Short answer: the Washington medical cannabis recognition card costs a minimum of $1 and lasts as long as your authorization, according to the Department of Health patient information page. The three differences that matter most are tax, purchase limits and home growing. A cardholder buys “excise and sales tax free,” can buy and possess up to three times the adult-use amounts, and may grow six plants at home (up to 15 if the practitioner allows), which the Department’s page describes for patients only. These differences matter most to a frequent buyer (tax and limits), to a patient aged 18 to 20 (who must hold a card to buy from a medically endorsed store), to a parent of a minor patient (who must be the registered designated provider), and to anyone who wants to grow at home. For the steps to get the card, see our Washington medical marijuana card guide.
How does a card compare with buying as an adult?
The table sets an adult-use buyer aged 21 or older beside two patient positions: a practitioner’s authorization without registry enrollment, and a registered cardholder with the recognition card. Each cell gives the state’s figure or wording and the page or statute it comes from. For how Washington compares with other states’ card programs, see our Medical Cannabis Card Guide.
| Point | Adult-use buyer, 21 or older | Authorization holder, not in the registry | Registered cardholder (recognition card) |
|---|---|---|---|
| Tax on a purchase | 37% excise tax on each retail sale, plus general sales tax (RCW 69.50.535(1)(a)) | No registration benefits, including tax exemptions (DOH patient FAQ) | Excise tax does not apply to qualifying sales until June 30, 2029 (RCW 69.50.535(2)(a)); “excise and sales tax free” (DOH patient page) |
| Purchase limits | One ounce usable cannabis; 16 oz solid infused product; 72 oz liquid infused product; seven grams concentrate (DOH patient page; RCW 69.50.360(3)) | “Purchase only the amounts allowed for non-patients” (DOH patient page) | Three ounces usable cannabis; 48 oz solid infused product; 216 oz liquid infused product; 21 grams concentrate (DOH patient page) |
| Minimum age | 21 (RCW 69.50.360(3)) | Registration is voluntary for adults 18 and older. Patients aged 18 to 20 must register and hold a card to buy from a medically endorsed store (DOH patient FAQ) | Patients aged 18 to 20 may buy general-use and high-CBD products from a medically endorsed store with a card (WAC 246-70-040(1)(d), (3)(c)) |
| Products and potency | Single serving up to 10 mg active delta-9 THC; single package up to 100 mg (WAC 314-55-095(1)(a)-(b)) | Same serving and package limits as adult-use buyers (WAC 314-55-095(1)) | High-THC compliant products of more than 10 and up to 50 mg THC per serving, sold only at medically endorsed stores, for cardholders aged 18 and older (WAC 246-70-040(2)) |
| Home growing | The Department’s patient page does not describe home growing for adult-use buyers | Four plants and up to 6 oz produced from them (DOH patient page) | Six plants and up to 8 oz produced from them; up to 15 plants and 16 oz if the practitioner allows (DOH patient page) |
| Cooperatives | Membership requires a valid recognition card (DOH patient page) | Membership requires a valid recognition card (DOH patient page) | Up to four patients or designated providers may grow together, with a maximum of 60 plants (DOH patient page; RCW 69.51A.250) |
| Arrest protection | Possession within the adult-use amounts is not a violation (RCW 69.50.4013(3)(a)) | RCW 69.51A.040 covers an unregistered patient holding a valid authorization within set amounts, but the authorization form must state that it does not protect from arrest unless the patient is also entered and holds a card (RCW 69.51A.030(3)) | Protection from arrest, prosecution and seizure for possession under state law, when the conditions of RCW 69.51A.040(1) are met |
| Buying plants, clones or seeds | Not listed among the Department’s registry benefits (DOH patient FAQ) | Not listed among the Department’s registry benefits (DOH patient FAQ) | May buy immature plants, clones and seeds from a licensed producer (DOH patient FAQ; RCW 69.50.325) |
How does the card change the tax?
For adult-use sales, RCW 69.50.535(1)(a) sets a cannabis excise tax “equal to thirty-seven percent of the selling price on each retail sale in this state.” It is separate from general state and local sales taxes. The Liquor and Cannabis Board tax reporting guide describes the same 37% tax, collected from consumers at the time of purchase.
For a cardholder, RCW 69.50.535(2)(a) says that until June 30, 2029, the excise tax “does not apply to sales by a cannabis retailer with a medical cannabis endorsement to qualifying patients or designated providers who have been issued a recognition card.” The exemption covers only cannabis concentrates, useable cannabis or cannabis-infused products that the Department identifies as compliant under chapter 246-70 WAC and that are tested to the standards in WAC 246-70-040. The Board’s guide lists the same conditions: the sale is made by a licensed retailer with a valid medical endorsement, to a patient or designated provider with a valid card, and of a DOH-compliant product. The Department’s patient page says cardholders may buy “excise and sales tax free,” and its FAQ says cardholders receive the excise and sales tax exemptions when they buy DOH medical cannabis products from a medically endorsed retailer.
If you are not in the registry, you get none of this. The Department’s FAQ says “unregistered patients will not receive registration benefits, such as tax exemptions.”
How much can I buy and possess?
The purchase amounts in the table come from the Department’s patient page. An adult-use buyer aged 21 or older may buy the adult-use amounts from a licensed retail store under RCW 69.50.360(3), and possession within those amounts is not a violation under RCW 69.50.4013(3)(a). A cardholder may buy the higher amounts listed in the table. The Department’s FAQ says registered patients may “possess up to three times the limits for recreational users and grow your own plants.” An authorization holder who is not in the registry is held to the adult-use amounts: the patient page says these patients may “only” purchase “the amounts allowed for non-patients.”
Which products can a cardholder buy?
The Department’s FAQ says “any licensed retail store may sell medical cannabis other than products in the high-THC classification.” High-THC products may be sold only by a medically endorsed retailer and must be bought by a patient or designated provider entered in the registry. Under WAC 246-70-040(2), a high-THC compliant product contains more than 10 but no more than 50 milligrams of THC per serving, and the only product types that can qualify are capsules and tablets, tinctures, transdermal patches and suppositories. Cardholders aged 18 and older may buy these products (WAC 246-70-040(2)(f)).
Adult-use buyers, and patients who are not in the registry, are limited under WAC 314-55-095(1) to a single serving of cannabis-infused product of no more than 10 milligrams of active delta-9 THC, and a single package meant to be eaten or swallowed of no more than 100 milligrams.
Can a cardholder grow plants at home?
The Department’s patient page describes home growing for patients. A cardholder may grow six plants for personal medical use and possess up to 8 ounces of usable cannabis produced from them. If the practitioner determines more is needed, the authorization can allow up to 15 plants and 16 ounces. An authorization holder who is not in the registry may grow four plants and possess up to 6 ounces, and the page says “these amounts may not be exceeded, even if the healthcare practitioner entered a higher number of plants on the authorization form.” The Department’s patient page does not describe home growing for adult-use buyers. For qualifying patients and designated providers, no more than 15 plants may be grown or located in a housing unit, even if multiple qualifying patients or designated providers reside in the housing unit, except in a registered cooperative.
Cooperatives
RCW 69.51A.250 allows up to four medical cannabis patients or their designated provider to join a cooperative to grow for personal use. Each member must be 21 or older, hold a valid recognition card and be entered in the registry. Members may grow only up to the plants on their authorization, with a maximum of 60 plants, and the cooperative must be at a member’s home, limited to one per tax parcel.
What is the minimum age for a card?
For adult-use purchases the minimum age is 21 (RCW 69.50.360(3)). The Department’s FAQ says registration is voluntary for adult patients aged 18 and older. It also says patients aged 18 to 20 “must register and have a recognition card to purchase products from a medically-endorsed store,” and that these patients “may not purchase cannabis from a store without a medical endorsement.”
A practitioner may authorize cannabis for any patient, regardless of age, if it is medically appropriate under the law and the profession’s standard of care (DOH patient FAQ, citing RCW 69.51A.030). Patients under 18 must have a designated provider who is their parent or legal guardian, must be entered in the registry, and must renew every six months (DOH patient FAQ; RCW 69.51A.230(4)(a)). The designated provider must be 21 or older. MedlinePlus says “providers are not allowed to prescribe medical marijuana to people younger than age 18,” which differs from the Department’s position, so ask the practitioner how it applies to you.
Does the card protect me from arrest?
RCW 69.51A.040 says the medical use of cannabis under chapter 69.51A RCW is not a crime, and a patient or designated provider may not be arrested, prosecuted or subject to other criminal sanctions for possession, manufacture or delivery under state law if the conditions are met. These include: the patient is entered in the database and holds a valid recognition card, or holds a valid authorization and has not been entered and has no card; the patient possesses no more than the amounts under RCW 69.51A.210; the patient keeps a copy of the card or authorization and posts the provider’s contact information next to any plants or products at home; and the designated provider has not served more than one patient within a fifteen-day period. Patients in a registered cooperative under RCW 69.51A.250 are also covered.
The authorization form itself must carry a statement that an authorization “does not provide protection from arrest unless the qualifying patient or designated provider is also entered in the medical cannabis authorization database and holds a recognition card” (RCW 69.51A.030(3)).
Can a police officer see whether I have a card?
Under RCW 69.51A.040(1)(b), you present your recognition card, or your authorization if you have no card, to any law enforcement officer who questions you about your medical use. RCW 69.51A.230(1)(d) lets law enforcement in a bona fide specific investigation of suspected cannabis-related activity confirm the validity of a card. RCW 69.51A.230(9)(a) makes the registry’s personal information confidential and exempt from public disclosure.
What does the card not change?
Adults aged 21 and older already may buy and possess cannabis within the adult-use amounts under RCW 69.50.360(3) and RCW 69.50.4013(3)(a), so you do not need a card for those purchases. The card does not change federal law. MedlinePlus states that “possession of marijuana is illegal under federal law.” The arrest protection in RCW 69.51A.040 is written for possession, manufacture or delivery “under state law.” For jobs and drug tests, read our Washington cannabis pre-employment testing exceptions guide before you assume the card covers you.
Who qualifies, and can a doctor say no?
The Department’s patient page says a qualifying patient must have been diagnosed with a qualifying condition, and it limits the list to cancer, HIV, multiple sclerosis, epilepsy or other seizure disorders, spasticity disorders, intractable pain, glaucoma, Crohn’s disease with debilitating symptoms, hepatitis C with debilitating nausea or intractable pain, certain diseases causing nausea, vomiting, wasting or spasms, posttraumatic stress disorder and traumatic brain injury. Anxiety is not among the listed conditions.
A qualifying condition gives you legal access to the program, not proof that cannabis helps. A 2014 review indexed by PubMed, in Expert review of neurotherapeutics, says a small number of high-quality clinical trials support cannabinoids for spasticity of multiple sclerosis, pain that does not respond to opioids, glaucoma, and nausea and vomiting, and that data on adverse events and safety are limited.
Yes, a practitioner can say no. The Department’s FAQ says the law permits certain practitioners to authorize cannabis “but does not require them to” (RCW 69.51A.060(3)). When you are with the practitioner, expect the record to document your condition and that cannabis may benefit it, and the practitioner must inform you of other treatment options and document other measures you have tried (RCW 69.51A.030(2)(b)(iii)-(v)). Describe your condition and the other treatments you have used.
What does the card cost, and how do I get one?
The Department’s patient page says the law requires a minimum $1 fee for the card. The FAQ adds that “the law does not restrict retail stores from charging more than the $1 fee” (RCW 69.51A.230(10)). Your recognition card has the same expiration date as your authorization. The FAQ says adults must renew both “each year” and patients under 18 “every six months.” The clinician visit is a separate cost the state does not set, and the FAQ notes that insurance companies “are not required to cover medical cannabis.”
The steps are short. A practitioner from the listed provider types (ND, DO, MD, PA or ARNP) may issue an authorization if they determine you qualify, and the Department does not keep a list of which providers authorize. Then a certified consultant at a medically endorsed store registers you and issues the card, and you bring your authorization and government or state-issued identification to that appointment.
You cannot get the card online. The Department’s FAQ says that by law the first doctor visit must be in person and the initial recognition card must come from a medically endorsed store. After the initial visit, your practitioner may note in your health record that you can renew the authorization by telemedicine.
The trade-offs to weigh: adults renew every year, renewal means another practitioner visit plus a store visit for the card, and the registry offers account activity reports that show who accessed your account.
Are there other patient-only protections?
The Department’s patient page describes Ryan’s Law, which it says will require hospitals, nursing homes and hospice care centers to allow the medical use of cannabis by qualifying patients with a terminal condition while on the premises. Facilities must comply by January 1, 2027. Emergency departments, patients receiving emergency care and patients who have not been admitted for inpatient services are excluded. Each facility’s policy must prohibit smoking or vaping as a method of use, and patients must provide a copy of their authorization. The Department also describes compassionate care renewal, which lets a designated provider renew your card at a medically endorsed store if your practitioner determines that renewing in person would cause severe hardship.
Before you visit a store
- Call the medically endorsed store ahead of time, because the Department’s FAQ says you schedule an appointment with a certified consultant.
- Bring your authorization and government or state-issued identification.
- Ask the store what it charges beyond the $1 state fee, and ask whether a product is DOH-compliant and tested to chapter 246-70 WAC.
- Be wary of any website that charges for a “card” the state itself does not issue. Under the Department’s steps, the recognition card is made by a certified consultant at a medically endorsed store.
HealthDataConsortium.org is a publisher. It is not a clinic and not a government office.
By HealthDataConsortium.org Research Team
This article is for general information purposes only and does not constitute medical advice. Consult your doctor or qualified healthcare provider before making changes to your health routine.
