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Can Health Insurance Plans Provide Coverage for Medical Marijuana Claims?

The presence of legalized medical marijuana has not only been increasing throughout New Jersey, but nationwide, and it appears this trend will continue. Currently, medical marijuana is not covered under health insurance plans in the U.S. and it is likely to remain that way if it remains a Schedule I drug. The FDA’s approval is needed for drug coverage under all group health insurance plans, and it is unlikely approval will change until the Controlled Substances Act (CSA) is changed. Do these rules apply to self-insured group health plans? Although self-insured group health plans can operate with a degree of discretion, they can still face consequences of such coverage. The Internal Revenue Service (IRS) has made it clear with IRS Publication 502, that “qualified medical expenses” cannot include medical care using illegal drugs. Although rare, it is possible for the IRS to disqualify a groups health insurance plan if they provide these benefits to their participants. As more drugs are removed from the CSA Schedule I list and approved by the FDA, it is possible that we could start seeing coverage changes in the next several years. To learn more about health insurance plans and medical marijuana, read my blog post on Employee Benefits Informer.