One of the most frequently asked questions we receive are “Does private health insurance pay for Medical Cannabis or CBD oil in Australia?”.

The costs of Medical Cannabis may be overwhelming compared to first-line treatments however, some are looking towards their private health insurers to lessen the financial blow of their treatment. In Australia, most patients are used to lower medical costs thanks to Medicare and the PBS. However, when it comes to Medical Cannabis, subsidies and claims can vary depending on the insurance provider.

Does the PBS cover Medical Cannabis?

The short answer is no. Unfortunately, Medical Cannabis products such as cbd oil is not covered by the PBS. This is because Medical Cannabis is an unapproved medication in Australia, and it is not listed on the Australian Register of Therapeutic Goods (ARTG). The reason Medical Cannabis is not listed on the ARTG is due to a lack of clinical research to meet the eligibility requirements for a listing. Currently, there are only two Medical Cannabis products listed on the ARTG; Sativex and Epidiolex, however, the PBS does not cover these products.

What about Veterans?

The Department of Veteran Affairs (DVA) is responsible for supporting those who serve or have served in the defence force. With regards to Medical Cannabis, the DVA patients can apply and may be approved for a subsidy for consultation costs and products. If you’re a veteran, please visit our DVA article here for more information.

What private health insurances cover Medical Cannabis?

In order to help you, we’ve listed below some private health insurers that may subsidise Medical Cannabis along with the process you will need to take to begin your claim.


Download Insurance Comparison

 

You may need to provide your private health insurer with some documents in order to be eligible for cover. These documents may be:

  • A letter from your doctor
  • A receipt of your product from your pharmacist (This receipt is a specific receipt different to a tax invoice)
  • Proof of your TGA approval

Claims Processes for each private health insurer

AHM

The AHM claims process is:

Purchase your Medical Cannabis medication, ask for a receipt. Download the AHM app. Complete the claim through the app.

(OR)

Purchase your Medical Cannabis medication, ask for a receipt. Fill out the claim form from ahm.com.au. Email your claim form with the invoice/receipt to info@ahm.com.au.

(OR)

Purchase your Medical Cannabis medication, ask for a receipt. Log into the AHM website

(www.ahm.com.au). Make a claim.

CBHS Health Fund

The CBHS Health Fund claims process is:

Call CBHS and ask for ‘pharmacy forms’. Ask your doctor to fill out the forms. Purchase your Medical Cannabis medication, ask for a receipt. Download CBHS app. Complete the claim through the app.

(OR)

Call CBHS and ask for ‘pharmacy forms’. Ask your doctor to fill them out. Purchase your Medical Cannabis medication, ask for a receipt. Download claims form from CBHS’s website. Send forms and receipt to claims@cbhs.com.au.

Defence Health

Purchase your Medical Cannabis medication, ask for a receipt. Ensure you have evidence of TGA approval. Download Defence Health App. Complete the claim through the app.(OR)

Purchase your Medical Cannabis medication, ask for a receipt. Ensure you have evidence of TGA approval. Get claims form from defencehealth.com.au. Email your receipt and the claims form to claims@defencehealth.com.au

Health Partners (Excl. SA)

Purchase your medication, ask for a receipt. Make your claim through the Health Partners App.

(OR)

Purchase your medication, ask for a receipt. Log into Members Online at healthpartners.com.au. Make your claim.

Health Partners (SA)

Purchase your Medical Cannabis  medication from a pharmacy that dispenses medicinal cannabis. Present your Health Partners card. Pay the reduced amount on the spot.

HIF

Purchase your Medical Cannabis medication, ask for a receipt. Keep a copy of your script to include in claim. Download HIF app. Complete the claim.

(OR)

Purchase your medication, ask for a receipt. Keep evidence of your SAS-B/AP approval. Download claims form from www.hif.com.au. Post/Email form, script and receipt to HIF claims@hif.com.au

Medibank

Purchase your Medical Cannabis medication, ask for a receipt. Download the Medibank app. Complete the claim through the app.

(OR)

Purchase your medication. Visit your local Medibank branch with the receipt.

Disclaimer:

This is not an inducement to use Medicinal Cannabis. Medical Cannabis doesn’t work for everyone, and it may not work for you. How Cannabis affects a person depends on many things, including their size, weight, age and health, dosage and tolerance, and the results can vary.