Medical Cannabis is Legal — So I Qualify, Right?

Medical use of cannabis was legalized in Canada since 2001 and administered by Health Canada under the conditions outlined by Access to Cannabis for Medical Purposes Regulations.

Now cannabis is legal for recreational purposes since October 17, 2018.  Since then, insurance carriers agreed to offer medical cannabis to plan members with a nominal annual limit and guidelines for qualification.

The criteria for acceptance by all insurance carriers is similar across the board.

1. Chronic neuropathic pain
2. Spasticity due to multiple sclerosis
3. Nausea and vomiting due to cancer chemotherapy

One would think, if I satisfy one or more of the three criteria, I’m eligible for cannabis. Not so fast. The employee must first submit a Medical Cannabis Special Authorization Request Form. The form explicitly states, candidates for consideration must be age 25 and older. The insurance company request a list of pharmaceutical medications taken along with duration and any side effects. This will lead to an attending physician report for the insurance underwriter to assess your case.

Patients who suffer from chronic neuropathic pain, the carrier is looking for medications belonging to the Analgesic family such as: Cymbalta, Percocet, Pregabalin, Ralivia, Tylenol #3, etc. Keep in mind, each patient’s file will be reviewed on a case-by-case basis. Therefore, there is no guarantee you will qualify for medical cannabis even if Health Canada agreed to administer the drug.