Medicare does not cover medical marijuana, even in states where it is legal

Medicare will not pay for marijuana in any form — not smoked, not edible, not oil, not for any condition. This is true even if you live in a state where medical marijuana is legal and even if your doctor recommends it. The reason is federal law: marijuana remains a Schedule I controlled substance under the Controlled Substances Act, which means the federal government classifies it as having no accepted medical use. Medicare follows federal law, not state law, when it makes coverage decisions.

If your doctor suggests medical marijuana for chronic pain, nausea, or another condition, you would pay for it entirely out of pocket. The cost varies widely by state and product — from roughly $10 to $20 per dose in some states to much more in others — but Medicare will not reimburse any of it.

Key Takeaways

  • Medicare does not cover medical marijuana under any circumstance because federal law classifies marijuana as a Schedule I drug with no accepted medical use.
  • State-level legalization does not change Medicare's coverage rules, which are based on federal law.
  • If you pay for medical marijuana out of pocket, you cannot deduct it as a medical expense on your taxes.
  • Medicare does cover some other treatments for the conditions people often use medical marijuana for, such as prescription pain relievers and anti-nausea medications.
  • Your doctor can discuss alternative treatments that Medicare does cover if medical marijuana is something you are considering.

Why federal law matters more than state law for Medicare

Medicare is a federal program, so it follows federal rules about what drugs it will and will not pay for. Even though more than 30 states now allow medical marijuana, and some allow recreational use, the federal government still lists marijuana as Schedule I. That classification means the Drug Enforcement Administration (DEA) considers it to have no currently accepted medical use in the United States, no matter what individual states decide.

This creates a legal conflict in states where medical marijuana is legal: you can legally buy it there, but Medicare will not pay for it, and you cannot claim it as a tax deduction for medical expenses. Your state may not prosecute you for using it, but the federal government's position on coverage does not change.

What Medicare does cover for conditions people use medical marijuana for

Medicare covers prescription medications for many of the conditions people turn to medical marijuana for. If you have chronic pain, Medicare covers prescription opioids, muscle relaxants, and anti-inflammatory drugs. If you have nausea from chemotherapy or another condition, Medicare covers prescription anti-nausea medications like ondansetron (Zofran) and metoclopramide (Reglan). If you have anxiety or insomnia, Medicare covers prescription medications for those as well.

These medications are not the same as medical marijuana, and they work differently in your body. Some people find them effective; others do not. The point is that if you are considering medical marijuana because you need relief from a symptom, your doctor can discuss what Medicare-covered options exist first. You may find something that works for you and that Medicare will pay for.

Your doctor can also refer you to a pain management specialist, a palliative care doctor, or another specialist if your current treatment is not working. Medicare covers these referrals and the visits themselves.

What happens if you buy medical marijuana and try to get Medicare to pay

If you purchase medical marijuana and submit a claim to Medicare, Medicare will deny it. You will not be reimbursed. There is no appeal process that will change this outcome, because the denial is based on federal law, not on a coverage decision that could be reconsidered.

You also cannot deduct medical marijuana as a medical expense on your federal income taxes, even if you have a doctor's recommendation and live in a state where it is legal. The IRS follows the same federal classification as Medicare: because marijuana is Schedule I, it is not a deductible medical expense.

How to talk to your doctor about pain, nausea, or other symptoms

If you are thinking about medical marijuana because you have chronic pain, nausea, insomnia, or another symptom that is not well controlled, tell your doctor directly. Bring a list of what you have already tried and how it worked (or did not work). Tell your doctor what your goals are — for example, whether you want to reduce the amount of opioids you take, or whether you want to avoid certain side effects.

Your doctor can then discuss what Medicare-covered treatments might help. If your current medications are not working, your doctor may adjust the dose, try a different medication, refer you to a specialist, or suggest non-medication approaches like physical therapy or counseling. Some of these options may take time to work, and you may need to try more than one before you find what helps.

If you live in a state where medical marijuana is legal and you decide to pursue it anyway, your doctor does not have to recommend it, but they should not penalize you for asking. You can also ask your doctor to monitor your health while you use it, even though Medicare will not pay for the marijuana itself.

State programs and other resources if you cannot afford medications

If you cannot afford the prescription medications Medicare covers, several programs may help. Medicare's Extra Help program reduces your out-of-pocket costs for prescription drugs if your income is low enough. Pharmaceutical companies offer patient information programs that provide free or reduced-cost medications to people who meet income requirements. Your state may also have a pharmaceutical information program.

Your doctor's office, a social worker, or your local Area Agency on Aging can help you find these programs. You can also call 1-800-MEDICARE to ask about cost-reduction options for a specific medication your doctor has recommended.

Frequently Asked Questions

If my state legalized medical marijuana, can I ask Medicare to reconsider its coverage?

No. Medicare's coverage decisions are based on federal law, not state law. Even if your state legalizes medical marijuana, Medicare will not cover it because the federal government still classifies it as Schedule I. State legalization does not change Medicare's rules.

Can I use my Health Savings Account or Flexible Spending Account to pay for medical marijuana?

No. These accounts follow the same federal rules as Medicare and the IRS. Because marijuana is Schedule I under federal law, you cannot use pre-tax health savings or flexible spending money to buy it. The IRS will not allow the deduction.

What if my doctor writes a prescription for medical marijuana?

Doctors cannot legally prescribe marijuana under federal law, even in states where it is legal. In legal states, doctors can only "recommend" it. Medicare will not cover a recommendation any more than it would cover a prescription. You would pay out of pocket.

Does Medicare cover CBD products?

Medicare does not cover CBD (cannabidiol) products, even though some are sold over the counter. The FDA has approved only one CBD-based medication — Epidiolex, for certain types of seizures — and Medicare's coverage of that specific drug is limited. Most CBD products are not FDA-approved and are not covered.

What should I do if I want to try medical marijuana but cannot afford it?

Talk to your doctor first about Medicare-covered treatments you have not yet tried. If those do not work and you still want to explore medical marijuana, ask your doctor about the cost in your state and whether any patient information programs exist. Some dispensaries offer discounts for seniors or low-income customers, though these vary by location.