No 10% excise
Medical purchases are exempt from the 10% adult-use excise that dispensaries collect on non-medical sales.
Registering with the state costs $0. The yearly visit with a certified physician is the only bill. Below is the checklist, plus what changed when Ohio legalized adult use and again when SB 56 took effect on March 20, 2026.
Pick the closest match. This checks the State Medical Board list only. It is not a medical opinion.
If your condition appears on Ohio's list, a physician with a Certificate to Recommend can review your records and decide whether to recommend medical marijuana. If it is not clearly on the list, the physician still makes the call on whether your diagnosis fits the Board's wording. Nothing here is an approval.
Start my Ohio evaluationIn Ohio the physician opens your Registry file. You cannot start it yourself, so the visit always comes first.
An MD or DO holding a Certificate to Recommend from the State Medical Board reviews your history, in person or by telehealth.
If the physician finds you have one of the 26 listed conditions, they enter a recommendation and create your Registry account.
Sign in to the Patient and Caregiver Registry and activate your registration. The state charges nothing for this.
Shop at a licensed dispensary. Each year, get a new recommendation and renew in the Registry, as early as 30 days before expiry.
Adults 21 and over have been able to buy without a card since August 6, 2024. These are the differences that are left.
Medical purchases are exempt from the 10% adult-use excise that dispensaries collect on non-medical sales.
Patients may buy up to four days' worth of the daily limit (2.5 oz of plant material or 15,000 mg THC per day) in one transaction.
Patients may possess up to a 90-day supply. Adult-use consumers are held to 2.5 oz of plant material and 15 g of extract.
Ohio sets no minimum age for patients. Minors need a parent's consent and a registered caregiver. Adult-use starts at 21.
Lawful medical use cannot be the sole or primary basis for a custody finding, a transplant-list denial or turning down a tenant (ORC 3796.24).
A patient can name up to 2 registered caregivers, each at least 21, to buy and handle medicine on their behalf.
Type the evaluation price you were quoted and your usual monthly spend. The calculator shows what skipping the 10% excise is worth over a year.
Registration is free in Ohio and medical purchases are exempt from the 10% adult-use excise (Division of Cannabis Control FAQ; Ohio Department of Taxation); sales tax is not included, and the evaluation price is set by the provider.
The State Medical Board keeps this list and takes petitions every November 1 to December 31. A CTR physician decides whether your diagnosis fits.
An Ohio medical marijuana card is a registration in the state's Patient and Caregiver Registry, run by the Division of Cannabis Control (DCC) inside the Ohio Department of Commerce. It costs nothing to register or renew. It lasts a year. And it still matters in a state where any adult over 21 can walk into a dispensary, because medical buyers skip the 10% adult-use excise and play by a different set of limits.
The program dates to House Bill 523 in 2016, with the first medical sales on January 14, 2019. A lot has moved since then. Three changes are worth knowing before you do anything else:
Ohio does things in an unusual order. You do not apply to the state and then find a doctor. A physician with a Certificate to Recommend (CTR) from the State Medical Board of Ohio examines you, enters the recommendation and creates your Registry account. Only MDs and DOs with a full, unrestricted Ohio license can hold a CTR. The Board counted 484 of them on October 14, 2026.
That visit can happen by video. Since February 29, 2024, OAC 4731-32-03 has let the physician-patient relationship be set up through telehealth. Read how online evaluations work in Ohio before you book, and our step-by-step application checklist walks through the visit, the Registry and activation in order.
In Ohio the physician starts your Registry file, so the visit comes first. Online evaluations are available for Ohio residents, and code DRWDY85872 takes 5% off. Registration itself is free.
Start my Ohio evaluation →The State Medical Board lists 26 qualifying conditions, including chronic and severe or intractable pain, PTSD, Crohn's disease and Tourette's syndrome. Anxiety and insomnia are not on it. Our full table of Ohio qualifying conditions also explains the petition window, which runs November 1 to December 31, 2026.
With the state fee at $0, the physician's price is the whole bill, and the state does not set it. On the other side of the ledger, every medical purchase skips the 10% excise that adult-use shoppers pay. Plug your own numbers into the Ohio card cost calculator to see where you land.
If you are 21 or older, you could skip the program and buy adult-use. Whether that makes sense comes down to how much you buy, whether you want to smoke (medical patients may not) and whether a 90-day supply matters to you. We lay the rules side by side on the medical vs. recreational comparison, with an honest answer on when the card stops paying off.
Medical marijuana cannot be smoked in Ohio. It can be vaporized only on private residential or agricultural property. Edibles have to stay in their original packaging when you are not using them. Your employer can still fire you for use. The Ohio patient rules page covers purchase limits, public use, driving and travel.
The DCC's own numbers show how easily cards go stale. On August 31, 2026, the Registry held 475,281 registered patients, but only 73,096 had both an active registration and an active recommendation. A registration needs a fresh recommendation every year to stay usable. The DCC sends a notice 45 days before expiry, and you can renew from 30 days out. Set a reminder now with our Ohio renewal timeline.
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Nothing from the state. The Division of Cannabis Control says there is no activation or renewal cost for registration. You still pay the recommending physician for the visit, and the state does not set that price.
No. Only MDs and DOs with a full, unrestricted Ohio license and an active Certificate to Recommend from the State Medical Board can recommend. Nurse practitioners and physician assistants are not on that list.
Yes. Under OAC 4731-32-03, effective February 29, 2024, the physician-patient relationship can be set up in person or through telehealth. The yearly follow-up can also be a telemedicine visit.
One year. The registration expires one year after issue, on the last day of the month it was issued. You can renew starting 30 days before that date.
It depends on how much you buy and your age. Medical purchases skip the 10% adult-use excise, patients can buy four days' worth at once and hold a 90-day supply, and patients under 21 have no other legal route. The cost is the yearly physician visit.
No. ORC 3796.06 prohibits smoking or combustion of medical marijuana. Vaporizing is allowed only on private residential or agricultural property, and not for patients under 18.
No. Under ORC 3796.28 an employer may refuse to hire, fire or discipline someone for marijuana use, medical included, and may keep drug-testing and zero-tolerance policies.
We found no official source showing a reciprocity agreement in effect, and the Division of Cannabis Control says cannabis bought in another state cannot be brought into Ohio. Registration requires Ohio residency.
Nothing happens in the Registry until a CTR physician enters your recommendation. Online evaluations are available in Ohio, and code DRWDY85872 takes 5% off.