How old do you have to be to get a medical card?

Short answer: In most states, you can get a medical card in your own name at 18. Under 18, a parent or legal guardian usually has to consent and register as your caregiver. A few places set a higher age: North Dakota treats patients under 19 as minors, and Puerto Rico’s program starts at 21. If you’re 18 to 20, a medical card is often the only legal way to buy cannabis.

The age rules for medical cannabis are set by each state, not the federal government. They also differ from the rules for recreational cannabis, which is 21+ in every state covered here. Here’s how the age requirements work, state by state, as of October 2026.

How old do you have to be to get a medical card?

In most states, 18. That’s the age at which you can be certified by a physician and register as a patient without a parent or caregiver.

A handful of states and territories work differently:

• Puerto Rico: The age of majority is 21. Anyone under 21 can only take part through a parent or court-appointed guardian, needs recommendations from two physicians, and cannot enter a dispensary.
• North Dakota: State law defines a minor as anyone under 19. An 18-year-old patient needs a parent or guardian as caregiver and is limited to pediatric products.
• Washington DC: Patients 21 and older can self-certify. Patients aged 18 to 20 need a written recommendation from an authorized practitioner.
• Minnesota, Louisiana and Texas: The law sets no minimum patient age. Texas and Louisiana don’t issue a state patient card at all; a physician or clinician recommends or prescribes directly.

Some states also set a higher age for certain products. In Minnesota, smokable flower is sold only to registered patients and caregivers who are 21 or older. In Louisiana, a patient under 21 can only buy raw flower with a recommendation that specifically covers it.

Can you get a medical card at 18?

Yes, in almost every state with a medical program. At 18 you apply as an adult patient, in your own name, with no parent involved.

You still need to meet the same criteria as any other adult. That means having a condition your state recognizes, getting certified by a licensed physician, and registering with your state program where registration is required. Age alone doesn’t qualify you.

One limit catches many 18-year-olds: you usually can’t be someone else’s caregiver yet. Florida, Illinois, Pennsylvania, Ohio, Michigan, Missouri, Maryland, Massachusetts, Maine, Arkansas, West Virginia, North Dakota and Puerto Rico all set the caregiver minimum at 21, with limited exceptions.

Why a medical card matters if you’re 18, 19 or 20

In every state in the table below that allows recreational cannabis, the minimum age is 21. If you’re 18 to 20, a medical card is the legal route.

In these states, recreational stores serve adults 21 and over, while registered medical patients aged 18 to 20 can buy at medical dispensaries: California, Connecticut, Delaware, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nevada, New Jersey, New Mexico, New York, Ohio, Oregon and Washington.

In Virginia and Washington DC, adults 21+ can legally possess cannabis, but there are no legal recreational sales. The medical program is the only legal way to buy, at any age.

In medical-only states such as Florida, Pennsylvania and Georgia, there’s no recreational option for anyone. The card is the only legal route whether you’re 18 or 58.

A few details for 18- to 20-year-olds:

• Washington: Patients aged 18 to 20 need a recognition card and can only shop at stores with a medical cannabis endorsement.
• Minnesota: Patients under 21 can buy medical products, but not smokable flower.
• Washington DC: Patients under 21 need a practitioner’s recommendation instead of self-certifying.

A medical card is a protection under state law. Since April 28, 2026, state-licensed medical marijuana has been in Schedule III federally, but that doesn’t make cardholders federally protected, and recreational cannabis remains Schedule I. Some questions, such as gun ownership for cardholders, are still unresolved.

18 or older? Find out if you qualify

Talk to a licensed physician online and see whether you meet your state’s criteria for a medical card.

See if you qualify →

Medical card age requirements by state

This table covers the states where Leafwell connects patients with physicians; click a state for its full application guide.

Rules change often. Check your state’s program before you apply.

Can you get a medical card if you’re under 18?

Usually not in your own name, but you can still be a registered patient. In nearly every state, a parent or legal guardian has to consent and register as your caregiver. The caregiver, not the minor, buys and holds the medical cannabis.

Many states add extra steps for minors. Florida, Illinois, Massachusetts, Michigan and Oklahoma require two physicians, and Connecticut requires letters from two clinicians. Several states also limit which products minors can use; Connecticut, Maine and Montana, for example, don’t allow smoking.

For the full process, read our guide to getting a medical marijuana card for your child and our overview of medical marijuana caregiver rules.

How old do you have to be to go to a dispensary with a medical card?

In most states, the same age as getting the card: 18. Registered patients aged 18 to 20 shop at medical dispensaries, while recreational stores stay 21+.

The exceptions follow the table above. In North Dakota, an 18-year-old patient’s caregiver buys for them. In Puerto Rico, no one under 21 may enter a dispensary. For store-entry rules, including for visitors without a card, see can you enter a dispensary at 18?

What you need to get a medical card at 18

The steps are the same as for any adult patient:

1. Check your state’s qualifying conditions. Each state publishes its own list. Your state page shows it.
2. Get certified by a licensed physician. In many states this can be done online. The physician decides whether you meet your state’s criteria.
3. Register with your state program, if your state requires it, and pay any state fee.

Costs vary by state. See our breakdown of how much a medical marijuana card costs. Most cards expire, so plan for renewing your medical card too.

This article is general information, not legal advice. State rules are summarized as of October 2026.