Medicare Advantage Medicare Marijuana Doctor

[vic120]

I have a client in FL on Humana MAPD

He understands he has to pay for the prescription out of pocket

What he is having an issue with is getting prescription, He was told by his doctor, He has to go to a specific type of doctor called a Medicare Marijuana Doctor, However, the one he spoke with Said he need to pay office visit plus consultation fee and has to pay for visit every 4 to 6 weeks after

He called Humana and they told him they have none in the network in his area, However, they did not say it was not covered, Leavin him to believe it is covered

My question is, Is this just a noncovered service?

Or if covered can he request an out of network doctor be covered if they have none in the area available?

 

[somarco]

HMO or PPO? South FL as in Miami?

Just a wag, and it may vary by jurisdiction, but it MAY be that your MJ Rx needs doc verification on each refil like opioids.

Does the MJ doc have a real degree? Does he/she have a practice that involves pts that need something other than weed?

I know there are docs whose license was yanked that are running pain clinics and writing pain Rx left and right that can only be filled at the pharmacy next door.

Medicare Marijuana Doctor or Medical Marijuana Doc?

 

[vic120]

HMO or PPO? South FL as in Miami?

Just a wag, and it may vary by jurisdiction, but it MAY be that your MJ Rx needs doc verification on each refil like opioids.

Does the MJ doc have a real degree? Does he/she have a practice that involves pts that need something other than weed?

I know there are docs whose license was yanked that are running pain clinics and writing pain Rx left and right that can only be filled at the pharmacy next door.

Medicare Marijuana Doctor or Medical Marijuana Doc?

It is Palm beach

Don't know about all those details about what if a degree or not and such

The main thing I am looking for is if this type of service is generally covered or Not?

I would guess No. However, since Humana just said to him they have no doctors in his area He thinks it is covered and therefore should make an exception for out of network due to not having one in the area

Honestly was surprised Primar could not do it, I did not know they had to go to a special doctor

 

[somarco]

since Humana just said to him they have no doctors in his area He thinks it is covered and therefore should make an exception for out of network due to not having one in the area

Well of course they should make an exception.

We have CA agents on the forum. They might know if it is covered, by exception or otherwise, under insurance plans.

My guess is no but you should encourage him to ask . . .

 

[vic120]

Well of course they should make an exception.

We have CA agents on the forum. They might know if it is covered, by exception or otherwise, under insurance plans.

My guess is no but you should encourage him to ask . . .

I am hoping an agent that has had this issue before can shed some more light

If not that is what I will do

I was hesitant Because in the back of my head I feel like it is a noncovered Doctor in the first place, They only reason I feel like maybe I am wrong and it can be covered is Humana just simply told him they don't have a doctor in his area and did not say it's not covered

So I can't tell him confidently it's not covered or to ask for exception

 

[goillini52]

I am hoping an agent that has had this issue before can shed some more light

If not that is what I will do

I was hesitant Because in the back of my head I feel like it is a noncovered Doctor in the first place, They only reason I feel like maybe I am wrong and it can be covered is Humana just simply told him they don't have a doctor in his area and did not say it's not covered

So I can't tell him confidently it's not covered or to ask for exception

My youngest son qaulifies for a medical marijuana card, but he chose not to get it because in Michigan you can't have a medical marijuana card and a gun permit. His gun permit was more important to him. I'm not sure if that changed after they legalized it.

I'll have to ask him if he had to go to a special doctor to get the weed card.

 

[vic120]

I see

My youngest son qaulifies for a medical marijuana card, but he chose not to get it because in Michigan you can't have a medical marijuana card and a gun permit. His gun permit was more important to him. I'm not sure if that changed after they legalized it.

I'll have to ask him if he had to go to a special doctor to get the weed card.

I See when doing a google search on info In FL def need to see a medical marijuana doctor to get Medical Card

Where I can't find info is if it should be a covered doctor vist for an MA plan, Only thing I seem to get in results are an advertisement for plans

Or the prescription is not covered

Nothing on if the doctor is covered or not

 

[vic120]

I just called one of the places, I found out that the doctor visits are not covered by any insurance due to the fact it's not federally approved

 

[334MEDIGAP]

My wife is med user, it is not a prescription! It is a recommendation from the doctor, that is how these meds are not FDA clinical trial tested, you are not getting prescription medication. Don't get me wrong, I'm all in favor of it, have seen big reduction in pain meds for her. So I don't believe any plan is going to assist with the cost.

 

[goillini52]

I just called one of the places, I found out that the doctor visits are not covered by any insurance due to the fact it's not federally approved

Yep, the prescription can't be covered until the FDA approves it and the FDA can't approve it until it's legalized Federally. I've called and talked to Medicare about it.

That would be fantastic to have Medicare pay for my weed, but unfortunately, COPD's not a qualifying medical condition.