Insurers ponder cannabis coverage

Health insurance providers in the Cayman Islands that previously did not cover medical cannabis are now reviewing their positions, according to the leader of Cayman’s health insurance advisory group.

Cayman Islands Insurance Association Health Insurance Standing Committee Chairman Annikki Brown told the Cayman Compass that local insurers recently received guidance from Chief Medical Officer Dr. John Lee based on guidelines out of the United Kingdom.

“Now that we have this, cannabis should be covered in accordance with these guidelines,” Brown said.

Three insurance companies – Generali, Pan-American Life Insurance Group and CINICO – have covered medical cannabis prescriptions to date. Five others have not, she said.

“As of [last] week, those who did not cover previously are reviewing their positions,” Brown said.

The guidelines are based on the UK’s National Health Service. They allow insurers to determine what is considered ‘medically necessary’. Providers’ concerns had centred around a lack of clarity on how cannabis should be used and prescribed, and on what terms insurers could deem it to be medically necessary and non-experimental.

The NHS guidelines include recommendations such as only prescribing medical cannabis where there is evidence of benefit, and in patients where there is a clinical need that cannot be met by a licensed medicine and where established treatment options have been exhausted.

“Anything outside of these guidelines can appropriately be denied for coverage,” Brown said.

CTMH Doctors Hospital Clinical Compounding Pharmacist Kevin Gipple told the Cayman Compass last week he estimates there are approximately 600 medical cannabis prescriptions in the Cayman Islands.

Brown said providers had met previously with former Chief Medical Officer Samuel Williams-Rodriguez, but did not receive guidance until meeting earlier this month with Dr. Lee.

“I don’t have a timeline on implementation beyond as soon as possible,” Brown said. “There are some practical steps that each insurer will need to take to bring this into effect.”

She said insurers generally are not opposed to cannabis, but need to ensure their practices and policies adhere to the country’s laws, and regulations set by Dr. Lee and other healthcare leaders.

“I think it should be stated that we do not object to decriminalisation for medical use in principle, and some insurers have no objections to legalisation outright,” Brown said. “Our concerns have stemmed from our commitment to adhere to the laws of the Cayman Islands in word and in spirit, and both insurers and medical providers have been working in the absence of guidelines and regulations for some time.”

That is welcome news for patients using medical cannabis who have had to pay for their prescriptions out of pocket.