Why marijuana is rejected by health insurers?


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Just when you think medicinal marijuana is winning the hearts of many, there’s a new blow that’s both unwelcome and totally arbitrary. However, health insurers are justified for excluding this medical treatment from their coverage.

Patients in the USA may now legally acquire marijuana for medicinal purposes to relieve their pain and chronic symptoms. But they have to pay for these treatments some other way since health insurers are now reluctant to cover it because of conflicting laws.

From the Perspective of the User

Last week, news about the latest health insurance controversy is getting attention from marijuana users for being too arbitrary. ABC news calls it an “unwanted hit” for marijuana users who pay up to $1,000 per month to manage their pain, curb their appetite or stop seizures.

Over the recent years, marijuana has been gaining wide acceptance for its wonderful role in medically treating chronic patients. The law has also been quite accepting as several states are already lifting the marijuana ban for recreational use (citing Colorado’s new ruling as reported by ABC news back in January 2014.

But in as much as anyone can legally and within limits use marijuana casually, it doesn’t feel as casual to the one who uses it for medicinal purposes. Costs of marijuana use can pile up monthly. Having insurance carry this weight for them, at least partially, is a big help.

At an approved dispensary, buying 1/8 of an ounce of marijuana to make 3 – 7 seven joints can cost a buyer up to $60. Advocates for the marijuana safe use monitor the prices for fear of arbitrary pricing caused by competition. If you’re a patient who can afford to shell out about $1,000 per month for this, you wouldn’t be affected by the news.

The only way you get a break at the costs is if you have a low income exception status which isn’t easy to apply for at legalized dispensary shops.

There isn’t any cheap and easy way to get marijuana. If you live in a state where cannabis is available for medical use, getting it legally can only be done via a government-approved dispensaries. And this is something advocates seem to keep fighting against.

What’s in their way now is the fact that health insurers are refusing to carry the costs for marijuana use.

From the Perspective of the Insurers

But no one can blame insurers for this reluctance at all. They’re also facing their own obstacles, which is something the public doesn’t seem to get.

Part of the problem is the conflicting laws: 21 States approve marijuana for medical use, but the federal ban on this Schedule 1 narcotic is still in place and implemented.

That’s not even the “meat” of the difficulties insurers are facing now.

The government is deliberately making marijuana difficult to acquire for a reason. It’s a narcotic whose ingredient is still capable of placing lives in danger for abuse and misuse. That’s why several safety measures are in place. The law criminalizes casual use and so is the growing, manufacturing and selling (distribution) of marijuana.

However, more leniencies have been shown by making medicinal marijuana available. The only thing is regulations have to be strictly followed.

Health Insurers are careful in considering medical marijuana part of their roster of approved medications. The dilemma is this: They know people would gladly pay for insurance if they carried medical marijuana. But the regulations and the red tape won’t allow them to.

What they need to do isn’t easy should they really pursue this move.

First, they have to tackle the U.S. Food and Drug Administration. As a rule, insurers generally can’t cover treatments that aren’t approved by the FDA. Next, treatments have to first undergo major clinical studies to “measure safety, effectiveness and side effects”. Research like this can take years and millions in cost.

So far, insurers haven’t seen enough evidence in the marijuana medical journal that it’s safe to use and more effective than medicines in treating particular diseases and symptoms. That’s why the insurance industry considers marijuana unchartered territory.

And what’s not helping is the federal ban which still classifies it as a drug with no medical use. Hence, there’s a need to further study its effects.

Secondly, researches of this type of caliber and precedence requires the FDA stamp of approval. Then, many government agencies will want to hone in on the issue. Next, the Drug Enforcement Administration would also have to issue permits for securing facilities for the actual testing, acquiring of scientists and the National Institute on Drug Abuse (NIDA) would also want a complete explanation of why this study has to take place.

And if this isn’t enough, researchers can only use marijuana supplied by NIDA. That means the samples would be very limited. Patients, too, who would participate in the study must be monitored from day 1.

The bottom line is this: The road from approval to insurers finally getting the go signal to carry marijuana is long and fraught with challenges. The government must do its job to keep marijuana off the hands of those who find no logical use for it. Addicts have been made and lives were destroyed in the process.

Making it legal and having your insurance pay for it isn’t going to happen any time soon. Not when the government can still do something about it.

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