The Winds of Change

Is Medical Cannabis the Next Employee Health Benefit?

Medical cannabis is a controversial enough subject, without adding to the conversation whether your workplace employee benefit plan will cover the cost.

Or not.

If you’re one of the lucky Canadians who has access to an employer-provided health insurance plan or health spending account (HSA) then your plan likely provides access to certain prescription and non-prescription medications as well as a variety of other benefits like dental, vision care to chiropractic, to name a few.

Now that cannabis is a legal treatment option for patients in Canada, coverage of associated costs through your plan is becoming more and more likely.

However, at this time, most Canadian plans do not consider requests for coverage of medical cannabis. But, the winds of change are blowing through the health insurance plan hallways, and that wind smells like pot.

A CBC News article published in May 2017 quoted benefits industry insider Mike Sullivan who represents private companies with benefit plans that cover about three million Canadian workers across a range of industries.

“The insurance industry itself has been hesitant to cover medical marijuana”, according to Sullivan. “Insurance company actuaries cannot get their head around how to price the risk of medical cannabis” he adds, citing the range of products available, the personalized nature of dosing, and the wide range of potential indications as complicating factors.

What About Your Plan?

Does your employer administer its own employee health benefit plan while paying the costs of coverage directly themselves? This arrangement is also known as self-insured or self-funded.

Self-insured companies get to choose what their benefit plans cover — and apparently, many of their workers want medical cannabis coverage. Further, if your employer offers an individual HSA, which allows discretionary spending of an annual amount of money on approved medical expenses-that likely opens the door for cannabis coverage.

The CBC article goes on to say that paying for employees’ medical cannabis raises a host of complex questions, especially in safety-sensitive industries.

Yet, as self-insured health benefit plans start covering medical cannabis, employees shouldn’t expect blanket approvals for the drug. Coverage will be approved on a case-by-case basis.

However, all is not lost.  If your health plan or HSA rejects your claim for coverage, remember medical cannabis still qualifies as a legitimate medical expense under Canada Revenue Agency guidelines.

Canadian Companies Leading the Way

Loblaw Companies; but only in a limited number of cases (restricted to covering MS and chemotherapy patients at this time).

Ontario Public Service Employees Union (OPSEU) began rolling out a new benefit that provides medical cannabis coverage for insured staff.

Veterans Affairs Canada has a reimbursement policy on medical cannabis which allows a limit of up to three grams a day.

Shoppers Drug Mart has introduced a medical marijuana benefit to their drug plan which comes with a cap of $1,500 per year.

And the list continues to grow.