With the legalization of recreational marijuana looming in Canada, businesses across the nation are setting themselves up to be a part of this potentially lucrative industry. This shift in the public perception of the drug is also pushing the healthcare community to re-evaluate their stance on medicinal marijuana, including health benefit providers.
One of the main reasons why medical marijuana insurance claims are denied is because of their lack of a Drug Identification Number (DIN). Health Canada assigns a DIN to a drug after it has gone through research trials and testing. Having a DIN is the industry standard for allowing the drug to be sold or reimbursed. For insurance companies, this means no DIN, no coverage. But it is easy to see that the landscape is changing.
Starting March 1, 2018, Sun Life has introduced medical cannabis as an optional coverage add-on to it's Extended Health Care benefit. This means that employers who have Sun Life plans now have the option to purchase medical marijuana coverage for their group benefits plan.
This coverage, however, does come with many caveats and a lot of paperwork. The below information comes from Sun Life’s Focus Update published on February 15, 2018.
Eligibility: Plan members are only eligible for this coverage if they meet the clinical criteria as defined by Sun Life. Conditions eligible for coverage currently include Cancer, Multiple Sclerosis, Rheumatoid Arthritis, HIV/AIDS, and palliative care. Additionally, these conditions require that specific symptoms are present.
Approval: Plan members must submit an approval form for adjudication by Sun Life. They must also comply with ACMP Regulations which means providing a physician’s letter and registering with a Health Canada authorized medical cannabis producer.
Although this may not be the all-encompassing coverage with easy access that a lot of people are looking for, it is still a step in that direction and should be recognized as such.
If you want to add medicinal marijuana coverage to your benefits plan, but you are not currently with Sun Life, you don’t have to change carriers. Medical marijuana is listed as an eligible medical expense with the CRA*, meaning that it can be claimed against a Healthcare Spending Account (HSA). HSAs are offered by most insurance carriers and can be added onto a traditional benefits plan with relative ease.
With that being said, although HSA’s are generally open to the CRA eligibility list, this does not mean it will automatically be covered. Plan members will still have to follow ACMP Regulations. Before submitting a claim, we recommend speaking to your insurance carrier representative to know if your expenses will be covered and what documentation is required.
*subject to change, check the CRA website for the most up-to-date list of eligible medical expenses
Are you with Sun Life and want to add Medical Marijuana coverage? Do you want to add an HSA to your existing plan? We are happy to help! Email us at email@example.com to get in touch with our experienced group benefits team. See Humi Benefits
Hilary is a Client Experience Manager at Humi and has a penchant for salty snacks.