Cannabis is a complex substance unique in the health benefits landscape. It is not considered a prescription medication by Health Canada and does not meet typical requirements to be eligible for coverage under a prescription drug plan. Medavie Blue Cross will continue to monitor the latest clinical evidence and emerging trends to assess the new benefit on an ongoing basis.
Medavie Blue Cross has introduced a new Extended Health Care benefit covering medical cannabis. The benefit is available as an optional, stand-alone coverage option for plan sponsors effective October 2018.
The medical cannabis benefit is provided as a reimbursement benefit covering fresh and dried cannabis and cannabis oil. Other cannabis products and products related to the consumption of cannabis are ineligible. Plan sponsors may choose from a few different annual benefit maximum options.
To qualify for reimbursement, plan members must receive pre-authorization and obtain medical cannabis in accordance with the Access to Cannabis for Medical Purposes Regulations (ACMPR). Clinical evidence supporting the use of cannabis for medical purposes remains limited. Coverage will be considered for certain conditions based on Canadian Family Physician Guidelines for prescribing medical cannabinoids:
Interested plan sponsors may reach out to their Medavie Blue Cross representative for additional information, or to discuss adding the optional benefit to their plan.
Veterans Affairs Canada reimburses eligible medical cannabis users, those with a K# and Awarded Conditions, for up to three grams of dried cannabis or equivalent in oils/edibles per day. If there is a need for additional daily dosage of cannabis, Apollo can help complete all necessary paperwork allowing veterans to receive more than 3grams a day to be covered. Eligible cannabis must come from a medical Licensed Producer with whom a patient is registered through an authorized medical document (prescription). Grey market and recreational cannabis purchases are not reimbursable.
Many Licensed Producers (LPs) also offer compassionate pricing to low-income individuals, seniors, and those on ODSP. Medical cannabis users should work with a patient educator who can help them determine if they qualify for compassionate pricing or other benefits. Patient educators are also able to recommend Licensed Providers who offer compassionate pricing, as not all LP’s offer this benefit. Apollo Cannabis Clinics employ patient educators to work with each individual after they receive a medical cannabis recommendation. Patient educators are committed to helping medical cannabis users understand what benefits certain Licensed Producers may offer. They also work to help individuals select LPs who carry the product they require.
If you would like to book a free virtual/telephone appointment, we assist our patients 1-on-1 with any insurance questions as well as assisting in finding you the best LP that suits your needs and budget.
You can fill out a form here and someone from our bookings team will give you a call or you can reach us directly toll-free at 1-877-560-9195.
Veterans Affairs: A Pioneer in Coverage
If you need any paperwork filled out by your doctor, please contact Apollo and we will be happy to assist you*.
More than 17 years after cannabis was first legalized in Canada for medical use, some insurers are just beginning to cover the cost of the medication. Slowly things are changing for the better as companies are being given the option from insurers to include medical cannabis. However, many plans limit coverage to just a handful of medical conditions that qualify and do not cover the cost of medical cannabis for most users.
But don’t fret – if your health insurance plan includes a Healthcare Spending Account (HCSA or HSA), you are likely able to claim medical cannabis under this category. Be sure to chec k the details of your insurance plan to see what is and is not covered. The Canada Revenue Agency lists medical cannabis as an eligible medical expense . Your proof of purchase (receipts) that include your prescription information, can be found online under your personal account with each Licensed Producer (LP) on their respective websites.
If you have any questions about your prescription, your apollo educator is here to assist you free of charge, 7 days a week.
Veterans Affairs Canada was the first Canadian institution to cover medical cannabis and has a revised coverage policy since November 22, 2016 through Medavie Blue Cross. The Veterans Affairs Canada website states “the health and well-being of Veterans is a top priority for the Government of Canada. This was the fundamental consideration in the development of VAC’s reimbursement policy for cannabis for medical purposes”.
As with most medical benefits there is a limit on the cost Veterans Affairs Canada will reimburse per gram of cannabis. A maximum rate of $8.50 per gram of cannabis is covered and medical users must pay the rest out of pocket. However, many reputable LPs will adjust the cost accordingly specifically for veterans.
CBD basically stopped the seizures where no medications were working.
Our guess is yes.
CBD’s classification by the US government and FDA is an important hint at how health insurance will treat it.
The problem is that they're beholden to the FDA and medical practice which moves very slow.
Maybe they'll start when they realize the cost savings for the entire health care system.
What about HSA's?