A German court has ruled that a health insurance provider must cover the cost of a woman’s medical marijuana treatment, in a case that highlights an ongoing battle between insurers and patients.

Germany’s medical marijuana program, which was launched in 2017, requires public health insurance providers to reimburse patients for the cost of medical cannabis, except in “justified, exceptional cases,” Marijuana Business Daily reports. This year alone, the German National Association of Statutory Health Insurance Funds (GKV), which covers the public health insurance for 90 percent of the country’s population, has coughed up €75 million ($88.8 million) to cover the cost of patients’ cannabis expenses.

This is a huge improvement over countries like the UK and the US, where patients are forced to shoulder the entire cost of medical cannabis on their own. But although Germany’s law says that insurers can only refuse to cover medical pot costs in the most extreme cases, insurance providers have rejected nearly 40 percent of all applications for cannabis reimbursement since 2017. 

One of the many patients whose request for reimbursement was denied decided to take the matter to court. This patient, who is receiving a disability pension from the German government, suffers from “very pronounced restless legs syndrome with massive sleep disorders, chronic pain disorder with somatic and psychological factors, migraine, recurrent depressive disorder, emotionally unstable personality disorder (borderline) and tinnitus,” according to court documents reported by Marijuana Business Daily.

The patient has been using dronabinol, a synthetic form of THC that is often used to help combat nausea, gastrointestinal issues, and night sweats. But despite the severity of her symptoms, the patient’s public insurance service refused to reimburse her for the cost of this essential medicine. 

After a protracted legal battle, the Social Court of Berlin and Brandenburg ruled that the insurer must cover the patient’s dronabinol costs for one full year. In their ruling, the court explained that “it is undisputed that the applicant has a serious illness,” and since “the suffering of the applicant living on social benefits is serious,” denying her access to medical marijuana would violate her “fundamental rights.” The court also ordered the insurer to cover the patient’s legal costs for the case.

Legal advocates are hopeful that the precedent established in this case will help convince more health insurance providers to respect the law and cover their patients’ medical marijuana costs.