If you have an existing ACC cover and you are considering applying for extra funding for medicinal cannabis, please find below all the latest information and learn if cannabis is covered by your insurance.
ACC Applications
Since the Medicinal Cannabis Scheme began in April 2020, unfortunately only a handful of applications for additional funding for medicinal cannabis via ACC have been approved, and only then through a complicated independent review process.
If you wish to apply for additional ACC funding for medicinal cannabis, please note that we are no longer assisting with ACC117 applications. However, we can provide your clinical records and relevant file information should you choose to seek independent assistance.
Health Insurance Pre Approval
If you carry health insurance, please contact your insurer prior to your consultation and apply for pre-approval. You will be asked to provide a copy of the consultation cost estimate and any other relevant medical information for your insurer to consider.
The Cannabis Clinic is a private health provider. We are also an affiliated contract provider with Southern Cross Healthcare and a NIB partner ensuring an easier pre-approval process for some consultation options. Please get in touch for more information.
Other ways to reduce the cost
A few things genuinely change what treatment costs.
Tell your prescriber that cost matters. There is often more than one product that would suit you, and they cannot factor price in unless they know it is a constraint.
Compare cost per day rather than per bottle. A concentrated product at a higher price frequently lasts considerably longer at the same dose.
Check whether you qualify for our Supported Access Programme, which reduces consultation fees for Community Services Card holders.
Ask about interest-free payment options, which spread the cost rather than reducing it.
Do not stockpile. Ordering ahead before a dose review is a common way to waste money, because the product you are on may not be the one you stay on.
Current consultation fees and product costs are set out in full on our pricing page.
ACC applications
If your symptoms relate to an injury ACC covers, medicinal cannabis can be put forward as part of your treatment. It is not something ACC funds automatically.
What we do. Your doctor can prepare the clinical documentation an application needs. That usually means a treatment plan setting out what is being prescribed and why, what you have already tried and what the intended outcome is, together with any supporting clinical letters ACC asks for.
What you do. The application goes through you and your ACC case manager. You will need your claim number and, in most cases, a conversation with your case manager about what you are asking for before anything is submitted. If you already have a case manager, start there.
What ACC considers. Broadly, whether the treatment relates to the covered injury, whether other options have been tried, and whether there is a clinical rationale. Decisions are made on the individual claim, so somebody else’s outcome tells you very little about yours.
Timeframes. Expect weeks rather than days.
Treatment does not have to wait for a decision, but if you start privately you should understand that funding may not be granted retrospectively.
If you are not sure whether your claim is relevant, raise it at your consultation and your doctor will tell you whether an application is worth making.
Health insurance pre-approval
Insurers treat medicinal cannabis inconsistently, so the first step is always to ask yours what your own policy covers.
Ask before you start. Most insurers require pre-approval, meaning agreement in principle before treatment begins. Claiming afterwards for something that was never pre-approved rarely works.
What to ask them. Whether the policy covers medicinal cannabis at all. Whether unapproved medicines are excluded, since most cannabis products prescribed here are unapproved medicines. Whether consultations are covered separately from medication. And what documentation they want from your prescriber.
What we provide. Your doctor can supply a treatment plan and clinical letters setting out the diagnosis, what has been tried, what is being prescribed and the clinical reasoning. We will complete what your insurer asks for, but we cannot argue your case for you and we have no visibility of their decision.
A realistic expectation. Consultation fees are more often covered than medication, and medication is more often covered where the condition is well documented and other treatments have clearly been tried. Exclusions for unapproved medicines are the most common reason a claim fails.
If your insurer declines, ask for the reason in writing. Occasionally it is something correctable, such as missing clinical detail, rather than a blanket exclusion.
Can ACC or health insurance cover medicinal cannabis?
Sometimes, but it is not routine and it is better not to plan on it.
ACC does not fund medicinal cannabis as a matter of course. Cover is considered case by case and only where the treatment relates to an injury ACC already covers.
Health insurance is more variable. Some policies will consider medicinal cannabis through a pre-approval process and others exclude it outright, often because most cannabis medicines here are unapproved medicines. The only reliable way to find out is to ask your insurer directly what your policy covers, before you start treatment rather than after.
What we can do is complete the clinical side of an application. What we cannot do is lodge it for you, influence the decision, or tell you in advance whether it will succeed.
If funding is not available to you, there are other ways to bring the cost down and they are set out below.