Frequently Asked Questions

Does health insurance cover a patient’s medical visit to a doctor’s office?

For a primary care visit to treat an injury or illness or discuss treatment options for a debilitating medical condition, a patient will typically pay for the visit according to network provider co-pay or out-of-network coinsurance terms. Usually, there are no limitations or exceptions for this type of primary care visit.

For a specialist visit to treat an injury or illness or discuss treatment options for a debilitating medical condition, preauthorization or referral is generally required. The patient will typically pay for the specialist visit according to network provider co-pay or out-of-network coinsurance terms. Without preauthorization or referral, benefits covering the cost of the specialist visit could be reduced.

What happens if a doctor recommends a test, treatment or prescription that isn’t covered by insurance?

Most things a doctor recommends will likely be covered by most health plans, but some may not. When a test, treatment or prescription isn’t covered, insurance won’t pay for that test, treatment or prescription. The patient can still obtain the test, treatment or prescription, but will have to pay for it out of pocket.

Does health insurance cover medical marijuana products if recommended by a doctor?

Even though a majority of states including Louisiana have legalized the use of marijuana in medical treatments, patients will have to pay for medical marijuana products out of pocket at a licensed pharmacy due to the Schedule 1 controlled substance classification of marijuana.

Can a Health Savings or Flexible Spend Account fund the purchase of medical marijuana products?

Medical marijuana has been found to provide relief against a variety of medical conditions such as nausea, chronic pain, and muscle stiffness. However, marijuana is a Schedule 1 controlled substance, so the cost of medical marijuana products are ineligible for reimbursement under a Health Savings or Flexible Spend Account.

Does Medicare or a Medicare Advantage plan cover the cost of medical marijuana products?

Medication must have FDA approval for coverage under Medicare or Medicare Advantage plans. Since marijuana is a Schedule 1 controlled substance, patients will have to pay out of pocket for the products.

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