Published: Sep 26, 2020

Why Does the Cost of a Medical Card Differ from Doctor to Doctor?

In our latest question and answer, the pharmacist discusses why the cost of obtaining a medical cannabis card is different depending on which doctor you go to.

Answered by: Dr. Geoffrey Brown, PharmD

Medical Card Doctor

Mia asked

Why does my doctor charge me $150 every three months for a medical card, but my friend that is also a medical patient only pays $100 a year?

Summary

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There is no standard price for obtaining a medical card in NYS.

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The doctor themselves or the company they work for decides the price.

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Legal requirements, risks associated with medical cannabis, and the level of care and IT assistance provided may influence the price.

Answer

Hi Mia and thanks for the great question. This is certainly a hot topic amongst patients in the medical cannabis community. So why does the cost of getting certified (i.e. getting your medical card) differ so much doctor to doctor?

While a portion of the costs may certainly be up to the doctor themselves or the company/practice they’re working at, there are some key factors that may contribute to the cost including the level of care provided, whether the doctor or their office provides IT assistance, and the risks associated with cannabis as a medical treatment.

Before we take a look at each of these factors individually, let’s take a quick look at what doctors (or other registered practitioners) are legally required to do before they certify you for medical cannabis.

Legal Requirements

First, the doctor must ensure you qualify for treatment with medical cannabis by making sure you have a qualifying diagnosis documented in your medical chart. The list of qualifying conditions for medical cannabis in NY can be found here.

The doctor must also rule out any contraindications to medical cannabis. This just means they make sure you don’t have any conditions that would preclude the use of medical cannabis. The jury is still out regarding on determining what those conditions are, but one that is heavily agreed upon is any history of psychosis or a first-degree relative with psychosis. Other potential contraindications may include severe kidney or liver disease, or an allergy to cannabis.

Doctors are also required to discuss the risks and benefits of medical cannabis with you and they must document that this occurred in your medical chart.

Doctors must then check the State’s prescription monitoring program and review your controlled substance purchase history. Medical cannabis is monitored as a controlled substance in NY.

After completing the steps above, the doctor may  certify you for treatment with medical cannabis.

IT assistance

The actual process of certifying is done entirely online through the State’s Health Commerce website. The state developed the Medical Marijuana Data Management System (MMDMS) to help manage patient data and practitioner recommendations for the medical cannabis program. This system allows doctors to “e-prescribe” medical cannabis by allowing information input to the MMDMS by your doctor to be accessed by staff at the dispensaries using their seed-to-sale dispensing software (Biotrack).

The MMDMS can be quite a pain to work with. It definitely wasn’t designed by the guys at Google. After you get certified for medical cannabis, you can’t get up and go to a dispensary right away, you’ll have to set up a patient account through MMDMS and complete a form confirming your address and DMV photo are up to date. After you do this, you’ll receive a temporary card that will allow you to pick up medical cannabis while waiting for your official purple card to come in the mail.

Some doctors or their staff will help you get set up with an account and a temporary card. Doctors that offer this service may charge an additional “IT” Fee. Not all doctors will do this and some may do it without charging extra, but either way, it is a required step in the process that will need to be done before you’re able to purchase at dispensaries.

Level of Care

Level of care refers to the amount of effort that is required by your doctor to take care of you. If you have more than one condition or take more than a few medications, then this usually means it will take more time to treat you effectively and safely. Many patients seeking treatment with medical cannabis have very complex medical situations as they often turn to cannabis as a last resort.

Some doctors charge as low as $150 for certifying you for one year. For example, our affiliate NuggMD charges just $150 per year for certifying patients through secure telemedicine. This is really just a transactional process, you pay a fee, and if you qualify, you’re certified and are able to purchase medical cannabis from a dispensary. There is really no “care” involved at all.

Other doctors charge up to $300 every few months. These doctors aren’t necessarily taking advantage of you, as long as they provide you with a higher level of care or additional services in return. For instance, some doctors will work directly with their patients to find them affordable products as well as an individualized dosage form and dose of THC/CBD. Patients using medical cannabis frequently complain of being unable to focus or that they feel “foggy”. Some doctors will help their patients achieve symptom relief and avoid certain unwanted side effects by adjusting their dose of THC or CBD. Some doctors even provide advice on how to taper off other medications such as benzodiazepines and opioids. Surely, this level of care requires more time and effort from the doctor and, thus can arguably be compensated as such.

Risk

Medical cannabis is not an FDA-approved medication. Doctors and other providers choosing to recommend medical cannabis are taking a substantial risk as they may increase their exposure to litigation if a patient were to experience an adverse effect as a result of medical cannabis (and the doc did not adequately warn the patient of this effect).

Most people think medical cannabis is harmless, but adverse effects do occur more frequently than you’d think. In Colorado, where cannabis is recreationally legal, an individual killed themselves by jumping off a building while intoxicated from an edible. If that were to happen in NY, from a medical cannabis product, the patient’s family might pursue litigation against the doctor that certified their daughter or son. For this reason, some doctors may feel they need to be compensated more for taking this risk.

Do you think medical cannabis might be right for you?

If you think medical cannabis is right for you, there are a number of providers in the Buffalo Niagara region that can help you come to that conclusion. Here is a curated list of doctors in the area that will recommend medical cannabis in the right situations. You can also get certified at home through our affiliate, NuggMD.

Dr. Geoffrey Brown, PharmD

Dr. Geoffrey Brown is a registered medical cannabis pharmacist in New York State and the founder of CannaBuff. He graduated from the University at Buffalo with a Doctor of Pharmacy degree in 2018. He has published cannabis research that's been featured by NORML and numerous news outlets. Please feel free to reach out to him if you want to connect!