Medical Cannabis
What is covered?
- 100% up to $2,500 every calendar year (January 1 to December 31)
What is not covered?
- Devices to consume medical cannabis (e.g., pipes, vaporizers)
Government regulations in Canada allow you to have a 30-day supply of medical cannabis, up to a maximum amount of 150 grams.
All medical cannabis prescriptions require prior authorization. You will have had to first try other treatments to determine that they are not effective before you can get approved for medical cannabis coverage.
Example 1:
2 grams x 30 days = 60 grams
Since Sandra’s 30-day supply is less than the 150-gram maximum allowed, she can fill her entire prescription and have it refilled every 30 days.
Example 2:
Gary’s healthcare provider recommends 6 grams of medical cannabis each day to give him relief from his chronic pain. The amount Gary will need for 30 days is:
6 grams x 30 days = 180 grams
As you can see, Gary’s recommended 30-day supply will be more than the allowable 150-gram maximum. He will need to refill his medical cannabis prescription more often than every 30 days.
Your coverage maximum resets on January 1 each year.
If you reach the medical cannabis plan maximum partway through the year, the full coverage amount will again be available to you on January 1.
For Example:
Don is prescribed medical cannabis to alleviate nausea from chemotherapy. Last year, he submitted the following claims:
Don reached the annual medical cannabis maximum at the end of July. He then had two choices:
- Continue to refill his medical cannabis prescription and pay out of pocket for the remainder of the year (until December 31); OR
- Continue to refill his prescription and use his Health Care Spending Account (HCSA) to help cover his cost—in full or in part.
