There is no minimum age to qualify for a medical cannabis card in most U.S. states. Adults 18 and older can apply on their own, while patients under 18 can also qualify but face additional requirements, including parental consent and extra physician evaluations. The process for minors is more involved by design, but the option exists in nearly every state with a medical cannabis program.
Adult Applicants: 18 and Older
If you’re 18 or older, the process is straightforward in every state with a medical marijuana program. You need a certification from a licensed physician confirming you have a qualifying medical condition, then you submit an application to your state’s cannabis regulatory agency. Qualifying conditions vary by state but commonly include chronic pain, cancer, epilepsy, PTSD, and multiple sclerosis.
Registration fees are generally modest. New Jersey, for example, charges $10 for a physical ID card, and digital cards are free. Both types are valid for two years. Other states charge anywhere from $0 to $200 for the card itself, though the physician visit to get certified is a separate cost that typically runs $100 to $300 out of pocket since most insurance plans don’t cover it.
Patients Under 18: What’s Required
Minors can qualify for a medical cannabis card, but states build in extra safeguards. The core requirements are consistent across most programs: a parent or legal guardian must provide written consent, and that parent or guardian must register as the minor’s caregiver. The minor themselves cannot purchase cannabis from a dispensary. Only the designated caregiver can buy and administer it.
Most states also require certification from two physicians rather than one. In Florida, one of those physicians must be a pediatrician who independently evaluates the patient and agrees with the original certification. Massachusetts has a similar rule, requiring two certifying healthcare providers, one of whom must be a pediatrician or pediatric specialist. This dual-physician requirement is the biggest procedural difference between adult and minor applications.
Florida adds a further restriction on smoking as a delivery method: a patient under 18 can only receive smokable cannabis if they have a terminal condition, their physician determines smoking is the most effective route, and a board-certified pediatrician concurs. In practice, most minor patients use oils, tinctures, or capsules.
Which Conditions Qualify Minors
States don’t typically maintain a separate list of qualifying conditions for minors, but the practical reality is narrower. The American Academy of Pediatrics supports medical cannabis for children only with “life-limiting or severely debilitating conditions” when current therapies haven’t worked. Pediatric experts at Children’s Hospital Colorado note that clinical evidence so far only supports its use for a few specific types of epilepsy and chemotherapy-induced nausea and vomiting.
That said, many state laws are written broadly enough that other serious conditions could qualify. A minor with Crohn’s disease, severe autism-related behavioral issues, or intractable pain from a chronic illness may be eligible depending on the state. The qualifying physician makes that call, and the requirement for a second physician to agree acts as a built-in check.
The Caregiver Role
When a minor holds a medical cannabis card, their parent or legal guardian takes on a formal legal role as their caregiver. This person handles every interaction with the dispensary, controls dosing, and is legally responsible for how the cannabis is stored and used. In California, caregivers must be at least 18 unless they are an emancipated minor or the parent of a minor child who is the patient. Most states set the caregiver age floor at 21.
Caregivers typically need to register with the state, pass a background check, and in some cases pay a separate registration fee. Only the registered caregiver can pick up the patient’s cannabis. If the caregiver can’t make it to the dispensary, a substitute can’t step in unless they’ve also been registered with the state program.
Medical Cannabis at School
One practical concern for parents of minor patients is whether their child can access medical cannabis during school hours. A growing number of states have addressed this. Maryland, for example, allows both public and nonpublic schools to establish policies for administering medical cannabis to qualifying student patients during school hours and school-sponsored activities. However, school nurses cannot be required to administer it, so in practice, a parent or designated caregiver often needs to come to the school.
Policies vary widely by state and even by school district. Some states permit only non-smokable, non-inhalable forms on school grounds. Others leave it entirely to local school boards. If your child is a medical cannabis patient, checking with your school district before assuming campus access is allowed will save you complications.
How to Get Started
For adults, the first step is scheduling an appointment with a physician who is registered with your state’s medical cannabis program. Many states maintain a searchable directory of certified physicians on their health department websites. After receiving your certification, you submit your application online, pay the registration fee, and receive your card, typically within a few weeks.
For minors, start with your child’s pediatrician. Even if they don’t certify cannabis patients themselves, they can refer you to a physician who does and may serve as the required second evaluator. Gather your child’s medical records showing prior treatments that haven’t worked, as this documentation strengthens the application. From there, the parent or guardian submits the application on the child’s behalf and registers as the caregiver in the same process.