Medavie Blue Cross has introduced a new Extended Health Care benefit covering medical cannabis. The benefit is available as an optional, stand-alone coverage option for plan sponsors effective October 2018.

The medical cannabis benefit is provided as a reimbursement benefit covering fresh and dried cannabis and cannabis oil. Other cannabis products and products related to the consumption of cannabis are ineligible. Plan sponsors may choose from a few different annual benefit maximum options.

To qualify for reimbursement, plan members must receive pre-authorization and obtain medical cannabis in accordance with the Access to Cannabis for Medical Purposes Regulations (ACMPR). Clinical evidence supporting the use of cannabis for medical purposes remains limited. Coverage will be considered for certain conditions based on Canadian Family Physician Guidelines for prescribing medical cannabinoids:

  • Chronic neuropathic pain
  • Refractory pain in palliative cancer
  • Nausea and vomiting due to cancer chemotherapy
  • Spasticity in multiple sclerosis or spinal cord injury

Cannabis is a complex substance unique in the health benefits landscape. It is not considered a prescription medication by Health Canada and does not meet typical requirements to be eligible for coverage under a prescription drug plan. Medavie Blue Cross will continue to monitor the latest clinical evidence and emerging trends to assess the new benefit on an ongoing basis.

Interested plan sponsors may reach out to their Medavie Blue Cross representative for additional information, or to discuss adding the optional benefit to their plan.