Quick answer
Medical cannabis is legal in 39 states and the District of Columbia as of 2025, according to the National Conference of State Legislatures. Federal law still lists cannabis as a Schedule I controlled substance. Patients buy medical cannabis at dispensaries licensed by their state. Each state health department publishes the list of licensed stores. Use that list, not a search ad.
Step 1: Confirm your state runs a medical program
Programs differ by state. Check the state health department site for four items.
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- Qualifying conditions. Common ones include cancer, chronic pain, epilepsy, multiple sclerosis, Crohn's disease, and post-traumatic stress disorder.
- Residency. Most states require a state ID or proof of address in that state.
- Age. Most programs set the minimum at 18. Patients under 18 need a caregiver.
- Fees. State registration runs $25 to $100. Some states waive the fee for veterans or low-income patients.
Step 2: Get a certification from a licensed provider
A physician, and in some states a nurse practitioner or physician assistant, reviews your records and certifies that you have a qualifying condition. Certification costs $50 to $200. Insurance does not cover it. Ask for the certification in writing or in the state portal. A certification is not a prescription. The provider does not pick the product or the dose.
Step 3: Register with the state
Submit the certification, your ID, and the fee to the state. Approval takes 1 day to 30 days. Most cards last 1 year. Some states, including Florida and Pennsylvania, charge separate fees for a caregiver card. Renewal needs a new certification each year.
Step 4: Find a licensed dispensary
Three sources list licensed stores.
- The state licensee lookup. Search by city, ZIP code, or license number.
- The state public license registry, which shows inspection and disciplinary records.
- State-licensed delivery services. Check the license number on the store site against the state list.
Unlicensed delivery services operate in some cities. Product from these sellers has no testing record for pesticides, mold, or potency.
Step 5: Confirm details before you go
- Medical-only or dual license. A dual license means the store also sells to recreational customers. Medical patients may get a separate line, lower tax, or higher purchase limit.
- Purchase limits. Limits are set by weight or by a 30-day to 90-day supply.
- Tax. Medical cannabis tax ranges from 0% to about 20% by state.
- Hours and delivery radius.
Out-of-state patients
Some states accept a card from another state. Examples include Arizona, Maine, Michigan, Nevada, New Hampshire, New Mexico, Rhode Island, and the District of Columbia. Oklahoma issues a 30-day visitor license. Call the dispensary before you travel. Rules change, and a store can decline an out-of-state card.
States without a medical program
Eight states have no medical cannabis program as of 2025: Idaho, Indiana, Kansas, North Carolina, South Carolina, Tennessee, Wisconsin, and Wyoming. Nebraska voters approved a program in 2024. It has not opened. CBD products with 0.3% THC or less are legal under the 2018 Farm Bill.
Federal note
The FDA has approved four cannabis-related drugs: Epidiolex, Marinol, Syndros, and Cesamet. The DEA moved to reschedule cannabis in 2024. The rule is not final. A medical cannabis card does not protect you under federal law, and it does not apply on federal land.