Costs · Germany
Cannabis and the health insurers in Germany
On 30 July 2026 the most significant change since 2017 came into force, and it affects tens of thousands: dried cannabis flower is excluded from the benefits of the statutory health insurance. Anyone who stays on it pays privately — even where the insurer once approved the therapy without an end date.
Since 30 July 2026 dried cannabis flower has been excluded from reimbursement by the statutory health insurers. Anyone who stays on it pays privately — even with an old, open-ended approval.
What was cut and what remains
| Product group | At the insurer's expense? | Condition |
|---|---|---|
| Dried flower | No | Excluded since 30 July 2026. Available only on a private prescription. |
| Extracts of standardised quality | Possible | As a compounded preparation only where an authorised cannabis-containing finished medicine has first failed to show sufficient efficacy over six months. |
| Dronabinol, nabilone | Possible | Under the conditions of § 31 Abs. 6 SGB V. |
| Authorised finished medicines | Yes | Within the terms of their marketing authorisation, like any other medicine. |
If you hold an older approval
The uncomfortable news first: for flower it now has no effect, and the insurer does not even have to revoke it. The statute provided for no grandfathering, and the first social courts confirmed that in the summer of 2026. Anyone who stays on flower pays for it themselves.
In practice there are three routes, and you should discuss all three with your doctor:
Consider switching to a reimbursable preparation
An authorised finished medicine or — after the six-month therapeutic trial — a standardised extract. Medically this is not equivalent for everyone, but it is the only route that keeps the insurer in the picture.
Carry on as a self-payer
A private prescription, a free choice of pharmacy, the full cost. Budget for the preparation plus the doctor's fee plus delivery — the complete list of items is on Costs.
Stopping — but in a planned way
A legitimate option that almost nobody names, because nobody earns anything from it. If you are considering it, taper off under medical supervision rather than stopping abruptly.
Application and objection
For the preparations that remain reimbursable, the insurer's prior approval is still required. What carries an application is always the same thing: a documented history.
- The diagnosis and its severity, worded by the doctor — not in the patient's own words.
- Which standard therapies were tried: preparation, dose, duration, outcome, side effects or contraindication. This list decides the application.
- Why standard therapy is not an option or has been exhausted.
- The specific therapeutic goal and how it will be measured.
- For compounded preparations: evidence of the six-month therapeutic trial.
If the application is refused, the objection is time-barred — the deadline is stated in the notice's instructions on legal remedies, and it is short. Lodge the objection first to preserve the deadline and set out the reasons afterwards. Check as well whether the insurer answered within the statutory decision period: if it misses the deadline under § 13 Abs. 3a SGB V, the benefit can be deemed approved. That is a formal point which refusal notices rarely mention of their own accord.
We are not a legal advice service. What is set out here is the structure of the procedure with a reference to the norm. For an individual case there are concrete places to turn: the Unabhängige Patientenberatung Deutschland, the social associations VdK and SoVD (whose social-law advice also supports members through objection and court proceedings), the Verbraucherzentrale of your federal state and, if the matter reaches the social court, a solicitor specialising in social law. Proceedings before the social court cost insured persons no court fees.
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The full guide to the insurance question · The route to a prescription · Pharmacies in Germany