Frequently Asked Questions: Insurance
Is there coverage for medical cannabis under my provincial government drug plan?
Currently, there is no coverage for medical cannabis under provincial drug plans (e.g. OHIP). However, we offer several Financial Access Programs to help assist with the cost of your medicine.
Is there coverage for medical cannabis under my private insurance?
You may have coverage for medical cannabis under your private insurance plan. Since everyone’s drug plan varies, please reach out to your insurance provider to confirm if you have any coverage under your plan and if so, how much, and how to be reimbursed for it. The number to your insurance company is generally found on the back of your benefits card.
I have private insurance with Manulife/GWL/Johnston Group, can you directly bill them for my medical cannabis?
For us to be able to directly bill your medical cannabis purchases to a Manulife/GWL/Johnston Group plan, please first confirm with your private insurance company if you have coverage for medical cannabis under your particular plan.
If so, please ask your insurance company for a Prior Authorization Form. Your family doctor or medical cannabis prescriber would need to fill this Prior Authorization Form out for you to submit to your insurance company. Once submitted, your insurance provider will assess the information on the form to see if you meet the criteria required for coverage. Every insurance company uses a different set of criteria to assess eligibility. For more coverage details, please contact your insurance company directly.
If your insurance company approves your coverage for medical cannabis, they will forward us your coverage details and limits.
For Manulife patients, we will reach out to notify you when we receive your coverage approval.
For all other insurance companies, you will receive a letter from your insurer to notify you of the outcome of your prior authorization request for coverage. If you are approved, please contact us and we can assist you with direct billing for your orders.
What is a medical allotment deduction?
A medical allotment deduction is the number of grams will be deducted from your authorized amount when you purchase a product. For dried cannabis flower, 1g dried flower is equal to 1g Medical Allotment Deduction.
Gram for gram, products such as edibles, oils, creams, and vapes have a greater concentration of cannabis than flower does, so they are assigned a medical allotment deduction greater than their physical weight based on their concentration and cannabinoid content. This equivalent amount makes up the medical allotment deduction.
I see on the website I can order up to 150g at once, will I be fully covered for this?
The previous Canadian medical cannabis legislation, called Access to Cannabis for Medical Purposes Regulations (ACMPR), included a “30-day limit rule”, meaning a federally licensed seller could not dispense to a patient more than 30 times the daily prescribed quantity in a 30-day period, and no more than 150 grams of product at any one time. This rule was removed from the Cannabis Act to ensure there is no disruption in your supply of medicine.
In compliance with the Cannabis Act, we removed the 30-day limit, meaning there is no longer a limit on the amount of cannabis you can purchase in a 30-day period. Registered patients can now purchase up to 150 grams (or the equivalent) of medical cannabis per order. There is no limit to how many 150-gram orders you can place.
If you are eligible for reimbursement coverage, there may still be monthly or yearly limits. Anything purchased outside of your reimbursement limits will require payment out of pocket.
Can you send me a copy of my medical document for insurance purposes?
Please reach out to your healthcare provider for a copy of your medical document.