Insurance Coverage

Insurance coverage for cannabis is becoming more common as time goes on but it can still be a difficult process to navigate. Our staff members have been trained in the processes involved in getting cannabis covered with carriers in Canada and are here to help. There are no fees associated with this service. We are here to help get you covered. 

What do I need in order to be qualified for medical cannabis coverage?

Currently, most insurance companies will consider medical cannabis coverage for individuals suffering from:

  • Chronic Neuropathic Pain
  • Symptoms related to palliative care
  • HIV / AIDS
  • Severe pain from cancer, or nausea and vomiting due to cancer treatments
  • Stiffness and involuntary muscle spasms in people suffering from Multiple Sclerosis
  • Other insurers have a ‘special authorization’ process for all symptoms related to cannabis therapy – we are able to help walk you through this process.

Will ODSP cover my medical cannabis?

ODSP does not currently cover medical cannabis but there is still some hope to get help. If you vaporize your cannabis, we can help you get up to $300 towards a new vaporizer. There are some companies that will direct bill, meaning that there will be no out-of-pocket expenses for you. If this is something that you are interested in, please let us know.

Insurance Plan Information

Information on each individual company varies by plan and factors such as workplace and tiers of coverage so the below information is for general use. Laws, regulations and insurance plans are constantly changing as they pertain to medical cannabis coverage. Please contact us at info@karthia.ca or 1 (833) 222-6777 for further information.

Medavie Blue Cross

Medavie Blue Cross has introduced a new Extended Health Care benefits covering medical cannabis. In order to qualify for reimbursement of medical cannabis a plan member must be first preauthorized to obtain medical cannabis and there must be supporting clinical evidence of the use of cannabis for medical purposes. 

Currently Medavie Blue Cross will consider coverage for those who are suffering from the following conditions: chronic neuropathic pain, refractory pain in palliative cancer, nausea and vomiting due to cancer chemotherapy, spasticity in multiple sclerosis or spinal cord injury. To find out if you qualify for coverage you will have to speak to your plan administrator.

Manulife

Manulife medical cannabis claims can be considered under a Health Care Spending Account (HCSA). 

Medical cannabis coverage will be approved if a doctor authorizes it for a condition where there is evidence supporting its use, such as: stiffness and involuntary muscle spasms in people suffering from Multiple Sclerosis, nausea and vomiting in people undergoing chemotherapy, chronic neuropathic pain. 

To get coverage, the plan member and their doctor will be asked to complete and submit medical information to Manulife, including details about their condition and previous treatments. Once they’ve received your information they will review it and decide whether or not the claim is eligible for coverage. You will have to contact your plan administrator to see if you qualify.

Great West Life Insurance

Great West Life will cover medical cannabis, but it depends on your particular policy- it is very plan specific. In order to be eligible for medical cannabis coverage you must be authorized for cannabis for the following conditions:

  • Multiple Sclerosis
  • Cancer
  • HIV / AIDS
  • Symptoms related to palliative care
  • The best way to inquire about coverage would be to speak with your plan administrator to see if you qualify.
Medical Cannabis Form
Green Shield Canada

Green Shield does offer medical cannabis coverage and it is offered under extended health care coverage, not the drug benefit. Unfortunately at this time, medical cannabis does not have a DIN number so it is not considered a drug benefit.  Please be advised that there will be benefit maximums put into place.

To receive reimbursement, claimants will have to follow a prior authorization process with criteria based on specific medical conditions. The specific medical conditions to start coverage is limited to Chronic neuropathic pain, Multiple Sclerosis, nausea and vomiting due to chemotherapy. Each plan is individualized, you will have to contact your plan administrator to see if you qualify.

Sunlife Insurance

Sun Life has added an option for medical cannabis coverage through its group benefits plans. Employers with group benefits plans insured or administered by Sun Life will have the option to add medical cannabis to their plans.

Currently, the coverage offered by Sun Life is only available for conditions where there’s sufficient clinical evidence to support its use:

  • Severe pain with cancer, or nausea and vomiting with cancer treatments
  • Spasticity or neuropathic pain, with multiple sclerosis
  • Rheumatoid arthritis, when all other standard treatments have failed
  • Anorexia or neuropathic pain, with HIV / AIDS
  • Palliative care

To find out if you qualify for medical cannabis coverage you will have to speak to your plan administrator. If you know your plan is with Sun Life, you can contact the Customer Care Centre at 1-800-361-6212, Monday to Friday, 8 a.m. to 8 p.m. ET. Please have your coverage card ready.

 

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