Medicare does not cover CBD oil, but as research continues, that could eventually change. There are four different ways to get a prescription for CBD oil or medical cannabis products. Learn how to get a cbd oil prescription in Canada. Answers to the key questions: How to get CBD on prescription? Who's eligible? What products are available? How different are these to CBD supplements?
Why Medicare Still Doesn’t Cover CBD Oil, And How That May 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.
How to get a CBD oil prescription or medical cannabis prescription
There are four ways to get a prescription for CBD oil or other medical cannabis products:
- From your doctor or specialist
- From a cannabis nursing service
- From a cannabis clinic (“canna clinic”)
- From a cannabis telemedicine service
Here’s what you can expect from each of these approaches.
Your doctor or specialist
Very few doctors and specialists are readily prescribing cannabis, for a variety of reasons. Many will simply refer you to a cannabis clinic, or even suggest you go buy it from a retail store.
If your doctor is knowledgeable and willing, count yourself lucky. That said, they are unlikely to have time to educate you on all of the ins-and-outs of medical cannabis, or help you decide which licensed producer to register with. Nor are they likely to have staff at their clinic who can help.
Some doctors may have a single licensed producer that they have a relationship with. They will forward your prescription to that producer, who will then call you to help you choose a product. It’s convenient for the doctor, but it doesn’t leave the patient with any choice of producer. This is unfortunate because no single producer can meet the diversity of needs that patients have.
[By the way, Wayfare works with quite a few doctors who are prescribing cannabis but count on us to provide educational support to their patients. We can even help prepare documents you can take to your doctor.]
Cannabis nursing service
You can think of this service as a mobile clinic. The nurse will come to your home, provide education, take a medical history and connect with a doctor or Nurse Practitioner to obtain the authorization. She will also help you select an appropriate product and develop a detailed treatment plan and dosing schedule. She will then help register you with a licensed producer so you can order products by phone or on-line, and will follow up with you semi-weekly while you work toward your goal.
The cost for this service is usually fully-covered by insurance as a home nursing expense.
Wayfare falls into this category, although we do often work with patients’ own doctors, and there are some cannabis clinics who refer to us to provide extra support for patients. We are now also providing a telehealth option as well.
Over the past few years a number of specialized cannabis clinics have opened up. These are typically staffed by doctors who work there on a part-time basis. These doctors may come from specialties including psychiatry, surgery, and anesthesiology. This means that some patients may see a heart surgeon for their arthritis! But really, bless these doctors for making time to learn about cannabis and help people.
The educational portion of your visit, where you select a licensed producer and product, is quite often handled by a lay person who may have the title of “cannabis educator”, “canna counsellor”, or “patient educator”. These people rarely have medical training, although they may be knowledgable about particular strains, the pricing programs of the various producers, and how to use a vaporizer.
Cannabis telemedicine services
You can get on a video conference with a doctor or Nurse Practitioner, who will assess you and provide an authorization for medical cannabis. Some of these services are stand-alone whereas others are provided by cannabis clinics as described above.
The educational component of the service may again be handled by a lay person, sometimes via a separate video call or by telephone through a call centre.
Can you get CBD on prescription?
CBD is available on prescription in the UK, but the process can be time consuming and expensive. The latest National Institute for Health and Care Excellence (NICE) guidelines have prevented the NHS from supplying anything but a small selection of licensed cannabis-based products.
However, the introduction of several private cannabis clinics means that a range of CBD and cannabis products can be prescribed if a specialist doctor believes it’s the only practical option.
CBD products on this site are sold as food supplements. They are not intended to assist with the diagnosis, prevention, treatment, or cure of any disease, ailment or medical condition. Any statements provided on this site are for information only and do not constitute medical advice. Read our full legal disclaimer for more information.
What products are available?
In the UK, cannabis-based products for medicinal use in humans’ (CBPM) fall into two main categories.
These are medicines that have been trialled and approved by the MHRA for specified uses. There are three cannabis-based medicines licensed for use in the UK:
- Epidyolex (aka epidiolex) – This is a pharmaceutical preparation of CBD designed for oral consumption. It has 100mg per ml, which is about 10%. The pure CBD is mixed with sesame oil, dehydrated alcohol, strawberry flavour and sucralose. Specialists can only prescribe Epidyolex for seizures associated with Lennox-Gastaut syndrome and Dravet syndrome.
- Sativex – This is a mouth spray produced from cannabis with a 1:1 ratio of THC to CBD. A specialist can prescribe it for moderate to severe cases of the muscle stiffness caused by Multiple Sclerosis.
- Nabilone – Also known as Cesamet, this is a synthetic cannabinoid that can be prescribed by a specialist if other medicines are unable to reduce the severity of the nausea and vomiting caused by chemotherapy.
Because these medicines are licensed, their use is strictly controlled. Unless you’re receiving specialist treatment for one of the conditions mentioned, you won’t get a prescription for them.
An unlicensed medicine hasn’t yet been through the authorisation process, or is being used for a different reason to that outlined in the license. Medications like this will only be prescribed after careful consideration by a multidisciplinary team of specialists. They must look at the evidence available and decide if an unlicensed medicine is the best option.
Despite the slightly worrying term ‘unlicensed’, these products are produced to strict MHRA standards and sourced from pharmaceutical companies. There may not be enough evidence to apply for a license, but they won’t be prescribed unless the prescriber has weighed up all the options.
Unlicensed cannabis-based medications available in the UK include:
- Cannabis flower
- Hemp flower
- Cannabis oil
- CBD oil (doctors can prescribe higher daily amounts than is allowed by the current FSA guidance for CBD food supplements.)
- THC and CBD products for vaporising
If you receive a prescription for an unlicensed cannabis-based medication, the type and cannabinoid content of what you receive will depend on what your specialist doctor thinks is appropriate for your condition. They will write the prescription and the pharmacy will try to source it. With several specialist cannabis clinics opening in the UK, it’s more likely that you’ll be able to find a pharmacy that can fill your prescription.
Who is eligible for a prescription?
You’re eligible for a prescription for a CBPM or CBD oil if a specialist doctor believes that it’s the most appropriate medication for your condition. This is likely to be after you’ve tried several other options and your remaining choices are limited.
However, you’re only likely to receive a prescription from a private specialist doctor or a cannabis clinic. This is because NHS doctors follow the guidelines outlined by the National Institute for Health and Care Excellence (NICE). These currently recommend that:
- Doctors should not prescribe CBD or THC for chronic pain.
- Nabilone may be used for specific cases of nausea and vomiting.
- Sativex is appropriate for some adults with MS.
- Epidiolex should only be used as part of a scientific study.
If you choose to pay for a consultation with a private specialist, they may prescribe a CBPM if you have one of the following conditions:
Cancer-related appetite loss
Inflammatory bowel disease
Irritable bowel syndrome
Autistic spectrum disorder
Alzheimer’s disease symptoms
Chronic fatigue syndrome
Traumatic brain injury
Multiple Sclerosis Neuropathic pain
Functional neurological disorder
Motor neurone disease
Muscular dystrophy symptoms
Degenerative disc disease
Spinal cord injury/disease
Post-operative surgery pain
Sleep disorder Posttraumatic stress disorder
Having a diagnosis for one of these conditions does not automatically qualify you for a CBD or medical cannabis prescription. But, if you’ve unsuccessfully tried conventional medications and there are no more available to you, you may be eligible.
How can I get a prescription?
If you’ve exhausted all other options to treat your condition, you can book a consultation with a private specialist doctor or cannabis clinic. Although any doctor on the special register of the General Medical Council can legally prescribe CBPM, some may be reluctant to and might not have access to pharmacists who can fill the prescription. The best option is cannabis clinics staffed by specialist doctors who can guide you through the process and fill your prescription.
In most cases, the cost of a private consultation, repeat appointments and medication can range from a total of between £200 to £450 per month. The medicine itself is costly because multiple companies are involved from farming to production and delivery. At each stage, extra costs are added, resulting in an expensive end product. However, there are now a small number of companies who own every step of the process so are able to keep the costs down.
Although the process differs with each clinic, these are the likely steps involved:
- Find a clinic. Several options can easily be found on Google.
- Visit their website and complete the online form. They will likely want to collect personal and medical details, including permission to access your records.
- If you’re accepted to the next stage, you should receive information on how to pay for and book an appointment.
- Attend the appointment. This will be with a specialist doctor and may be over the phone or in person. It will likely involve a discussion about your condition and possible treatment.
- If they decide to prescribe you a CBPM, they will talk you through the options, including possible strengths and strains. If you want a CBD-only product such as CBD oil you can discuss this with the doctor at this point.
- Most clinics will now pass your prescription to their pharmacy who will contact you to arrange payment.
You may be eligible for a subsidy with Project 21
Project 21 is an ambitious research project that aims to create a large body of evidence on the effects of cannabis-based medicinal products. To do this, they hope to recruit more than 20,000 participants and offer them a £150 per month subsidy towards the cost of private medical cannabis.
To be accepted, you must have a history of at least two prescribed medications, that failed to manage your condition effectively and a diagnosis of at least one of these conditions:
- Anxiety Disorder
- Chronic Pain
- Multiple Sclerosis (MS)
- Post-Traumatic Stress Disorder (PTSD)
- Substance Use Disorder
- Tourette’s Syndrome
If you’re eligible for Project 21, you’ll still need to make an appointment with a clinic and follow the steps above to be assessed for a prescription. However, there is a list of approved Project 21 partners that are the best place to start.
What is the difference between prescribed CBD and CBD food supplements?
CBD oils and other products with concentrations ranging from 1% to 50% are already legal and available in the UK. There are also many brands whose products undergo third-party lab tests and meet high quality and safety standards.
The difference with prescribed CBD is that a doctor will match a specific product and strength to your diagnosis. Because it’s an unlicensed medicine, they aren’t bound by the same restrictions as retailers are for food supplements. They can prescribe daily amounts that could even be as much as 1000mg if they consider it necessary. They could even prescribe a product with a higher level of THC if they believe that it’s the best course of action for you.
Currently, prescription CBD oils are likely to be slightly more expensive than food supplements and they have the additional cost of private doctors’ appointments. However, clinics and suppliers are working together to bring the prices down and make it more accessible for those who need it.
Since the legalisation of medical cannabis in 2018, it’s taken a disappointingly long time for genuine patients to be able to access the treatment they need. However, now things are moving faster. If you go private, you can get an appointment with a specialist doctor with the ability to prescribe CBD oils and cannabis-based medications.
Join us to get updates and special deals monthly:
Tom Russell writes extensively about CBD oil and other groundbreaking food supplements. He and his wife share their home with two daughters and a lifetime’s collection of books.