The short answer
A medical cannabis card comes from a state, and you apply to that state's own program for it. In most states a practitioner has to certify you before the state looks at your application. In the District of Columbia you can self-certify instead, if you are 21 or over.
The detail
In most states the steps run in this order. A few programs work from the practitioner's recommendation with no card, so read your own state's page before you rely on the sequence.
- Open your state's page from cannabis law, state by state, and check that a medical program runs there.
- Collect the ID and the proof of address the program requires.
- Book a visit with a practitioner your state's program authorizes to certify you.
- The practitioner examines you and decides whether you qualify.
- The practitioner signs the certification, and either hands it to you or sends it to the state.
- You apply to the state's registry with the certification, your ID and the state's fee.
- The state reviews the application and issues the card if it accepts you.
- You show the card and your ID at a licensed store, which checks it in the way its own state requires.
- You renew before the card expires, on the schedule your state sets.
Federal law lists marijuana in schedule I of the drug schedules (21 U.S.C. § 812. Schedules of controlled substances). In April 2026 the Acting Attorney General moved two forms of it into schedule III: marijuana in a product the Food and Drug Administration has approved, and marijuana subject to a state medical marijuana license. Every other form stays in schedule I (Schedules of Controlled Substances: Rescheduling of Food and Drug Administration Approved Products Containing Marijuana From Schedule I to Schedule III; Corresponding Change to Permit Requirements, 91 FR 22714 (Apr. 28, 2026)).
A store registered under that order may dispense to a person whom state law authorizes to possess marijuana for medical purposes, within the limits of its state license. A document your state accepts as authorizing you to obtain medical cannabis is enough for that store to dispense to you. The order sets the federal prescription rules aside for that document. The document has to be dated and signed on the day it is issued. It carries your full name and address, and the name, address and state license number of the practitioner who signed it, who must be authorized to do so under state law (Schedules of Controlled Substances: Rescheduling of Food and Drug Administration Approved Products Containing Marijuana From Schedule I to Schedule III; Corresponding Change to Permit Requirements, 91 FR 22714 (Apr. 28, 2026)).
What varies by state
A state decides who may apply, which conditions qualify, what it charges, how long a card lasts and what a renewal asks for.
In 20 states and districts a medical store is the only cannabis store licensed, so you buy there through the state's medical program: Alabama, Arkansas, District of Columbia, Florida, Georgia, Hawaii, Iowa, Kentucky, Louisiana, Mississippi, Nebraska, New Hampshire, North Dakota, Oklahoma, Pennsylvania, South Dakota, Texas, Utah, Virginia and West Virginia. Most of those programs issue a card, and a few end at the practitioner's recommendation instead. Do I need a medical card to buy weed in my state? sorts every state by what it asks for.
Every state that licenses recreational stores runs a medical program as well, so a card is worth having in all 43 jurisdictions with a counter.
Most states' statutes list the conditions that qualify, and this site does not repeat those lists. A few list none and leave it to the practitioner. Open the page for the state you live in and follow the citation in its medical section to the statute itself.
What to watch out for
A medical program can set a lower age than a recreational store, and where a state sets one it is nearly always 18.
Do I need a medical card to buy weed in my state? takes the question of whether a second state will accept the card yours issued.
The practitioner charges you for the visit, and the state charges you for the card.
Where to go next
Cannabis law, state by state holds a page for every state and the District of Columbia, and one for federal law. A state page's medical section says whether a program runs there, and its minimum age section carries the age its program sets, with the statute behind it, or says so where that state's own text could not be read. What federal law says about weed explains what the April 2026 rule changed.
Search the store directory by city or by ZIP code, and filter it to a medical dispensary. A store page gives the date its record was last checked against the state's own list.