Becoming a cannabis patient legally? In Germany, a doctor's prescription is the first step. The reform in April 2024 has simplified many things: medical cannabis is now often prescribed by electronic prescription and bureaucratic hurdles are lower. Both inpatient doctors and online platforms offer access to customized therapy with preparations containing THC and CBD. While health insurance often covers the costs for approved indications, self-pay patients usually pay between 150 and 300 euros per month.
Two paths lead to a cannabis prescription
To become a cannabis patient in Germany, you need a doctor's prescription. This prescription is the starting point for an individually tailored medical therapy that can alleviate symptoms and improve quality of life. Whether the route is via an inpatient doctor or online via telemedicine depends on the patient's personal needs. A medical prescription is not just a formality, but a central component of the legally safe use of cannabis as a medicine. For many patients, the first consultation with the doctor is the most important step in clarifying any unanswered questions about the therapy.
Doctors as a proven route to cannabis therapy
Many cannabis patients start their journey with a registered doctor. In Germany, all licensed doctors - with the exception of dentists and veterinarians - are allowed to issue a medical prescription for cannabis. In practice, however, it is often the case that medical specialists are more familiar with cannabis therapy than GPs. For example, neurologists for chronic pain or multiple sclerosis, psychiatrists for anxiety disorders or depression and pain therapists for treatment-resistant pain have more experience in dealing with medical cannabis. This specialization often facilitates the entire process - from the indication to the optimal adjustment of THC and CBD dosages.
For patients with statutory health insurance, the following has applied since October 17, 2024: For certain specialist groups, such as general medicine, neurology or special pain therapy, prior approval by the health insurance company is no longer required. Other specialist groups may also prescribe, but still require approval for an initial prescription if the costs are to be covered.
Doctor on site - becoming a cannabis patient step by step
The path to cannabis therapy with an inpatient doctor can be divided into four to five steps - depending on whether the health insurance company should cover the costs or whether the patient finances the therapy themselves:
- Medical history and consultation
The doctor checks the medical requirements based on the patient's medical history and existing findings. Previous therapies are also discussed in order to confirm suitability for medicinal cannabis. - Application to the health insurance company (optional)
For those with statutory health insurance, an application for cost coverage is often submitted. Processing usually takes two to six weeks.
Self-payers skip this step and can proceed directly to the prescription issue. - Prescription
After approval by the health insurance company or in the case of self-payers, the doctor issues the medical cannabis prescription. Since April 2024, this is usually done as an e-prescription. - Start cannabis therapy
The prescription, whether paper or e-prescription, can be filled in any pharmacy in Germany - both in local pharmacies and online pharmacies. Medicinal cannabis is taken in the form of drops, capsules, as a spray or using a vaporizer. - Aftercare and adjustment
The effect is checked at regular check-ups and the dosage is adjusted individually. Cannabis medication can be THC-dominant or CBD-dominant and in very different proportions. The cannabis varieties used with their terpene content also play a role in tolerance, meaning that aftercare and adjustment of the therapy are very important aspects of cannabis therapy.
The great advantage of inpatient doctors is the close support they provide. Cannabis patients benefit from long-term support and a higher chance of having their costs covered. One disadvantage is often long waiting times or doctors who have little experience with medical treatment.
Online - Becoming a cannabis patient step by step
If you want to speed up the process, you can apply for your cannabis prescription online. Digital telemedicine platforms have become increasingly important in Germany in recent years because they shorten waiting times and facilitate access to medicinal cannabis. Many cannabis patients use this method, even though health insurance companies do not usually cover the costs. The online process is divided into the following steps:
- Registration and medical history
The patient creates a profile and fills out a medical questionnaire on complaints, previous therapies and findings. - Digital consultation (optional)
What was standard in the past is now optional. Only a few online clinics still offer a digital consultation. In most cases, a licensed doctor checks the information from the completed questionnaire, see step 1, and issues the prescription directly if the requirements are met. - Prescription
If the indication is confirmed, the patient receives an electronic prescription. As the costs are not usually covered by health insurance, the therapy is often self-pay. - Starting and monitoring therapy
The medicinal cannabis is purchased at a local pharmacy in Germany or often delivered directly to your home by mail order from an online pharmacy. Regular follow-up appointments via video call are now also more of an exception, but help to optimally adjust THC and CBD dosages. However, it is quite common for a follow-up prescription to be requested online without further monitoring.
The advantage of organizing cannabis therapy online is the speed. As a rule, you don't need an appointment, instead you enter all the data directly online. There are disadvantages in terms of cost coverage, as health insurance companies do not normally pay for medication prescribed online. In addition, depending on the online clinic, you have to pay for the prescription and follow-up prescriptions yourself; the costs vary. If you also insist on a digital consultation, high additional costs can arise. Nevertheless, many cannabis patients use this method to start treatment quickly.
Inpatient vs. online to become a cannabis patient in comparison
| Aspect | Inpatient doctors | Online doctors (telemedicine) |
| Appointment allocation | Often long waiting times, several weeks | Fast appointment allocation, usually within a few days or even completely without an appointment |
| Assumption of costs | Good chances with prior application to the health insurance company | Generally self-payers, reimbursement of costs rather excluded |
| Treatment | Personal support and close follow-up care required, especially for serious illnesses | Digital accompaniment, if desired. Otherwise no personal contact |
| Flexibility | Locally bound, fixed practice times | Location-independent, flexible use |
| Prescription and pharmacy | Prescription can be redeemed at any pharmacy in Germany | Prescription is issued digitally, usually redeemed in partner or mail-order pharmacies, but in principle there is a free choice of pharmacy |
Costs, pharmacy prices and health insurance companies
The cost of cannabis therapy depends heavily on the selected preparations and dosage. Flower prices vary depending on origin and quality. In German pharmacies, prices are usually between €5 and €15 per gram, sometimes also between €3.50 and €16 depending on the variety and supply. These price ranges explain why the costs, as mentioned at the beginning, are usually between €150 and €300 per month - depending on consumption and preparation mix.
Becoming a cannabis patient with the help of health insurance or as a self-payer?
For those with statutory health insurance, the health insurance company will cover the costs, provided that an indication is clearly proven and an application has been approved (takes around 2 - 6 weeks). Self-payers avoid this bureaucracy, but bear the costs themselves - this is particularly common in the case of therapy by online doctors, as health insurance companies generally do not pay.
Cost example: Medicinal cannabis flowers at 10 €/g each cost around 200 € for 20 g consumption per month, plus any prescription fees or shipping costs.
Conclusion
Becoming a cannabis patient in Germany is now easier than ever. The traditional route via an inpatient doctor offers personal care and higher chances of cost coverage. Cannabis therapy organized online offers speed and flexibility, but usually requires self-financing. It is important that patients work closely with their doctor to optimally adjust the medicinal cannabis, the THC and CBD dosages and the course of therapy.
FAQ - Frequently asked questions about becoming a cannabis patient
In Germany, all licensed doctors - with the exception of dentists and veterinarians - are allowed to issue a medical prescription for cannabis. For the first therapy for people with statutory health insurance, an application is usually submitted to the health insurance company before treatment begins - if the therapy costs are to be covered.
With an inpatient doctor, it can take several weeks to months before an appointment is available, especially with specialists who specialize in medical cannabis. Doctors usually make it possible for seriously ill patients to get an appointment more quickly. In contrast, many cannabis patients often start their treatment immediately via online platforms.
Yes, the health insurance company will cover the costs if there is a recognized indication - for example chronic pain or neurological disorders - and it approves the application. If the health insurance company refuses, patients can start treatment as self-payers. The costs are then often between €150 and €300 per month, depending on the medical prescription and the dosage of THC and CBD.
THC and CBD come from the cannabis plant. Doctors often use the psychoactive effect of THC to treat severe pain, spasticity or sleep disorders. CBD has anti-inflammatory, antispasmodic and calming properties. Many cannabis patients receive medical prescriptions that combine both THC and CBD to achieve an optimal effect with minimal side effects.
Within Germany, carrying a medical prescription is not a problem. When traveling abroad, patients should always carry their current prescription and a doctor's certificate. Medical cannabis is still prohibited in some countries, so it is advisable to clarify the regulations in advance to avoid problems.
Patients should contact their treating doctor directly if they have any questions about the therapy, the medical prescription or the correct dosage. The online platforms also offer support and follow-up appointments as part of telemedicine in order to continuously adjust treatment with THC and CBD.
A medical prescription for cannabis is only valid for a limited time. Patients should make an appointment with their doctor in good time to obtain the follow-up prescription. At these appointments, doctors review the treatment and adjust the dosage to optimally alleviate pain or other symptoms - an important step in becoming and remaining a cannabis patient.
Yes, more and more cannabis patients are using medical cannabis to treat endometriosis, chronic pain during menstruation or hormonal sleep disorders, for example. Doctors often create combined prescriptions with a balanced THC and CBD content to treat inflammation and pain in a targeted manner.