Anyone researching cannabis therapy will quickly encounter abbreviations like MedCanG, KCanG, or BtMG. This article clarifies which law regulates what, what has been in effect since April 2024, and which amendments are currently under discussion but not yet in force.
Note: This article provides a general overview of the legal situation but does not replace legal advice in individual cases. Legal texts and their interpretations are subject to change—check the current status before making important decisions.
TL;DR: Since April 2024, medical cannabis has been regulated by the independent Medical Cannabis Act (MedCanG) and is no longer classified as a narcotic. Reimbursement by statutory health insurance companies continues to be governed by Section 31 Paragraph 6 of the German Social Code, Book V (SGB V). A draft bill to amend the MedCanG would restrict initial prescriptions of cannabis flowers via telemedicine and mail-order pharmacies—but as of July 2026, it has not yet been passed.
MedCanG vs. KCanG: Two Laws, Two Purposes
The 2024 cannabis reform created two separate laws that are often confused:
Law Regulates Applies
MedCanG (Medical Cannabis Act) Cultivation, production, and prescription of cannabis for medical purposes Patients with a doctor’s prescription
KCanG (Consumer Cannabis Act) Possession, cultivation, and cannabis social clubs for private consumption Adults without a medical connection
For cannabis therapy, only the MedCanG is relevant. The quantity and possession regulations of the KCanG (such as limits on home cultivation or social clubs) do not apply to patients with a prescription—they obtain their medication through a pharmacy.
What has changed with the MedCanG 2024
Before 2024, cannabis as medicine was part of the Narcotics Act (BtMG), Schedule III. This meant:
Prescriptions only on a special controlled substance prescription form (three-part, numbered)
Strict documentation and retention requirements for doctors’ offices and pharmacies
A practically higher hurdle for doctors who rarely issue controlled substance prescriptions
With the MedCanG (Medical Cannabis Act) coming into force in April 2024, medical cannabis was removed from Schedule III of the German Controlled Substances Act (BtMG). Since then:
Prescriptions on a standard private prescription or e-prescription
No special controlled substance documentation required
In principle, any doctor can prescribe, regardless of their specialty
This reduction in bureaucracy was the main driver for the fact that since 2024, significantly more practices—including telemedicine providers—have been issuing cannabis prescriptions.
Section 31 Paragraph 6 of the German Social Code, Book V (SGB V): the health insurance rule
Independent of the MedCanG, Section 31 Paragraph 6 of the German Social Code, Book V (SGB V) regulates when statutory health insurance covers the costs. This regulation was not changed by the 2024 reform. Key points:
Cannabis-based medicines must be used for a serious illness.
There must be a reasonable prospect of a noticeable positive effect on the course of the illness or on serious symptoms.
Before the first prescription, an application for approval from the health insurance company is generally required (exception: in certain situations involving ongoing therapy).
The health insurance company can reject the application, but must provide a reason; an appeal is possible.
Details on the process and chances of success: Costs for medical cannabis: Health insurance or self-pay?
The planned 2026 amendment to the Medical Cannabis Act (MedCanG)
Status: July 2026. The Federal Ministry of Health has presented a draft bill to amend the Medical Cannabis Act (MedCanG). The central planned points:
Prohibition of the initial prescription of cannabis flowers exclusively via telemedicine—personal contact between the patient and the prescribing practice will be mandatory at the start of therapy.
Regular personal contact afterward, at least once per quarter according to the draft.
Restrictions on mail-order pharmacies specifically for cannabis flowers.
The draft is being discussed controversially: Critics point to potential conflicts with the European freedom to provide services and the constitutionally protected freedom to pursue a profession. The agenda item in the Bundestag has already been postponed several times; the matter is currently before the Health Committee.
What this means in concrete terms: Until it is actually passed, the current legal situation (telemedicine prescriptions and mail-order pharmacies are possible) remains in effect. Whether and when this will change is currently unclear.
What this means in practice for patients:
Cannabis therapy is legally possible regardless of whether it is started via an in-person doctor’s office or telemedicine—as long as the current legal situation applies.
Those who opt for a telemedicine solution should be aware that the requirements (e.g., the obligation for personal contact) could change during the course of treatment.
For long-term therapy planning, it is advisable to consult official sources (Federal Ministry of Health, Federal Institute for Drugs and Medical Devices) rather than other sources.