Insurance Companies Are Finally Covering Medical Cannabis

In the ever-evolving uses for cannabis as medicine, there is one certainty that most users can agree on – the difficulty to cover the cost.

With nearly 300,000 individuals registered with Health Canada as medical cannabis patients, it only makes sense that insurance companies would begin to feel the pressure to make changes to their coverage.

In March of 2017, Loblaw Companies Inc., Canada’s largest food distributor and owner of mega-chain Shoppers Drug Mart, became one of the first major companies to allow for very limited coverage for medical cannabis. Nevertheless, it was a start.

Sun Life took the lead earlier this year when they announced plans to offer coverage for medical cannabis to those with group benefits. 

As of March 1, plan administrators were provided with the option to add medicinal cannabis coverage to extended health care plans. There were, however, restrictions to this coverage with only a small range of conditions included, such as cancer with severe or refractory pain, nausea and/or vomiting due to cancer treatment, multiple sclerosis with neuropathic pain or spasticity, rheumatoid arthritis with pain that has not responded to standard therapy, HIV/AIDS with anorexia or neuropathic pain and patients requiring palliative care.

Another major setback to this coverage includes a yearly maximum spend ranging between $1,500 and $6,000, with a prior approval process and coverage criteria. This leaves roughly $125 to $600 per month to spend on cannabis, hardly significant when the average medical cannabis user will typically access 3 to 5 grams per day.

The other set back? Plan administrators are required to make arrangements for this coverage with Sun Life, meaning employers would have the final say as to whether they approve of their employees taking cannabis for medical purposes.

A better step to support easier access

On June 15, Markers Financial Inc., a division of Evergreen Pacific Insurance Corporation (EPIC), announced that it would introduce Canada’s first guaranteed issue insurance product for individuals seeking coverage for medical cannabis prescriptions. The company plans to first launch its individual product August 15 followed by a group product for companies wishing to provide such benefits to their employees.

In a press release, Robert Wilson, Chief Executive Officer of EPIC said “our introduction of insurance coverage for medical cannabis will go a long way toward supporting a more legitimate, patient-centric approach to patient care in Canada. We anticipate a very positive market reception in August.”

What this means is, similar to the way dental insurance is administrated in Canada, medical cannabis producers licensed by Health Canada will be paid directly by the insurer. Patients will no longer be required to pay out of pocket for prescription costs.

The company also reported that policies will be customized to each person’s actual requirements with no caps or restrictions based on pre-existing conditions. Any medical cannabis producers licensed by Health Canada are eligible to participate in this program.

No further details or price points have been released but it can be assumed many will want to keep a close watch for more details on August 15.