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German Patient Wins Right to Insurance Coverage for Medical Cannabis

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Following an extensive lawsuit, one German medical patient’s insurance company must now cover the cost of her cannabis medicine.

The ruling of this case requires that it falls on the patient’s health insurance company to cover the cost of Dronabinol (also referred to as Marinol). However, according to Marijuana Business Daily, the ruling also stated that patients will continually need to “fight” their insurance companies to get things taken care of. Germany’s medical cannabis program requires that health insurance companies cover the cost of cannabis. The patient’s name was not included in the final court document published by the Social Court of Berlin and Brandenburg.

Insurance companies are allowed to deny a patient coverage, but only in “justified, exceptional cases.” However, evidence has come to light exposing that up to 40 percent of medical cannabis insurance cases have been rejected since 2017.

“It is undisputed that the applicant has a serious illness within the meaning of the standard that has a lasting effect on quality of life in the long term,” the ruling states. “The applicant, born in 1974, is receiving a disability pension. She essentially suffers from a very pronounced restless legs syndrome with massive sleep disorders, a chronic pain disorder with somatic and psychological factors, a migraine, a recurrent depressive disorder, an emotionally unstable personality disorder (borderline) and tinnitus (cf. treating and Dronabinol prescribing specialist in neurology Dr. K. T in the doctor’s letter of October 21, 2019 and in the report of January 28, 2020 as well as the P ambulanz R Kliniken GmbH, DM U. M, specialist in neurology and psychiatry, in the report of 3 February 2020).” As per the ruling, the health insurance company involved in the case will pay for the patient’s dronabinol for one year, as well as all court fees.

An amendment to German law in 2017 states that health insurance companies should cover medical cannabis costs if the patient meets the following criteria: 1.) the patient is recognized as “seriously ill”, 2.) Other medicines have been tried by the patient before medical cannabis and 3.) cannabis is approved as a medicine that can provide lasting benefits to the patient in order to treat their condition(s).

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