CanadaHealthIndustry

Canadian Health Insurer Announces Groundbreaking Medical Cannabis Plan

Published on February 15, 2018 · Last updated July 28, 2020
this image was taken of some marijuana used for medicinal purposes

One of Canada’s biggest health insurance companies will soon offer coverage for medicinal cannabis. Sun Life Assurance Co. of Canada today announced an extended-health care plan that insures medicinal marijuana, with the option available to members starting March 1.

Sun Life supplies group health and dental benefits to 22,000 businesses in Canada—or one in six Canadians.

The Toronto-based firm supplies group health and dental benefits to 22,000 businesses in Canada—or one in six Canadians. In its press release, Sun Life said coverage will range from $1,500 to $6000 a year, and will apply to cannabis dispensed “according the government regulations.”  Plan members and their dependents must meet clinical criteria or have undergone a prior approval process.

“Medical evidence supports the use of cannabis for some serious and severe medical conditions,” said Dave Jones, senior vice-president of group benefits, to  The Globe and Mail. “As this has become something our clients have been asking us about more and more, we have moved from the stage of evaluate and review, to now offering it as a benefit for medicinal purposes.”

Due to cannabis' lack of a drug identification number, Sun Life will cover medical cannabis under Medical Services and Equipment.

A longstanding obstacle for medical marijuana has been its lack of a drug identification number (DIN), without which it is ineligible under most employee health care plans. As a result, Sun Life will cover medical cannabis not through drug benefits but under the Medical Services and Equipment section of the extended plan, making medicinal cannabis subject to the same deductibles and reimbursements as other expenses in this category.

Jonathan Zaid, executive director of Canadians for Fair Access to Medical Marijuana (CFAMM), said the news is a positive step forward for the broader cost coverage of medical cannabis. However, since the plan is an optional add-on and not underwritten in normal drug benefits, it still rests on individual plan sponsors—the employers—to buy the coverage.

“We hope (employers) will see the positive benefits in medical cannabis coverage for their employees and include this type of coverage on their plan.”

“We hope plan sponsors will see the positive benefits in medical cannabis coverage for their members and employees, including potential cost savings and substation of more harmful drugs, and include this type of coverage on their plan,” said Zaid.

It’s also going to provide valuable counterevidence to the United States’ designation of cannabis as a Schedule I narcotic—how can the feds continue to claim cannabis has “no known medical benefits” when it’s covered by Canadian health insurance?

As for the specific conditions and symptoms covered under the Sun Life plan, they mostly relate to pain, nausea and appetite, and include:

*Severe or refractory pain related to cancer and nausea associated with cancer treatments

*Neuropathic pain and spasticity related to multiple sclerosis

*Pain related to rheumatoid arthritis that doesn’t respond to standard therapy

*Anorexia and neuropathic pain related to HIV/AIDS

*Palliative care

Sun Life says it will continue reviewing advances in clinical evidence related to conditions that currently don’t apply for coverage.

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Elianna Lev
Elianna Lev
Elianna Lev is a writer who splits her time between Toronto and Vancouver.
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