Insurers in holding pattern until government moves on cannabis legalisation

by David Keelaghan02 Dec 2016
Speaking to Life-Health Professional last week, Jordon Sinclair of Canopy Growth – Canada’s largest licensed medical marijuana producer – stated that engagement with the insurance providers was a major priority for the firm. According to Wendy Hope of the Canadian Life and Health Insurance Association (CLHIA), however, there isn’t much the insurance companies can do while one regulatory roadblock in particular remains in place.
 
“The reason medical marijuana is not included in health plans is because Health Canada has still not issued it a drug identification number (DIN),” she says. “We have been advocating to Health Canada that they follow the same path as for other prescription drugs.”
 
Of course, there are ways a patient can have medical marijuana covered by their insurance provider, although it is still pretty rare.
 
“There are a number of companies that have healthcare spending accounts and because of the treatment and recognition of medical marijuana by the Canada Revenue Agency, you can have it covered by a healthcare spending account,” explains Hope.
 
Another option, one that University of Waterloo student Jonathan Zaid pursued successfully, was to convince his plan’s sponsor (the student union) that medical marijuana was the best and most cost-effective remedy to his illness.

The plan’s provider, Sun Life, duly included medical cannabis as a benefit, and the experience convinced Zaid to form his own advocacy group – Canadians For Fair Access to Medical Marijuana (CFAMM).
 
“In 2014 I put through a special request claim for medical cannabis,” he says. “I have a chronic neurological pain condition and it causes constant headaches and migraines. I tried a number of different treatments – over 40 different pharmaceuticals – then finally I found some relief using medical cannabis with my pain.”
 
He is not alone in that respect, and today marijuana is becoming much more accepted by the medical community to treat a myriad of different ailments. It remains expensive though, which is something CFAMM hopes to address. 
 
“I saw how many patients struggled with affordability,” says Zaid. “Medical cannabis is charged a sales tax unlike all other prescription drugs. It is also difficult for patients to access cannabis in the forms and the potencies they need.”
 
With all signs pointing to legislation for cannabis being enacted in the spring, it complicates things a little for those that use the drug for medicinal purposes rather than recreationally. In the move to make cannabis available to the greater Canadian population, Zaid wants to ensure that patients are not forgotten.
 
“We partnered with the Arthritis Society and the Canadian Aid Society to put forward a submission to the task force on legalisation calling on the government to prioritize patients as they progress with legalisation,” he says. “This means eliminating the sales tax, improving the cost-coverage options and funding research.”
 
As the founder and chief driving force of CFAMM, Zaid regularly deals with insurance companies. These meetings are usually pretty productive he says, and will likely bear much more fruit over the next year.
 
“I’m helping between 30 and 40 patients advocate to their plan sponsors and insurers,” he says. “The conversations are really positive. It takes a lot of time to go over all the potential issues but I think insurers are aware they have to start creating policies for medical cannabis.”
 
While health insurance providers are currently in somewhat of a holding pattern waiting on the government’s next move, the life insurance industry has already made some proactive steps to normalize the drug when it comes to the underwriting process.
 
“The life insurance side has shifted quite a bit,” says Zaid. “When I started advocating in 2014, pretty much all life insurers were treating medical cannabis users equivalent to a tobacco smoker. That inequitable treatment has now come to an end.”


Related stories:
Major medical pot producer seeking a breakthrough with insurance giants
Cost of medical pot benefits for Canadian vets rise fifty-fold in three years
 

COMMENTS