Insurance Coverage in Canada – The Clinic Network

Insurance Coverage in Canada


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SunLife Sun Life Financial Inc.

Sun Life is Canada’s first major insurance company to offer coverage for medical cannabis to those with group benefits plans. Starting March 1, plan administrators can add medicinal cannabis coverage to extended health care plans.

It’s a sign that mainstream attitudes are opening up to cannabis’s medicinal applications. But for consumers who are currently using it to treat ailments and symptoms, getting reimbursed for medical cannabis is not just a matter of saving up receipts and filing a claim through your group benefits plan.



Here’s what you need to know:

Your Sun Life plan administrator will have to request coverage

This means if you haven’t already, you will have to tell your plan administrator that you are using medical cannabis for treatment. Concealing your medical cannabis use from your employer could present grounds for termination if there is a zero tolerance policy in your workplace. However, employers have a “duty to accommodate” employees with special needs, otherwise they could face allegations of discrimination. Your employer could have more questions for you and your doctor about your medical cannabis treatment plan, so be prepared.

You will have to qualify for coverage based on Sun Life’s criteria

Once your plan administrator has requested coverage, you’ll have to fill out a prior approval form, which will be assessed by Sun Life before you can make any claims.

Not all conditions are eligible for coverage

“There is a slowly growing body of clinical research for the medical uses of cannabis,” reads the memo from Sun Life. “For this reason, Sun Life will conduct periodic reviews of evolving clinical evidence, supporting the use of medical cannabis for conditions listed below.”

Those conditions are: cancer with severe or refractory pain, nausea and/or vomiting due to treatments; multiple sclerosis with neuropathic pain or spasticity; rheumatoid arthritis with pain that has not responded to standard therapy; HIV/AIDS with anorexia or neuropathic pain; patients requiring palliative care.

You have to be registered with Health Canada to qualify if you are medicating with cannabis for one or more of the above conditions, but you aren’t registered with Health Canada under the Access to Cannabis for Medical Purposes Regulations, then you will not be able to claim your medical cannabis.

There is a yearly maximum.

Sun Life plan administrators can choose their maximum amount that can be claimed for one year, ranging from $1500 to $6000/covered person per year.


Last modified: September 11, 2019

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