. Only time will tell if insurance will cover these products.
