Medical Cannabis: Is it Covered Under Group Insurance?
Article revised on 7 June 2018
The introduction of the bill to legalize recreational cannabis use has stirred up a lot of discussion, to say the least. Yet, well before anyone ever thought of legalizing recreational cannabis use, cannabis distribution for therapeutic purposes was authorized throughout the country and had been for a number of years.
However, the use of cannabis for therapeutic purposes is very controversial: Some doctors adopt it into their practice, while others are doubtful of its effectiveness. Here’s why.
Medical cannabis is currently prescribed by physicians as treatment for those suffering from particular health conditions such as chronic pain, anxiety, muscle spasms and epilepsy. The controversy stems from the fact that certain studies have demonstrated short- and long-term physical and mental health effects that can be harmful¹.
The Collège des médecins du Québec (CMQ) has moreover adopted the position that the use of cannabis for medical purposes is not a recognized treatment. The main reason is that the therapeutic value of cannabis and its derivatives has not been clearly demonstrated. As indicated in the CMQ’s guidelines, an unrecognized treatment can only be used within a research framework². This means that those wishing to have cannabis prescribed for them for therapeutic purposes must be a participant in a research project associated with a recognized institution such as the McGill University Health Centre (RI-MUHC).
Reimbursement of medical cannabis expenses
All therapeutic cannabis is available to those with medical authorization, its cost continues to be payable by users other than veterans for whom the Canadian government has implemented a reimbursement policy. In general, when cannabis is prescribed for veterans, it is to treat symptoms of post-traumatic stress and chronic pain relating to injuries. Cannabis is prescribed for them because it is a worthwhile alternative to other very costly and often more harmful treatment options, such as opiates.
At present, in general, private insurance companies and provincial public insurance plans do not reimburse medical cannabis expenses, since the therapeutic value of cannabis has not been clearly demonstrated and because cannabis does not have Health Canada’s approval as a therapeutic drug. To obtain that approval, a Drug Identification Number (DIN) is required.
What can we expect in the future?
For now, it is too soon to say whether or not therapeutic cannabis will be approved. However, medical marijuana might eventually be covered under private insurance plans, thanks to significant advances in research. Research would allow cannabis and its derivatives to obtain a DIN³, which might make insurance companies more willing to include it in the list of drugs eligible for reimbursement.
On the other hand, even if cannabis were to obtain a DIN, its therapeutic value in curing or relieving the symptoms of a specific disease or condition would have to be demonstrated. Therefore, cannabis would be prescribed and eligible for reimbursement only if it had been shown to be definitely effective in treating certain health issues.
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