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Why Medicare Still Doesn't Cover CBD Oil, And How That May Change

By Zawn Villines
Medicare does not cover CBD oil, but as research continues, that could eventually change.

Cannabidiol (CBD) is now decidedly mainstream. In fact, CBD-based products have flooded the shelves of many pharmacies and grocery stores in various states. But what about CBD and Medicare? Medicare doesn't cover CBD, despite its growing popularity.

Who Uses CBD Oil, and What Can it Treat?

A 2019 Gallup poll found that 14% of Americans report using CBD products such as chocolates, oils, fragrances, bath products, capsules, and lotions.

Despite limited research on the benefits of CBD, CBD proponents and manufacturers claim it can treat everything from cancer to anxiety. 40% of CBD users say they seek relief from pain. Other popular uses include anxiety (20%), insomnia (11%) and arthritis (8%). These conditions are notoriously difficult to treat. Traditional prescription drugs may cause unpleasant side effects, and do not offer relief to all sufferers. So the promise of a natural substance offering relief for these symptoms is very appealing.

CBD does have one clear, proven benefit. It can treat seizures associated with two types of epilepsy—Dravet syndrome and Lennox-Gastaut syndrome. In 2018, the U.S. Food and Drug Administration (FDA) approved a CBD-based drug, Epidiolex, for the treatment of these severe, rare forms of epilepsy.

Why Doesn't Medicare Cover CBD?

Original Medicare (Parts A and B) only covers treatment received in a medical facility such as a hospital or doctor's office. Part B covers a very limited number of prescription drugs, and CBD medications are not on that list.

Medicare beneficiaries have the option to purchase a Part D prescription drug plan in order to expand their drug coverage. They may also opt for private insurance through a Medicare Advantage (Medicare part C) plan, many of which cover prescription drugs.

However, even with a prescription drug plan, you cannot get coverage for CBD oil and other over-the-counter products. There are at least two reasons for this:

  • There are no drug products containing CBD, other than Epidiolex, that are approved by the FDA.
  • According to the Centers for Medicare & Medicaid Services, Part D plans only cover drugs that have been approved by the FDA.

If you have a prescription for Epidiolex and your Medicare Part D or Medicare Advantage plan covers the drug, then you can use Medicare to access this one medication containing CBD. However, a recommendation from a doctor that you try over-the-counter CBD oil is not sufficient for using Medicare to pay for any other product containing CBD. 

Will Medicare Cover CBD Oil in the Future?

With so many potential uses of CBD, research is ongoing. If scientifically-rigorous evidence finds support for other CBD uses, manufacturers could develop CBD-based drugs for many conditions.

If these future drugs receive FDA approval, they could also become medically-recognized prescriptions. That would open the door to Medicare coverage. No such drug approvals are on the immediate horizon, althoughsearch leaves open the possibility that Medicare may eventually cover other prescription forms of CBD.