Insurers more open to cannabis coverage, says advocacy group

by David Keelaghan24 Jul 2017
Legalization of recreational cannabis is now less than a year away, with obvious implications for health insurers. Presently none of Canada’s major providers provide medical marijuana coverage, bar a few notable exceptions. In February, the Nova Scotia Human Rights Commission ruled in favour of Gordon Skinner in his dispute against the Canadian Elevator Industry Welfare Trust Plan. Skinner uses medical cannabis as a pain reliever after a workplace injury, but despite having a prescription for the drug, was refused coverage by the trust.  

A Board of Inquiry concluded that the denial of coverage for medical cannabis amounted to unjustifiable discrimination and ordered the trust to reimburse certain expenses.

The trust subsequently appealed the decision, which will appear before the Nova Scotia Court of Appeal in October and may have major implications for the insurance industry.

Already the worm appears to have turned on this issue, with providers more willing to including medical cannabis.

Jonathan Zaid, the founder of Canadians For Fair Access to Medical Marijuana (CFAMM) has observed opinions change when it comes to cannabis’ medicinal value.

“Over the past few months we have seen a lot of progress with plan sponsors and insurers covering medical cannabis,” he says. “There have been a few major unions that have proactively added coverage on their plan, as well as other companies such as Shoppers Drugmart and Loblaws adding coverage. Employers are making that step to recognize the legitimacy of medical use of cannabis.”

With major corporations now open to including cannabis in their group plans, calls for insurers to follow suit are growing in volume. The current position of the industry is that insurers can’t include marijuana in its health plans without a Drug Identification Number, which Health Canada is yet to issue. This position is open to interpretation, however, as Zaid found out himself when he was able to get coverage for the drug while still at school. 

“The drug identification number has historically been used as an indicator of coverage, but that doesn’t necessarily mean if you don’t have the DIN that it can’t be covered,” he says. “In my case, Sun Life used a pseudo DIN to process the claim. The plan sponsor, in my case the University of Waterloo Student Union, can determine with the insurer what benefits are covered.”

Generally, the absence of a DIN number is a sticking point for most insurers, so CFAMM is striving to move things forward. This will only be achieved through funding, reveals Zaid, and already he and other supporters of medicinal marijuana have brought their case to the higher echelons of power.

“A DIN number would be a big step forward for medical cannabis, but at the same time there needs to be a lot of research to get to that level,” he says. “Part of that will be the advocacy we do along with the Arthritis Society – we are calling for the government to fund $25 million of research specific to medical cannabis over a period of five years. Hopefully that could lead to a DIN number and further coverage.”

In becoming the first western nation to fully legalize cannabis, Canada is blazing a trail on the international stage. But when it comes to using the drug for medicinal purposes, the nation still has some ways to go compared to other countries, says Zaid.

“It is extremely limited coverage in the US, even less than here,” he explains. “Cannabis is still illegal at the federal level, so financial institutions like banks won’t go near medical cannabis. Germany has a great model where they mandate that insurance companies cover medical cannabis that is authorized by a physician. Patients there get coverage just like they would any other medication.”


Related stories:
More evidence needed for cannabis’ merits as a medicine: Canadian Cancer Society
Insurers in holding pattern until government moves on cannabis legalisation
 

COMMENTS

  • by Chris Pryce, CEBS 2017-07-25 8:14:37 AM

    This is a very one sided op-ed. I agree that certain segments of the population could benefit, but it does not mean that plan sponsors who are already under stress with Specialty Drugs, should open up their plans to provide full coverage. Yes, we have an opiod epidemic and this can and will provide some relief for some, but there is a cost to be borne. If the cannabis industry is serious, they should put up the money for clinical trials and prove the efficacy for even just one strain of the plant/drug. Health Canada is not in the business of providing DIN's to products that have not been judged to be safe...So you believe the Government should put up 25M to prove cannabis is safe?? Does Health Canada do this with any other Pharmaceutical looking for NOC?

    Shoppers Drug Mart and the like have opened up their plan for political reasons because they want to be the dispensary of choice when the product is legalized. They don't want that license going to the LCBO (the alternative). If Shopper's was serious about coverage, they would not just provide 1.5K of benefit for 2 very narrow conditions (Chemo and MS). At $2g/day at say $12/g (avg. cost $9-$15) that is 9K annually for the average dosing, they would provide a benefit of 10K/annually. Are they expecting their employees to take just 1/7th of the required dose? Come on, lets get real....Lets put this issue under the full lens of the microscope and not just one side.