Is Medical Marijuana Covered by Insurance in Canada?

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  • Author Lilly Stevens
  • Published August 28, 2019
  • Word count 594

Medical marijuana can help relieve the symptoms of a number of health conditions. It is known for its ability to relieve pain, nausea, muscle spasms, anxiety and mood regulation, insomnia, low appetite, autism, multiple sclerosis, epilepsy (and other seizures), immune function, and neuroplasticity. Because of the unique range of symptoms it can provide relief for, it is often sought by those who suffer from conditions that are difficult to diagnose and treat, like fibromyalgia and anorexia, and it can even help with the symptoms associated with chemotherapy. But is medical marijuana covered by insurance in Canada for those who need it?

First, let’s clear up a couple of misconceptions about medical marijuana.

Medical marijuana isn’t quite the same thing as recreational marijuana. Both are plant-based, derived from the Cannabis Sativa or Cannabis Indica species, and both have three major active ingredients: THC, CBD, and CBN. Medical marijuana is used under the guidance and authorization of a medical practitioner in order to alleviate the symptoms of a health condition, and it is formulated differently than the kind of marijuana that is used for recreation. Medical marijuana contains higher concentrations of CBD (cannabidiol), which offers medical qualities, and lower concentrations of THC (tetrahydrocannabinol), which produces the "high" feeling associated with recreational cannabis. In other words, those who are prescribed medical marijuana are benefitting from its medicinal characteristics rather than its mind-altering characteristics, but does that mean they can get their medical marijuana covered by insurance in Canada?

How to get coverage for medical marijuana in Canada

Medical grade cannabis is eligible for Revenue Canada’s Medical Expense Tax Credit, so you can claim medical cannabis and its related expenses on your tax return—you just need to have your prescription and receipts from an approved producer with a Health Canada license. The tax credit, however, may not be your only form of assistance. Your medical marijuana may also be covered by your Canadian insurance plan.

Medical marijuana coverage is still relatively new because the potentially high costs present a higher risk to insurance providers, so not every insurance plan in Canada is going to provide coverage. There are some insurance providers, however, who are starting to provide medical marijuana insurance coverage under Canadian workplace benefits packages. Sun Life Financial is on such provider. Sun Life’s insurance plan requires employers to pay a premium, and in exchange it will provide coverage for medical cannabis through its workplace benefits plan provided the employee is suffering from one of the outlined medical conditions.

What are the eligibility requirements for medical marijuana insurance coverage in Canada?

Medical marijuana insurance is only available through select insurance providers if it is being used to treat the symptoms of a few specific medical conditions. This caveat is in place to help the insurance providers mitigate some of the risk associated with the high costs of medical cannabis. It is often more costly than established pharmaceutical medications, and there isn’t always strong evidence pointing to the efficacy of its use to treat the symptoms of the condition. Coverage is therefore provided for the conditions and symptoms for which there is clear clinical evidence that the use of medical cannabis can offer enough of a benefit to outweigh its risk.

Sun Life insurance currently provides medical marijuana coverage for:

  • severe pain, nausea, and vomiting that is associated with cancer and cancer treatments

  • spasticity or neuropathic pain resulting from multiple sclerosis

  • rheumatoid arthritis (only as a last resort to other forms of treatment)

  • neuropathic pain resulting from HIV/AIDS

  • anorexia

  • palliative care

How do you know if your Canadian plan offers medical marijuana coverage?

The best way to find out is to talk to your workplace HR personnel, your insurance broker, or to visit LSM Insurance to get a detailed comparison of different insurance plans and their provisions for medical marijuana insurance coverage in Canada.

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