Does Medicare Cover CBD and Hemp? Rules, Exceptions and Coverage Explained

A generation ago, the question would have been laughable: Does Medicare cover CBD and hemp products?

But opinions on marijuana have been evolving, and while CBD and hemp share similarities with the drug in that they all come from the Cannabis sativa plant, that’s about all they share in common. CBD, short for cannabidiol, is a compound found in cannabis, while hemp is a part of cannabis that has 0.3% or less of tetrahydrocannabinol (THC). THC is a chemical compound that makes you “high.”

In other words, CBD and hemp can have an effect on one’s body, but you can’t get “high” from it.

You can, however, feel better by using CBD and hemp, according to anecdotal evidence and some scientific studies. CBD is believed to help with sleep disorders such as insomnia, fibromyalgia pain, muscle spasticity related to multiple sclerosis and anxiety. Hemp, which refers to the marijuana plant or its seeds, can be found in foods, like oils and hemp seeds, and it’s used in skincare products for hydration and inflammation.

Medicare does cover some CBD and hemp products in a very narrow and limited way, largely as part of a recent pilot program launched by the Centers for Medicare & Medicaid Services (CMS).

Here is a complete guide to understanding Medicare’s rules on CBD and hemp products, who qualifies for coverage and what out-of-pocket options are available.

[READ: Does Medicare Cover Chronic Pain Management?]

What Is the Substance Access Beneficiary Engagement Incentive?

The Substance Access Beneficiary Engagement Incentive (BEI) is a pilot program run by the federal government that allows some Medicare members to get eligible hemp-derived products under clinician guidance. But technically Medicare isn’t actually paying for these products. The pilot program launched in April 2026, through the CMS Innovation Center, which looks at new products and services that Medicare can provide.

Here’s how it works:

The program allows CBD and hemp companies to sell their products to accountable care organizations (ACO) that are participating in this pilot program. Then the ACOs can give these products to the Medicare beneficiaries, who can receive up to $500 a year of CBD and hemp products.

So Medicare members are getting, for free, up to $500 a year in CBD and hemp products — none of which can contain more than 0.3 percent of THC.

Which Medicare beneficiaries are eligible to receive CBD products?

Eligibility is very limited. Not just any Medicare member can receive CBD products. You only can only be eligible for the pilot program if:

— Your primary physician belongs to an ACO

— and that ACO has successfully applied to be in this pilot program

— and your doctor has decided you medically need CBD or hemp products and has written you a prescription.

— You’re seeing a doctor for cancer, and your doctor belongs to an Enhancing Oncology Model (EOM).

In addition, you’d have to live where it’s legal, which is in:

— One of the 41 states and Washington, D.C. or the U.S. territories where medical marijuana is legal

— Six other states that have a little wiggle room for using weed as a medicine

If you live in Idaho, Kansas and Wyoming, you have no options.

There are over 1,800 ACOs in the United States, but only a small fraction of those are believed to have applied. As of the initial launch of the pilot, exactly five ACOs have successfully applied and submitted implementation plans for CMS review.

Still, the pilot program may point the way for a future in which CBD and hemp products are paid for by Medicare.

“This effort suggests CMS is interested in learning more about how these products might be used in a controlled care environment,” says Whitney Stidom, vice president of consumer enablement at eHealth. “If more cannabinoid-based products eventually receive federal approval and demonstrate clear clinical value, Medicare coverage could expand on a product-by-product basis rather than through blanket coverage of all retail CBD products.”

[READ: Does Medicare Cover Cancer Treatment?]

Other CBD Products That Medicare Covers

Beyond the Substance Access Beneficiary Engagement Incentive, there are a few other narrow options Medicare members have to get coverage for CBD or hemp products.

Medicare Part D only covers FDA-approved drugs. And the only FDA-approved health benefit of CBD is the treatment of severe, rare forms of childhood epilepsy (Dravet syndrome and Lennox-Gastaut syndrome) using the prescription medication Epidiolex.

Dr. Sina Hartung, co-founder of Eureka Health, a healthcare company based out of San Francisco, says that Epidiolex, for certain seizure disorders, is covered as well as dronabinol and nabilone for chemo-related nausea and appetite loss. (Epidiolex’s main CBD ingredient starts off growing in a greenhouse; the cannabis in dronabinol and nabilone are synthetic, or made in a lab.)

[READ: 7 Reasons to Switch Medicare Part D Plans in 2026]

What Doesn’t Medicare Cover When It Comes to CBD and Hemp Medication?

Probably most of the CBD or hemp products that you would like to have, Medicare doesn’t pay for.

“Medicare does not typically cover CBD oils, gummies, creams or other hemp-derived products consumers commonly purchase online or over the counter, and it appears unlikely that coverage will be expanded more broadly in the immediate future,” Stidom says.

“There is clearly consumer interest in CBDs, particularly among older adults looking for help with pain, sleep or other chronic health issues,” she adds. “But consumer interest and Medicare coverage don’t always overlap, as coverage generally depends on evidence that a treatment is safe, effective and medically necessary, along with a clear regulatory and reimbursement framework.”

[READ: Does Medicare Cover Innovative Treatments?]

What Conditions Can CBD and Hemp Medication Assist With?

The jury is still out on how affective CBD and hemp can be. But here are the conditions that CBD and hemp may help with.

Health Condition	Evidence
Sleep disorders	Some studies have shown that CBD can help people fall asleep faster and stay asleep longer. Hemp seed oil is also used by some people to sleep; it’s thought that by reducing inflammation, you may sleep better.
Anxiety	Some research has shown that CBD can help reduce anxiety — without impairing physical or cognitive abilities.
Fibromyalgia pain	Evidence is mixed as to whether it truly does any good, but it won’t hurt you if you take it for fibromyalgia pain.
Muscle spasticity related to multiple sclerosis	Evidence from trials indicate that it could help, according to the National Multiple Sclerosis Society, but no scientific consensus has emerged yet. You’d want to talk to your doctor.
Seizures	The evidence seems pretty clear-cut here, that CBD does help reduce seizures; Epidiolex, which has CBD as a main ingredient, is an FDA-approved medication.