Will insurance companies cover medical cannabis?

Medical cannabis is typically taken with a ‘start low, go slow’ approach, with doses gradually increased to the desired level.

But playing this long game can become expensive. In the absence of NHS prescriptions, patients are increasingly accessing private prescriptions and their monthly bills can mount up.

Often medical cannabis is taken to treat a long-held condition like fibromyalgia that various pharmaceutical drugs have failed to tackle.

Should the need to try it emerge out of a new diagnosis, however, would insurers cover it? Perhaps it is needed for pain relief in chemotherapy or in the aftermath of a serious injury, for example.

The insurance giant AXA is particularly open to the idea.

Its PPP Healthcare division tells Cannabis Health it does not “regard the use of medicinal cannabis any different from that of any other treatment”.

When covering the cost of drug treatments on its health insurance plans, the firm has two criteria that must be met. The drug must be:

• Licensed for use by the European Medicines Agency or the Medicines and Heathcare products Regulatory Agency
• Used according to that licence

In a blow to those who are arguably most likely to use the treatment though, the company stated that its policies are “designed to cover the cost of treatment of unexpected illness and conditions that respond quickly to treatment”, meaning cover may not extend to those with chronic conditions.

As it only offers life insurance, critical illness cover and income protection, LV= advised us that it wouldn’t be able to comment specifically on whether insurers should pay the cost of actually supplying medicinal cannabis, for example, a treatment payment under a PMI type policy.

But the company has shared a similar view to AXA PPP, stating: “Our customers may have underlying medical conditions, which they may use medicinal cannabis to help treat. Any medicinal cannabis use in itself is usually acceptable for protection insurance.

“All cases would be considered on an individual basis, taking into account primarily the actual medical condition and the mortality/morbidity risks associated with the condition.”

Another insurer, North East Healthcare Solutions (NEHS), however, advised Cannabis Health that it is “not aware of any insurers in the UK who currently cover the cost of treatment”.

The firm said: “UK private health insurance plans are designed to cover acute conditions, and only cover medications as an inpatient. As an outpatient, policy holders would get medication on the NHS or pay privately.

“Several of the conditions where medical cannabis is being used by patients is for chronic conditions, which again are not usually covered by UK insurers as plans are designed to diagnose and treat acute conditions, and only flare-ups of chronic conditions.”

NEHS continued: “When asked directly most insurers have either declined to comment, with others stating that they would not cover it as an out-patient medication.”

Professor Mike Barnes, chair of the Medical Cannabis Clinicians Society, says: “It’s a great pity that such a valuable medicine is not covered by insurance as most conditions helped by cannabis are by nature chronic, such as chronic pain or anxiety or epilepsy.

“Sometimes though cannabis can help an acute condition, such a more acute pain or nausea during chemotherapy, so I hope that insurance companies will cover this valuable medicine in those circumstances.”

Zurich is its native Switzerland’s largest insurer, and also holds a very strong customer base in the UK. As the company provides life insurance rather than health, its policies wouldn’t cover the cost of medicinal cannabis. It has, however, outlined its approach to insure those who use the treatment.

The firm stated that if a customer discloses that they use cannabis, they will be asked if it has been prescribed by their doctor or GP, full details on this prescription including the medical condition it is used to treat, and a doctor’s report. Depending on statements from the doctor, the company’s stance then differs slightly.

If the doctor confirms cannabis is being prescribed for a medical condition and is not being smoked, the customer will be assessed, but no additional rating or exclusions would be applied for the use.

However, if the cannabis is being smoked, or there is no valid prescription for it, the customer would be assessed as per any other individual who smokes cannabis. For less frequent use – 3 to 4 days per week – standard terms of insurance would usually be available to the user. Those with heavier use – over 16 days per month or over four days per week – would be subject to a loading or increase applied to their premium.

If adverse features such as alcohol issues or drug dependency were found, this may lead to no acceptance being made available to the customer.

Aviva held a similar stance to AXA PPP, stating that the conditions medical cannabis is usually recommended for are chronic conditions, which are not covered by private medical insurance.

When contacted, American International Group (AIG), which operates in over 80 countries and underwrites policies for several providers, was unable to comment.

Previously, speculation suggested that health insurance would not cover the use of medical cannabis in the UK, despite legalisation of use in late 2018 and resistance from the NHS, and these comments appear to back up these claims.

While it appears firms have no problem insuring those using the treatment – as long as it is prescribed and being taken solely for pain relief – some are reluctant to actually pay the costs.

It is important to remember that this is a constantly evolving treatment, and as the usage of medical cannabis continues to grow, policies and standings are likely to change too.

In the meantime, there are, at least, signs that insurers are adjusting to the emerging medical and wellbeing cannabis markets in the UK.

Erimus, a boutique insurance broker, said it recognises the ever-changing nature of the treatment and how insurers must constantly adapt to the changes.

It told Cannabis Health: “The insurance market for medicinal cannabis and cannabidiol (CBD) is continuing to evolve, with insurers developing specific wordings to meet the needs of growers, manufacturers, retailers and medical practitioners.

“Certain Life Sciences insurance providers can accommodate cannabis and CBD risks. Risk appetite varies and is dependent upon the end use of the product. As this is an emerging market, insurers have limited claims data available to assess risk. Therefore, some providers are more cautious than others.

“The insurance market for manufacturers and suppliers of products that contain a small amount of CBD in creams/balms but excluding edible substances is wider than for products that are edible and/or consumed.”

According to the firm, specific points insurers will need when deciding on policies include:

• Where is the CBD sourced from, can suppliers be easily traced and held legally responsible?
• Is the CBD isolate from THC and how/where is this tested?
• Are there any consumables?
• What raw products are used and where will end products be supplied to?

Details of compliance with relevant laws and regulations relating to the supply of CBS products, including licensing and certification by relevant health and government advisors/agencies.