Why medical marijuana isn’t covered under insured drug plans

There are three main reasons why medical marijuana isn’t currently considered an eligible expense under our core drug plans.

  1. Marijuana doesn’t have a Drug Identification Number (DIN)
    The Co-operators can’t provide coverage under our group insurance plans for any drug that doesn’t have a DIN as defined by the Food and Drugs Act. A DIN confirms that the product has undergone and passed a review of its formulation, safety, efficacy, quality, labeling, and instructions for use. If a product defined as a “drug” under the Food and Drugs Act is sold without a DIN, it’s not compliant with Canadian law.
  2. There are no clear dosing guidelines
    There aren’t enough guidelines for approved uses for treatment, allowable maximum amounts prescribed, or reasonable and customary charges. As long as all necessary Health Canada Guidelines are met, it may be considered an eligible expense under a Health Spending Account (HSA).
  3. There is limited conclusive clinical evidence supporting the use
    Medical marijuana advocates list numerous therapeutic uses for the drug, but the only conclusive evidence for using medical marijuana is to treat chronic pain, nausea caused by chemotherapy, and some symptoms of multiple sclerosis.

Is medical marijuana covered under Health Spending Accounts (HSA)?

As long as all necessary Health Canada Guidelines are met, it may be considered an eligible expense under a HSA.

What about other group insurers?

As far as we know, no traditional insured benefit plans have reimbursed any plan member to date. We’re involved in ongoing discussions with the Canadian Life and Health Insurance Association (CLHIA) and will continue to monitor and provide updates regarding this issue.

For more information, contact your Group Benefits Representative.

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