How To Qualify for Medical Marijuana in the U.S.

Medical cannabis is legal in 33 American states and the District of Columbia. For many Americans today, it’s accepted as a fact of life — even those who oppose its use for recreational purposes frequently concede that it has legitimate therapeutic applications. We now live in a world where Republican congressman Matt Gaetz can publicly state “it’s so stupid [to oppose medical cannabis]” without causing much of a stir from his staunchly conservative base.

Few could have envisioned such a rapid evolution of the country’s views on medical cannabis. When California became the first state to legalize the plant for medicinal use in 1996, it was the culmination of more than two decades’ worth of hard-fought struggle, largely led by LGBTQ activists and communities of color. Since then, the floodgates have opened, and acceptance of the plant’s medical benefits has become so widespread that many Americans now say they prefer medical cannabis to prescription drugs. 

However, since cannabis is still federally illegal (despite a bipartisan group of lawmakers’ best efforts), medical cannabis policies vary widely from state to state. Here’s a breakdown of how to qualify in each state where it’s legal:

Understanding Medical Marijuana Policies for U.S. States

Alaska

Alaska was one of the first states to legalize medical cannabis — its law was passed back in 1998, just two years after the next state on this list — but its program still hasn’t attracted many users. According to the state’s Department of Health and Social Services, there are only around 600 medical cannabis users.

To join the program, prospective patients must enroll in the state’s patient registry first. Minors are eligible as well, provided they have the authorization of their primary caregiver and a signed note from a doctor explaining the potential risks of using cannabis. 

Arizona

Arizona legalized the medicinal use of cannabis back in 2010. In some regards, it’s ahead of the curve: it’s one of eight states that have cannabis drive-thru dispensaries, which makes sense considering that seniors make up a sizable portion of the state’s residents (and the fastest-growing demographic of cannabis users).  

Getting a prescription from most general practitioners can be challenging, but a number of specialized clinics throughout the state (like the Arizona Medical Marijuana Certification Center) offer assistance for those seeking a medical cannabis card. These cards currently cost $150 and are valid for a year, though a bill recently submitted to the state legislature would extend this to two years.

Arkansas

Arkansas has allowed the medical prescription of cannabis since 2016. According to state government data, there are currently around 15,500 medical cannabis patients in the state. Anyone over the age of 18 with one of the qualifying conditions above is eligible to get a prescription from a doctor. 

Consumption of medical cannabis is tightly controlled within the state’s borders — patients may only use it legally in their own homes, and all public consumption is banned. Medical cards cost $50 and are valid for one year. 

California

As the first state in the country to legalize cannabis, California was the birthplace of the medical cannabis movement. It’s also home to some of America’s most relaxed medical cannabis laws, with physicians able to prescribe it for nearly any ailment. Many anecdotal reports suggest that, for most people, this is a fast and simple process.

There are also no restrictions on how much medical cannabis a person can possess, as long as it’s “consistent with the patient’s needs.” 

Colorado

Medical cannabis has been legal in Colorado since 2000, and even in this fully-legalized state, many people still participate in the program (the state’s Department of Public Health and Environment estimates that nearly 87,000 people hold medical cannabis cards).

Interestingly, minors can also qualify for medical cannabis prescriptions if both they and their primary guardian are Colorado residents, though the process is a bit stricter — two physicians’ authorizations are needed, while adults only need one. 

Connecticut

Connecticut decriminalized small amounts of cannabis in 2010 before legalizing its medicinal use in 2012. Since then, there have been rumblings that the state might legalize recreational use as well, especially in light of neighboring Massachusetts’ decision to do so, but so far nothing has come of the rumors. 

Still, the state’s medical cannabis program is among the most expansive in the country, allowing prescriptions for many conditions that aren’t on the lists of other states. Patients over 18 years of age can qualify by undergoing an exam from their physician, after which they receive a medical cannabis ID card. However, using the plant comes with tight restrictions: all public use is banned.

Delaware

A chronic or debilitating disease or medical condition or its treatment that produces one or more of the following:

• Cachexia or wasting syndrome
• Severe, debilitating pain that has not responded to previously prescribed medication or surgical measure for more than three months, or for which other treatment options produced serious side effects.
• Intractable nausea
• Seizures
• Severe and persistent muscle spasms, including but not limited to those characteristic of Multiple Sclerosis

Delaware legalized medical cannabis in 2012, and today around 6,000 residents are enrolled in the state’s program, according to the Delaware Health and Social Services agency. While home cultivation is forbidden, the maximum permissible allowance of 6 oz. is higher than in many states.

In some rare cases, such as for intractable epilepsy or severe autism, minors are eligible to be prescribed medical cannabis, though this requires special authorization from specialists. For adults, all that’s necessary is a physician’s note (and proof that one is a resident of Delaware).

District of Columbia

Qualifying Conditions: Any debilitating condition recommended by a doctor licensed in Washington D.C.

The nation’s capital, which legalized medical cannabis in 2010 (and recreational use in 2014) has perhaps the most least-restrictive medical cannabis program in the country — but the application process is a major hassle.

Applicants must provide two forms of identification proving their residency in the district, a letter from a qualified medical marijuana physician, a $100 processing fee … and then wait at least 30 days.

Florida

Florida’s medical cannabis program, which was first established in 2016, used to have one of the more curious restrictions in the country: patients were not allowed to smoke the plant, limiting them to cannabis edibles and other delivery methods.

That’s no longer the case, but the state still keeps tight control on how much cannabis patients can use: home cultivation is banned, and physicians can’t prescribe a patient more than three 70-day supplies of cannabis. Only certain physicians are permitted to authorize patients to use medical cannabis, at which point they can apply for a state-issued medical cannabis ID card. 

Hawai’i

Hawai’i legalized medical cannabis in 2000, but it would take fifteen years before the first dispensary opened on the main island of Oahu. Today, the state’s Department of Health estimates there are around 26,000 patients on the island. 

Enrolling in the program requires a doctor’s examination. If they determine the patient has a qualifying condition, the next step is to register with the Department of Health, which will provide a special identification card that can be used to access dispensaries. 

Illinois

Illinois, which recently became the 11th state to legalize cannabis for recreational use, also has one of the most robust medical cannabis programs in the country. And lately, enrolling has become remarkably easy.

Any patient diagnosed with one of the conditions above is automatically eligible for a medical cannabis prescription. All that’s needed is a letter from a physician, at which point patients can register with the state for an identification card that allows access to medical dispensaries.  

Louisiana

Although Louisiana passed a law authorizing medical cannabis in 2015, the plant is still not available to patients due to regulatory snafus and bureaucratic obfuscation. However, in March 2019, legislators finally approved a large-scale growing operation, raising hopes that medical cannabis might be available in state dispensaries sooner rather than later, though no definitive timetable was given.

In theory, applying for a medical cannabis card should be relatively straightforward: patients need to receive a written recommendation from their physician, and provide documents that prove their identity and place of residence to the state.

Maine

Maine, which first legalized medical cannabis in 1999, has also legalized recreational cannabis — but it’s still not available anywhere in the state (though many advocates are hopeful that the first recreational dispensaries will open by 2020).

In the meantime, the state has relaxed its laws on medical cannabis to the point where the list above is almost unnecessary: physicians can prescribe it to “any patient for which he/she believes it will benefit.” Anyone meeting that criteria can apply for an identification card online, though minors must present a signed letter from their parent or guardian as well.

Maryland

Although Maryland legalized medical cannabis in 2014, it did not have a functioning program in place until 2017. Even today, it remains one of the more restrictive programs in the country, with a limited list of qualifying conditions and edibles only recently being legalized for consumption. 

If a person does have one of the qualifying conditions, they’ll need an examination from their doctor to be eligible to apply for a state-issued medical cannabis identification card. Minors need written permission from their parent or legal guardian.

Massachusetts

Massachusetts legalized medical cannabis in 2013, with recreational use following in 2018 — making it the first East Coast state to have legal cannabis shops open to the public. However, that doesn’t mean it’s necessarily a free-wheeling cannabis paradise, as public use is still banned.

Applying for a medical prescription is relatively straightforward: patients need to be examined by a physician, who will explain the potential risks and benefits, and then issue a written recommendation if appropriate. 

Michigan

Michigan has had legal medical cannabis since 2008, and in 2018, it became the first Midwestern state to legalize it for recreational use — cementing its status as a regional trendsetter.

Applying for a medical card involves a doctor consultation, after which patients must fill out the state’s official application packet. After submitting it, all that’s left is to wait for the state to send your medical cannabis identification card in the mail.

Minnesota

Minnesota has had legal medical cannabis since 2014, but despite support for recreational legalization from both lawmakers and the public, it hasn’t yet followed in Michigan’s footsteps with recreational legalization. 

However, applying for a medical cannabis card is relatively straightforward, requiring only a written certification from a physician. After obtaining this, patients can register with the state and receive an identification card that allows them to access medical dispensaries.

Missouri

Any “other chronic debilitating or other medical condition” that may be alleviated by marijuana “in the professional judgement of a physician”

Missouri authorized the use of medical cannabis in 2018, though the program has still yet to take effect — there are currently no dispensaries available to qualifying patients. 

However, the long list of conditions indicates that, when the program does become fully operational, it could be easier to navigate than those of more restrictive states like Arizona. 

Montana

Montana legalized medical cannabis back in 2004, though efforts to pass recreational legalization have stalled since then. Still, the medical program has proven popular, attracting over 32,000 patients according to the state’s Department of Public Health and Human Services.

Applying for a medical card is simple: people over the age of 18 simply need a doctor’s authorization and a state-issued identification card, while those under the age of 18 also need their parent’s authorization. 

Nevada

Nevada has had legal medical cannabis since 2001, and in 2016, the state made recreational use legal as well. However, since medical cannabis is untaxed (unlike recreational products), more than 17,600 people have elected to remain in the medical program.

Medical cards are available to anyone over the age of 21 with a doctor’s authorization, and minors can also qualify if they have a signed release from their parent or legal guardian.

New Hampshire

New Hampshire legalized medical cannabis in 2013, but only around 7,000 people have enrolled in the program since then, according to the state’s Department of Health and Human Services. 

Patients must be over 18 years of age, and legal residents of the state. They also must have a “patient-provider relationship” of at least three months with the physician who writes their prescription.

New Jersey

New Jersey has had legal medical cannabis since 2010, and more than 42,500 people are currently enrolled in the program — but qualifying for it is a more time-intensive process than it is in other states. 

To become a patient, patients must be diagnosed with one or more of the qualifying conditions by a physician, then complete a follow-up visit with the same physician who will then establish an optimal monthly dosage plan. Then patients must register with the state to obtain a medical marijuana patient ID card. Once these steps are complete, the patient must visit the same physician for a third time in order to re-assess the dosage and the overall progress of  treatment. 

New Mexico

Medical cannabis has been legal in New Mexico since 2007, and the list of qualifying conditions has steadily expanded since then. Today, it has one of the more permissive programs in the nation — even minors under 18 are eligible to apply with the authorization of a caregiver.

Those over the age of 18 simply need to have an in-person consultation with a physician, submit an application to the state, and wait to receive their identification card. 

New York

Rumored to be one of the next states to legalize recreational cannabis, New York made medical use legal back in 2014. One quirk of the program is that only “non-smokable preparations” are legal for medical use. 

Another quirk: only a physician with whom the patient has “a bona fide relationship” can prescribe medical cannabis. Otherwise, the main requirements are proof of New York residency (or proof that the medical condition requiring cannabis is being treated in New York)  and, in the case of minors, a guardian’s authorization.  

North Dakota

North Dakota passed a law allowing medical cannabis in 2016, covering an extensive list of conditions. In 2019, the state’s first dispensary opened in Fargo. Cannabis edibles are not on the menu, as these are still forbidden.

To enroll in the program, patients must obtain a diagnosis and a written certification from a “trusted physician.” If the patient is under the age of 19, they’ll also need the written approval of their parent or legal guardian.

Ohio

In 2016, Ohio legalized medical cannabis — with some significant restrictions. Only oils, edibles, and concentrates are currently legal for use. 

To qualify for a medical cannabis card, patients need to schedule an in-person appointment with a state-certified medical marijuana doctor. If the doctor gives their approval, the patient will receive a card via email from the Ohio Board of Pharmacy. 

Oklahoma

Qualifying Conditions: Up to the discretion of the physician.

Oklahoma legalized medical cannabis in 2018, and wasted no time in implementing one of the permissive policies in the entire country.  

Patients can qualify for the program by filling out the Oklahoma Medical Marijuana Authority’s Physician Recommendation Form (with the assistance of a physician, of course) and submitting it online, along with their patient license application.

Oregon

Oregon has one of the longest-running medical cannabis programs in the country, having first legalized the plant for medicinal purposes in 1998 before voting to allow recreational use in 2014.

Medical cannabis users need a written certification from their doctor, which must be renewed each year, and then register with the state to receive their medical card. Patients under the age of 18 need the approval of their parent or guardian, and must fill out a separate application form.

Pennsylvania

Pennsylvania legalized medical cannabis in 2016 under tight restrictions: only pills, topicals, and liquids or tinctures were allowed. Today, vaporized herbal cannabis is also allowed, but smoking remains forbidden.

To qualify for the program (which over 116,00 people have already done), patients must enroll in the state registry, schedule an appointment with an approved physician, and submit an application along with a $50 fee. 

Rhode Island

Rhode Island has had legal medical cannabis since 2006, and nearly 19,000 people have enrolled in the program since then, according to the state’s Department of Health. 

Qualifying is a relatively simple process: patients need to schedule a consultation with a physician willing to fill out a certification form, then register with the state and wait to receive their medical cannabis identification card. 

Texas

Once criticized for having the most useless medical cannabis program in America (it covered only a single condition, intractable epilepsy, and even patients suffering from it found it nearly impossible to qualify), Texas recently passed a bill that would broaden the number of conditions covered. 

However, medical cannabis patients will still find it difficult to access: at least two physicians must approve it as a treatment, and the patient must have tried other medications first. 

Vermont

Vermont legalized medical cannabis in 2004, with recreational legalization following in 2018, making it one of the most cannabis-friendly states on the East Coast.

Patients who wish to enroll in the medical program will need authorization from a doctor they’ve been seeing for at least three months. They’ll also need to select a designated dispensary from which to purchase their cannabis. 

Washington

Medical cannabis has been legal in Washington since 1998. In 2012, the state became the first one in America to make the plant legal for recreational use as well.

Over 39,000 people are currently enrolled in the state’s medical program, which is easy to access: anyone over the age of 18 is eligible with the authorization of a physician.

West Virginia

West Virginia legalized medical cannabis in 2016, but the program is still inactive — proponents had hoped that it will be up and running by now. However, the latest reports from the state’s Office of Medical Cannabis suggest that sales will be delayed until 2021 or 2022 at the earliest.