The number of patients receiving such coverage is small. And because marijuana is illegal under federal law, insurers paying for the drug must use a financial workaround to avoid violations. One strategy is to reimburse patients for their costs rather than make a direct payment to a marijuana dispensary.

“The legality of this has not been tested in court,” said Ellen Sims Langille, the general counsel of the California Workers’ Compensation Institute.

Insurance company actuaries must realize that they’ll save money by reimbursing arthritis patients who medicate with, say, Craft’s CBD OG instead of Sigma’s Indomethacin. So why are the giant insurance companies reluctant to  reimburse medical marijuana users? Unfortunately, the insurance companies are connected to the pharmaceutical manufacturers —they’re joined at the bank.