Medicare does not cover medical marijuana in any form. Because federal law still classifies marijuana as a Schedule I controlled substance, Medicare is legally prohibited from paying for it, even if you live in one of the more than 40 states where medical cannabis is legal. This applies to Original Medicare (Parts A and B), Medicare Part D prescription drug plans, and Medigap supplemental policies.
Why Medicare Can’t Cover It
Medicare is a federal program, and it follows federal drug classifications. The Controlled Substances Act places marijuana in Schedule I, the same category as heroin and ecstasy, meaning the federal government considers it a substance with “no currently accepted medical use and a high potential for abuse.” As long as that classification stands, no Medicare plan can reimburse you for cannabis products, regardless of your state’s laws or your doctor’s recommendation.
This creates a gap for the millions of Medicare beneficiaries who use medical cannabis. You may have a valid state medical marijuana card, buy products legally from a licensed dispensary, and use them under a doctor’s guidance, but Medicare treats the entire category as off-limits for reimbursement.
What About Medigap and Medicare Advantage?
Medigap (Medicare Supplement) plans only help pay your share of costs for services already covered by Original Medicare, things like copayments, coinsurance, and deductibles. Since Original Medicare doesn’t cover medical marijuana, Medigap won’t either. These plans are designed to fill gaps in existing coverage, not add entirely new benefits.
Medicare Advantage (Part C) plans, which are run by private insurers, sometimes offer supplemental benefits like flex cards or wellness allowances. However, CMS guidelines are clear that these supplemental benefits operate within federal law and cannot override the Controlled Substances Act or authorize Schedule I substances. So even the most generous Medicare Advantage plan won’t reimburse you for cannabis purchases.
FDA-Approved Cannabinoid Medications Are Different
There is one important distinction. A handful of prescription medications derived from or related to cannabis compounds have gone through the FDA approval process. Because they are FDA-approved pharmaceuticals, they can be covered under Medicare Part D like any other prescription drug. These are not the same as buying flower, edibles, or oils from a dispensary. They are specific medications prescribed for specific conditions, and your Part D plan’s formulary determines whether they’re covered and at what cost tier.
If your doctor recommends one of these FDA-approved options, check your Part D plan’s drug list to confirm coverage and find out your copay.
Does Medicare Cover the Doctor Visit?
Getting a medical marijuana card typically requires a certification visit with a doctor, plus periodic renewals. Whether Medicare covers that office visit is not straightforward. The consultation itself, where you discuss your symptoms and whether cannabis might help, may or may not be reimbursed depending on your specific plan and how the visit is billed.
Before scheduling a certification or renewal appointment, contact your plan to ask whether the visit will be covered, whether there’s a copay, and whether you’ll need to pay out of pocket. Some doctors who specialize in cannabis certifications don’t accept Medicare at all, which means you’d pay the full fee yourself regardless.
What You’ll Pay Out of Pocket
Without any insurance coverage, the full cost of medical marijuana falls on you. The expenses break down into a few categories: the doctor’s certification visit, your state registration card, and the cannabis products themselves.
Certification visits vary widely by state and provider, ranging from around $75 to $300 or more. State registration fees also differ. Some states have eliminated them entirely. Connecticut, for example, dropped its $100 annual patient registration fee in 2023. Others still charge anywhere from $25 to $200 per year. The cannabis products are the biggest ongoing expense, and prices depend on what you use, how much, and where you live.
Could Federal Rescheduling Change Things?
There has been ongoing discussion about moving marijuana from Schedule I to Schedule III under the Controlled Substances Act. If that happened, marijuana would be reclassified as having “a currently accepted medical use,” which is a legal prerequisite that could open the door for insurance coverage. Legal analysts at Ohio State University’s Drug Enforcement and Policy Center note that rescheduling could give medical marijuana companies a stronger position to lobby for insurance reimbursement.
Rescheduling alone wouldn’t automatically make Medicare cover cannabis products, though. Medicare Part D covers FDA-approved drugs, and most medical marijuana products haven’t gone through that approval process. Even under a Schedule III classification, significant regulatory and legislative steps would still need to happen before Medicare reimbursement became a reality. For now, the entire cost remains yours to manage.