CBD Oil by Prescription - This is how health insurance pays!

It's clear: CBD helps. Be it with sleep difficulties, against pain or simply for more well-being - CBD has become an indispensable part of everyday life for many. Since CBD oil works so well for many, they ask themselves: Couldn't health insurance also cover the costs? After all, it works for (medical) cannabis, doesn't it?

We explain how you can get a prescription for CBD, which remedies can be prescribed at all, and in which cases the health insurance company will cover the costs of the prescription.

CBD (cannabidiol) is a natural active ingredient of the hemp plant and belongs to the so-called cannabinoids, chemical compounds that occur naturally in cannabis.

Unlike the well-known THC, CBD is not psychoactive, meaning it does not intoxicate or alter consciousness and perception. What it does, however - and this has now been proven by a large number of studies - is that cannabidiol has anti-inflammatory, antispasmodic, pain-relieving, and anxiolytic effects. It can therefore be used in a variety of ways, for example, to improve falling asleep and staying asleep, to relieve chronic pain, with anxiety and inner restlessness. Many users also report amazing results for muscle tension, migraines, osteoarthritis, or menstrual problems.

In addition, CBD has been used in conventional medicine for a long time. For example, there are cannabis medicines with a CBD focus (Epidyolex) against certain forms of epilepsy (Dravet syndrome, Lennox-Gastaut syndrome, and for structural epilepsies in tuberous sclerosis). Here, prescribing is particularly easy for doctors, as it is an approved medication for this use.

However, doctors can also prescribe CBD or other cannabinoid preparations for other symptoms if previous therapy attempts have not shown sufficient effect.

Here we need to differentiate. On the one hand, there are approved cannabis medicines (e.g. Epidyolex, Sativex and Dronabinol mentioned above). These are prescribed like any other medicine. Cost coverage by health insurance is usually possible without problems.

Then there is the possibility of having CBD-containing medicines and "compounded medicines", which are specially prepared in the pharmacy, prescribed. These are preparations with a relatively high active ingredient content for a specific treatment. Such medicines are often produced on the basis of pure cannabidiol (CBD isolate). If the mixture contained more than 0.1% THC, it had to be prescribed via a narcotics prescription until 2017. Since 2017, this only applies to nabilon (among other things, against nausea), the rest is prescribed via a normal medication.

Furthermore, medical cannabis can be prescribed. Here, the "Cannabis as Medicine" Act of 2017 has brought a real improvement, e.g., for pain patients. Since then, they can have medicinal cannabis (cannabis flowers or cannabis extracts) prescribed as a medicine under certain conditions.

Important: This primarily concerns THC-containing cannabis flowers or extracts, which were illegal in Germany before the changes in legislation. CBD always had a special status here from the beginning, because it contains either no (for isolates) or very small amounts of THC (for full-spectrum oils).

As if that weren't complicated enough, not all CBD-containing products are approved as medicines. CBD oils and other products available in drugstores or online shops are not considered medicines. They usually contain only very low concentrations of cannabidiol and are not prescription-only. However, since they are not approved as medicines, they may not be advertised as a therapy for diseases or regularly prescribed by doctors.

You may know this: just because something has been prescribed by a doctor doesn't automatically mean that your health insurance will cover the costs. In cannabis therapy, cost coverage is often particularly complicated. It depends on several conditions regulated by the Social Code and the guidelines of the Joint Federal Committee (G-BA).

First, the insured person must suffer from a serious illness. This condition is met if the illness is life-threatening, permanently and severely impairs the quality of life, or is chronic. Examples include chronic pain, multiple sclerosis, cancer with therapy-related complaints, or severe neurological disorders.

Secondly, all other therapy options must have been exhausted. Only if conventional medicines or treatments have not shown sufficient effect or are not an option due to side effects, can a cannabis therapy be considered.

Thirdly, the treating physician must demonstrate that a noticeable positive effect can be expected from the use of CBD. This justification is crucial, as it forms the basis for the application for cost coverage with the health insurance company.

You do not submit the application for cost coverage yourself, but rather your treating doctor. The health insurance company then has three to five weeks to decide whether to cover the costs. If the insurance company approves, you receive the medication through a pharmacy and only have to pay the prescription fee (10% of the drug price, at least 5 euros).

If the application is rejected, you can appeal with your doctor. Unfortunately, it is still the case that many applications are initially rejected because health insurance companies have doubts about their effectiveness or cost-efficiency. Many patients have to fight for a long time until they no longer have to pay for their CBD/cannabis medication themselves. Especially for people with chronic pain, this can make it difficult to access a remedy that actually helps them very well and to which they are entitled.

But beware: This procedure only applies to CBD medications with a higher active ingredient content (and possibly THC). The costs for over-the-counter CBD products are generally not reimbursed by health insurance.

As you can see, the situation is incredibly complex. The new legislation in 2017 and 2024 has actually changed only a limited amount. Previously, all cannabis products (even those with minimal THC content) fell under the Narcotics Act. Today, that is actually no longer the case, but many doctors and pharmacies are unsure what they are really allowed to do and how they should proceed.

In addition, CBD preparations with a comparatively low CBD content are not considered medicines at all, but - possibly - food supplements. However, despite extensive research and positive testimonials, authorities are often reluctant to approve these products (as so-called "Novel Food").

Another point: CBD products are quite expensive. Health insurance companies therefore check very carefully whether the expected benefit is in proportion to the costs. This can be frustrating for those affected, especially if they have already had very good experiences with CBD but do not want to bear the costs alone.

If you would like to get CBD oil on prescription, first talk to your family doctor or consult specialists. Online, there are reports from patients about which doctors are more open to cannabis medications - certainly also for your city.

It's best to prepare for the conversation and explain to your doctor why you believe CBD could help you. Here on our blog, you'll find many helpful articles on the topic, including scientific sources. Then discuss whether an application for cost reimbursement is promising. Because: Health insurance companies differ in their openness to new treatment methods. Doctors often have a lot of experience with the attitudes of health insurance companies. It may even be an option for you to change health insurance providers.

Remember: Without guideline recommendations, it is very difficult for doctors to justify a prescription. It is only in your interest to support them as much as possible. In any case, a detailed, well-founded anamnesis and prognosis of the course of the disease with and without CBD is important. And unfortunately also: a lot of patience.

For many, CBD is valuable support for chronic pain, sleep problems, or inner restlessness - and has long been part of many people's daily lives. The problem: doctors, pharmacies, and health insurance companies operate within a legally opaque framework. A complicated prescription process characterized by uncertainties makes access to an effective and low-side-effect remedy unnecessarily difficult - especially for less affluent people.

For CBD to truly unfold its medical potential, clear legal guidelines and a standardized regulation for cost reimbursement are needed. Only in this way can it be prevented that affected individuals forgo effective therapy for financial reasons or resort to dubious offers and poor quality CBD. Until then, CBD on prescription remains a difficult and often long road. This primarily requires patience and trusting support from the doctor.

Medical Disclaimer