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Is medical marijuana covered by medicare or health insurance in Australia?

FAQ

Even though medicinal Cannabis is considered a prescription medicine, it isn't an approved product under the Australian Register of Therapeutic Goods (ARTG). Currently, medicinal Cannabis is prescribed through the Special Access Scheme or Authorised Prescriber Program, which means that, unfortunately, Medicare and PBS don't cover medicinal marijuana.

Private Health Insurance

Your private health insurance might cover part of your medicinal Cannabis cost under their General Treatment or Extras plan. It might be a good idea before you order your medicinal Cannabis to review your policy and check how much you can claim for non-PBS pharmaceuticals under your extras. If it's unclear, you might want to contact your insurer, so you are not surprised by unexpected costs. 

Every private health insurance policy is different. Typically, a provider will cover up to a predetermined maximum cost each year and have a limit on the cost per script. We have seen coverage up to $900, but on average, the coverage is up to $500. You're responsible for paying the maximum PBS amount, which is $42.50.

Health insurance companies that provide some coverage for medicinal Cannabis

Medibank

Health Insurance Fund of Australia (HIF)

Onemedifund

The Defence Fund

Navy Health

Police Health

Transport Health

Insurers who only cover ARTG-approved products;  Epidyolex (for epilepsy) and Sativex (for multiple sclerosis).

nib Health Insurance and HBF

Teachers Health

Health Insurance companies that currently don't cover medicinal Cannabis 

Bupa 

HCF

When making your claim be sure to keep evidence of your TGA approval and verify with your insurer if they will need any extra documentation, so you can ask your prescriber during your consultation. 

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How to access medicinal Cannabis in Australia

In 2017, medicinal Cannabis was legalised in Australia. Medical doctors are allowed to prescribe medicinal Cannabis in Australia, provided they receive approval from the Therapeutic Goods Administration (TGA). In this article we will share how you can access medicinal Cannabis.

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