States That Allow Out-of-State Medical Cards

In theory, Arizona has a form of reciprocity with other states. Some provisions in its statutes (36-2804.03) state that out of state patients, called "visiting qualifying patients", are allowed to possess cannabis under the same set of rules that apply to Arizona medical marijuana patients. 

An important distinction however is that visiting patients are not allowed to purchase marijuana at dispensaries in Arizona. That means if you visit Arizona, you'll be fine if you have a friend's bud but you won't be able to buy your own. 

Possession limits in Arizona are set at 2.5 ounces of cannabis per patient.

When planning to consume marijuana, you may also want to review this page on legal use of cannabis in AZ. For instance, smoking weed in 'any public place' is prohibited among other limitations. 

To sum it up: Arizona does not provide reciprocity for purchasing MMJ, but a Pennsylvania card will provide you some protections for possession.

1) 36-2804.03 Issuance of registry identification cards

https://www.azleg.gov/ars/36/02804-03.htm

2) 36-2801. Arizona Medical Marijuana Act; Definitions

https://www.azleg.gov/ars/36/02801.htm

3) 36-2802. Arizona Medical Marijuana Act; limitations

https://www.azleg.gov/ars/36/02802.htm

While many states do not require you as an out-of-state visitor to interact directly with the state bureaucracy, Hawaii’s reciprocity provision presents several administrative hurdles for patients to clear before they can legally purchase cannabis at local dispensaries. Patients planning a trip to Hawaii must complete an application using the Hawaii Department of Health’s Medical Cannabis registry and meet several criteria for a successful application. Thankfully Hawaii’s DoH knows that the process can be a bit confusing and cumbersome and have clearly laid out links to resources, checklists, and regulations on their website.  

There’s a lot to go through, so here’s a quick run-down on the application process

• You must create an account on the Hawaii Department of Health web portal.  
• You may begin applying to be an out-of-state patient 60 days prior to your travel.  
• Although there doesn’t appear to be a minimum date before your arrival when you are required to begin, we would recommend starting this process as early as possible since your application has to go through an approval process.  
• You will need to select one of Hawaii’s approved qualifying conditions  
• You’ll need to provide a clear digital copy of both your valid, non-expired medical marijuana card and a government ID issued by the state that provided your medical card, i.e. a PA med card and a PA driver’s license.  
• The fee to apply is $49.50 and is non-refundable, even if your application is denied.
• When and if your application is approved, you will need to log back into your account and download and print your registration card
• You may only apply for two registrations per calendar year.

Applying successfully also requires your current certification in your home state to be issued for one the approved conditions in Hawaii (§329-122-c-2). Hawaii’s list of conditions unfortunately appears to be more limited in scope than other states, including Pennsylvania. This list of approved conditions is here, but to sum, conditions that are explicitly approved in PA but not explicitly in Hawaii include:  

• Anxiety
• Autism
• Chronic Hepatitis C
• Damage to the nervous tissue of the central nervous system
• Huntington’s disease
• Inflammatory bowel disease
• Neurodegenerative diseases
• Neuropathies
• Opioid use disorder
• Parkinson’s disease
• Sickle cell anemia
• Terminal illness
• Tourette syndrome

However, even if your specific condition is not listed on their approved conditions list, Hawaii has a broader set of criteria you may qualify for if you have “a chronic or debilitating disease or medical condition” or if treating your condition causes any of the following, you will qualify for out-of-state registration:

• Cachexia or wasting syndrome
• Severe pain
• Severe nausea
• Seizures, including those characteristic of epilepsy
• Severe and persistent muscle spasms, including those characteristic of multiple sclerosis or Crohn's disease
• “Any other medical condition approved by the department of health pursuant to administrative rules in response to a request from a physician or potentially qualifying patient.”

Consider whether any of the above apply to you before determining that you do not qualify for Hawaii’s program.  

Alright, you’ve gathered your documents, applied for out-of-state permission, paid the application fee, received your registration via email, and you're thinking, 'that must be the end of that'. But wait, there’s more! You must also ensure you are following Hawaii’s use and possession laws. Hawaii has a smoke-free law that must be followed and is applicable to smokers and vapers alike. We would list prohibited places here but the list is long and space is short so please review CHAPTER 328J to make sure you’re complying before whipping out your pen. 

Essentially, all publicly accessible areas, indoor and outdoor, are effectively off-limits for smoking AND vaping. A useful, much shorter list (§328J-7  Exceptions) contains places that are excepted from the rules which basically boils down to private residences, hotel rooms that are explicitly coded as smoking rooms, and retail tobacco shops. Also, these only apply if the smoke or smell does not leave the property or room. A human-readable summary of restrictions can be found here: https://health.hawaii.gov/medicalcannabisregistry/patients/restrictions/

Good to note before you buy: It is a misdemeanor to possess more than 1 ounce of marijuana, and a petty misdemeanor to possess cannabis without being registered (HRS 712-1248 and -12949). Definitely do not carry 2 lbs or more of cannabis; that is a class B felony in HI. 25 pounds or more of cannabis qualifies as a class A felony.

If you’re finding this all a bit difficult to keep track of, Hawaii’s DoH has provided a useful checklist for steps patients need to follow, links to instructions and resources, and frequently asked questions. https://health.hawaii.gov/medicalcannabis/files/2019/03/HDOH-Checklist-FAQ-for-OSP-Final-3.6.19.pdf

Finally, because Hawaii can only be accessed through air and sea and thus requires that visitors traverse through federal jurisdiction (and marijuana is still a controlled substance illegal to possess federally), they strongly caution against bringing marijuana from out-of-state onto the islands.  

To sum it all up:  Yes, Hawaii does have reciprocity, however with the caveat that you will need to jump through some administrative hoops, it ain't free, and restrictions apply that you should attend to carefully.

1) Hawaii Administrative Rules for the Medical Use of Cannabis (§11-160)

§11-160-6 through -8: Debilitating Medical Conditions

§11- 1 60-43.01 through -43.12: Rules regarding out-of-state patients and caregivers

https://health.hawaii.gov/medicalcannabisregistry/files/2023/01/2019-11-160-Administrative-Rules.pdf

2) Qualifying Medical Conditions

https://health.hawaii.gov/medicalcannabisregistry/providers/debilitating-medical-conditions/

3) Handy checklist and FAQ page

https://health.hawaii.gov/medicalcannabis/files/2019/03/HDOH-Checklist-FAQ-for-OSP-Final-3.6.19.pdf

4) Page that links to many of the other resources here:

https://health.hawaii.gov/medicalcannabisregistry/travel/

5) Human-readable list of restrictions for cannabis use

https://health.hawaii.gov/medicalcannabisregistry/patients/restrictions/

6) Hawaii Government Video Instructions for Applying:  

https://www.youtube.com/watch?v=252eigKZtwk

7) §329-121 through -128 Uniform Controlled Substances Act: Medical Use of Marijuana, including §329-122  Medical use of cannabis; conditions of use.   

https://health.hawaii.gov/medicalcannabisregistry/files/2014/11/HRS-3291.pdf

8) Application Login Portal

https://medmj.ehawaii.gov/medmj/welcome

9)§712-1248.  Promoting a detrimental drug in the second degree.

https://www.capitol.hawaii.gov/hrscurrent/vol14_ch0701-0853/HRS0712/HRS_0712-1248.htm

10) §712-1249. Promoting a detrimental drug in the third degree.  

https://www.capitol.hawaii.gov/hrscurrent/Vol14_Ch0701-0853/HRS0712/HRS_0712-1249.htm

Simple on the surface, Louisiana’s legal documents can be confusing to parse with many changes and amendments intended or planned without clear reference to when they have gone into effect without some digging.  

Louisiana allows out-of-state patients, referred to as ‘visiting qualifying patients’, to purchase medical marijuana at dispensaries if they can furnish a valid medical marijuana card from their state of issue along with a valid driver’s license or other government-issued photo ID. The law here is ambiguous about whether the identifying documents are restricted to IDs issued by the same state as your medical card, but a safe bet would be to use a photo ID issued by the same state as your med card rather than a passport or equivalent (RS 40:1046.1). 

The original law stipulated that dispensaries would have visiting patients fill out forms attesting that they have been ‘diagnosed with one or more debilitating medical conditions’, but that language is a bit vague and open to interpretation about whether those conditions must be valid in Louisiana as well (see Hawaii). There has been however an update to the law that went into effect September 24, 2025 that appears to loosen this restriction or at least clarify if it was ever a restriction to begin with. Louisiana now clearly defines visiting qualifying patients as non-residents of Louisiana who can provide their medical marijuana card as proof that they may legally partake in their home state’s medical marijuana program (§2101. Definitions). You will likely still need to sign an attestation and permit your medical card and government ID to be photocopied at the dispensary for their records.  

Important to note: Subsection D of the law requires the pharmacist or designee at the dispensary to review your patient records which in practice involves directly contacting your certifying physician to verify that you are in the Pennsylvania system. While this may seem redundant to having a valid PA medical card, our team's experience is that this requirement is taken seriously, and they really do call. 

We believe strongly in helping our patients access this medicine so if you are a patient of Herbal Care Rx and will be traveling to Louisiana, please let us know in advance and we will do our best to connect with the pharmacist. We've fielded calls from Louisiana pharmacists on occasion over the years, sometimes while our patients were still at the dispensary! 

If you are not a patient of Herbal Care Rx, please contact the physician who last certified you.

Be aware that you may be refused cannabis products if they are unable to reach your practitioner. 

Restrictions and limitations:  

Under RS 40:1046, dispensaries are permitted to sell no more than 2.5 ounces of marijuana every 14 days to an individual patient. Patients should also assume that Louisiana’s ‘Clean Air’ laws apply to the use of medical cannabis.  

The gist of it: Yes, Louisiana offers reciprocity contingent on some data collection. Dispensaries will verify your ID, Medical Card, etc.

1) Emergency Rule §2101

https://www.doa.la.gov/media/csboaiqi/2510emr011.pdf

2) Louisiana Law for THERAPEUTIC USE OF MARIJUANA  RS 40:1046  

https://www.legis.la.gov/legis/Law.aspx?p=y&d=1295726

3) Louisiana Smoke Free Air Act

https://www.legis.la.gov/legis/Law.aspx?d=964962

Spelt the 'Michigan Medical Marihuana Act' (333.2642), this MI statute has an explicit provision that grants card holders from other states the same rights and protections that a Michigan Medical Marijuana Card would offer (333.26424, subsection (k)). ‘Visiting qualifying patients’ are defined as non-residents or those who have been residents for less than 30-days (to give new residents time during their transition). When reading through the legal documents, you'll also find that all official documents pertaining to MMJ in Michigan use the spelling 'marihuana'.

If you intend to purchase MMJ in Michigan, Dispensaries, referred to as provisioning centers, are required to verify the following:

• You have a valid, unexpired medical marijuana card from a US state or territory. 
• You have a driver’s license or government-issued identification card with a photographic image.
  • Here, it is unclear whether a passport would suffice since the law only requires that the ID be government-issued and bears a photo of you. Several other states are explicit about requiring an ID from the same state as your medical card. A safe bet would probably be using an official ID from your state of residence.  
• The purchasing limit in Michigan has not been exceeded.
  • Patients are limited to purchasing 2.5 ounces of marijuana per day (much less restrictive than several of the states on our list here) and not more than 10 ounces of marijuana in total per month(R 420.506). To track this, dispensaries will record your purchases in a statewide system.  

Being treated similarly to Michigan patients also means you are required to observe the limitations and rules for using and possessing marijuana. Please review this page, 333.26427 Scope of act; limitations; application of certain provisions of the revised judicature act of 1961, and inform yourself before you travel. Some examples are that you may not possess marijuana on school or prison grounds, smoke marijuana anywhere in public, or be under the influence of marijuana if it would be considered dangerous or negligent to do so.

In Summary: Yes, Michigan has reciprocity with medical marijuana cards from other states, including Pennsylvania.

1) Cannabis Regulatory Agency FAQ

https://www.michigan.gov/cra/faq/licensing-list/licensing-new/can-licensed-michigan-provisioning-centers-accept-visiting-qualifying-marijuana-patient-cards

2) 'Michigan Medical Marihuana Act' as it pertains to visiting patients (333.26424)

https://www.legislature.mi.gov/Laws/MCL?objectName=MCL-333-26424

3)333.26427 This section talks about the scope of the law, including limitations and exclusions.  

https://www.legislature.mi.gov/Laws/MCL?objectName=mcl-333-26427

4) R 420.505 Marihuana sale or transfer rule set and R 420.506 Purchasing limits; transactions; marihuana sales location.  

https://www.michigan.gov/cra/-/media/Project/Websites/cra/Laws-Rules-Other-Resources/2019-72_LR_Marihuana_Sale_or_Transfer_694525_7.pdf?rev=6a590bcd5f06445fa3fcab920b3ecad8&hash=0290DDFAE172FF9389AC2036CD199FC1

5) 333.26424b Transporting or possessing marihuana-infused product; violation; fine.

New Mexico law allows patients in medical marijuana programs to purchase and possess cannabis as 'reciprocal participants' in their program (7.34.3.22). To qualify, you need to register (once per year) at a dispensary where they are required to verify that:

• You have a valid Medical Marijuana card from your issuing state (PA).
• You are not a resident of New Mexico. If you change your primary residence from Pennsylvania to New Mexico you will have to enroll in New Mexico's medical marijuana program instead. 
• You are a resident of the state that issued your medical card. That means if you live in PA and have a Pennsylvania medical card you're all set. If on the other hand you have a Pennsylvania medical card but you moved to Ohio recently, you would not qualify to purchase MMJ in New Mexico. 

If you meet these qualifications, you'll then need to bring your state ID card like your PA Driver's license. A passport won't do because they need to determine whether you are a resident of the same state as your medical card. You'll also need your PA Medical Card. Once you're at the dispensary, the staff will then register you as a reciprocal participant and track the amount of cannabis you purchase.

Once your registration is complete you'll be asked to sign an acknowledgement that you know the requirements and limitations of the program. 

Speaking of limitations regarding legal purchasing limits: It appears that there is some outdated information still floating around about the legal purchase and possession limits in NM for patients. Some online guides and older DoH documents still have 230 units (approx 8 ounces or 230g) of cannabis as the legal limit. This quick reference guide (yes, the link is really called '6969') also still has 230 units as the purchasing limit. 

However, since a 2021 update, the law itself states you can purchase and possess up to 425 grams within a 3-month period (7.34.3 Section 9, Subsection A). 

In any case, you won't have to worry too much about that regarding purchasing. The dispensaries in New Mexico are supposed to keep track of your purchases so that you do not exceed the limit within a given timeframe. 

According to this reference guide from the NM Department of Health, reciprocal use does not apply to products purchased in a state other than New Mexico. All cannabis products must have been purchased in NM for protections to apply.

Summing it all up: Yes, New Mexico has reciprocity with Pennsylvania's medical marijuana program, given that you register with a dispensary and have your PA ID along with your medical card. 

1) 7.34.3 Medical Use of Cannabis, 7.34.3.22 RECIPROCITY

https://www.srca.nm.gov/parts/title07/07.034.0003.html

2) Ruling that increased the limit from 230 grams to 425 grams

https://www.nmhealth.org/publication/view/rules/7024/

3) New Mexico Guide to Medical Cannabis Limits

https://www.nmhealth.org/publication/view/guide/9384/

4) Outdated DoH publication still floating on search results

https://cdd.health.unm.edu/infonet/wp-content/uploads/2021/08/Medical-Cannabis-Program-Guide.pdf

5) New Mexico DoH Policy Doc with Old Purchase Limit 

https://www.nmhealth.org/publication/view/policy/6969/

6) Reciprocal Use Only Applies to Cannabis Products Purchased In-State 

https://www.nmhealth.org/publication/view/general/7462/

7) Policy Guide for Dispensaries: Reciprocal Participants 

https://www.nmhealth.org/publication/view/guide/8906/

Does Puerto Rico Allow You to Use Your PA Med Card 

Since 2017, Puerto Rico has had a generous reciprocity program in place in conjunction with its medical cannabis law. According to Ley 42-2017, non-resident patients who reside in other parts of the US may participate in the Puerto Rican medical cannabis program if they have a valid medical cannabis card from their state of residence (42-2017 Art. 2, (v)), provided that they also have a valid ID from the same state (Art. 12) and are in compliance with all of the relevant rules and regulations. 

You might be wondering what exactly the implications of that last part are. An important aspect of not running afoul of the law in Puerto Rico is making sure you are abiding by the rules regarding possession and, importantly, use of marijuana. A full list of laws relating to using can be found in Article 10 of the law, but we'll outline a few of the major points below. 

• According to Article 10(b), the use of medical marijuana is only permitted at home and other privately owned places. 
• Use in public spaces is expressly prohibited (Art. 10(b)).
• You must have both your cannabis card and state ID on you physically at all times while you are using or carrying marijuana. (Art. 10(a,ii))
• You may not use cannabis at a dispensary, and no one under 21 may enter a dispensary (Art. 10(e)). 
• Marijuana must be carried in opaque, resealable, and childproof packaging (Art. 10 (i)).
• Smoking cannabis flower (defined as subjecting marijuana to 400 degrees Fahrenheit or more but plainly speaking: lighting it on fire) is prohibited, but using a vape is allowed (Reglamento 9038, Art. 7(A)). 

Puerto Rico also allows out-of-state travelers who don't have a medical card to acquire a temporary certification for up to 30-days (Reglamento 9038 , Art.116 (B)). You would still have to be authorized by a physician in Puerto Rico and pay a fee, so generally, if you have a PA card we recommend simply making use of it while on your trip. An exception to this recommendation comes from reports from some people (reddit.com/r/PuertoRicoTravel) that dispensaries will sell any product to you except for flower unless you have a card issued by Puerto Rico which includes the temporary traveler card. This seems to be dependent somewhat on the dispensary as others have reported buying flower without issue using their out-of-state cards. 

This inconsistency is possibly related to Art. 9 of Reglamento 9038 that lists the approved methods of consuming cannabis. Art. 9 (B) states that while the consumption vaporized flower is approved (Art. 9 (A)), an exception is made for its dispensation. The medical cannabis office will only approve the purchase of flower if the patient's physician has specifically written a medical rationale for its consumption through vaporizing in their certification. Since dispensaries may not have access to all of the details of your certification including which products you have been approved for, this may explain some of the discrepancies people experience.

Does Puerto Rico require your certification to be issued for one of their approved conditions? 

Like several other states, there is language in the law that implies that your certification should be issued for a condition that is on the list of conditions approved in Puerto Rico (Ley 42-2017, Art.10, (f)). However, the regulatory framework that governs the law's application does not require out-of-state card holders to provide any proof of this on their list (Reglamento 9038, Art. 116 (A)) so it seems unlikely to be an issue.  

Puerto Rico's list of approved conditions also covers many broad categories and conditions with multiple interpretations. Additionally, Pennsylvania's list of conditions is very similar to Puerto Rico's so PA residents should be well-situated under the law. 

Regardless, the full list of approved conditions in Puerto Rico is below. If you decide to get a temporary card it may come in handy: 

1. Alzheimer’s
2. Anorexia
3. Arthritis
4. Autism
5. Cancer and chemotherapy treatment for Cancer
6. Depression
7. Anxiety Disorders, as defined in the DSM-V (Diagnostic and Statistical Manual of Mental Disorders)
8. Disorders related to HIV (Human Immunodeficiency Virus) Positive status
9. Degenerative diseases such as: Amyotrophic Lateral Sclerosis (ALS), Multiple Sclerosis, and Inflammatory Bowel Disease
10. Incurable and advanced diseases requiring palliative care
11. Epilepsy
12. Fibromyalgia
13. Glaucoma
14. Hepatitis C
15. Insomnia
16. Spinal Cord Injuries
17. Migraine
18. Peripheral Neuropathies
19. Parkinson’s Disease
20. Post-Traumatic Stress Disorder (PTSD)
21. Acquired Immunodeficiency Syndrome (AIDS)
22. Bipolar Disorder
23. Any other condition causing cachexia
24. Chronic pain
25. Severe nausea or persistent muscle spasms

To sum it all up: Yes, Puerto Rico has reciprocity with your PA med card. Most of PA's approved conditions are also on Puerto Rico's list, and the process of using your card should be straightforward, however you should keep in mind that some dispensaries may not sell you flower but will sell you other products like edibles, topicals, etc.

What else might be interesting? 

Article 9 of the law reaffirms the illegality of recreational cannabis use within Puerto Rico. Ley 42-2017 was amended in 2021 to include protections for card holders from employment discrimination and termination. 

1) Ley 42-2017: Ley para Manejar el Estudio, Desarrollo e Investigación del Cannabis para la Innovación, Normas Aplicables y Límites (“Ley MEDICINAL”)

https://www.salud.pr.gov/CMS/DOWNLOAD/8934

2) Puerto Rico Department of Health page for the medical cannabis program: Junta Reglamentadora del Cannabis Medicinal

https://www.salud.pr.gov/CMS/364 

3) Reglamento 9038: Reglamento para Manejar el Estudio, Desarrollo e Investigación del Cannabi para la Innovación, Normas Aplicables y Límites

https://www.salud.pr.gov/CMS/DOWNLOAD/4866

4) Reddit posts related to using out-of-state cards

https://www.reddit.com/r/PuertoRicoTravel/comments/1bsqb1y/temporary_medical_card/

https://www.reddit.com/r/PuertoRicoTravel/comments/1991ehq/medical_cannabis_as_a_tourist/

Rhode Island's medical marijuana statute is called The Edward O. Hawkins and Thomas C. Slater Medical Marijuana Act (§ 21-28.6) and can be read in full here. If it looks like a website from the early 90's written solely in HTML, you’ve arrived at the right place.  

Euphemistically defined as Compassion Centers in Rhode Island law, licensed medical marijuana dispensaries are permitted to sell cannabis to out-of-state medical card holders in section 12, subsection (a) of the chapter. That means you’ll be able to use your PA medical card to purchase mmj at Rhode Island dispensaries aka compassion centers. 

Patients who qualify for purchase of medical marijuana in Rhode Island — referred to as ‘authorized purchasers’ — enjoy a broad set of protections under § 21-28.6 section 4. Subsection ‘(o)’ explicitly confers those protections to out-of-state card holders. Please note that the legal possession limit in Rhode Island is 2.5 oz of dried medical marijuana. If you are carrying more than that, you may be forgoing protections including the following: 

• protection from arrest and prosecution (b)
• tenant protection (d) for your status as a card holder, however it does not protect you if your landlord wants to refuse a lease because you smoke or vape on the premises. 
• protection from employment discrimination or disciplinary action by a business solely on one’s status as a card holder. (e) 
  • Exceptions to this are that it does not protect patients from using and being under the influence of marijuana at the workplace, nor from an employer who is a federal contractor or otherwise subject to federal law. 

As always, these protections are contingent on you informing yourself about permitted use and possession in Rhode Island. For a piece of state legislation, it’s a pretty quick and easy read so give it a look before you go to see the full set of rules and regulations. 

To sum it all up: Yes, Rhode Island has reciprocity with your PA med card.

An irrelevant but interesting note from the statute is that it has a retroactive safe-harbor provision granting some immunity to people who sold and distributed their own marijuana plants to compassion centers prior to Dec 2016 (c). While it’s not totally an act of restorative justice since it does not offer protections to people otherwise involved in the use and distribution of MMJ, it’s at least a little tip of the cap to some of the underground structures that had to arise due to the prohibition of cannabis. 

1) Chapter 28.6 in full

https://webserver.rilegislature.gov//Statutes/TITLE21/21-28.6/INDEX.htm

2) § 21-28.6-4. Protections for the medical use of marijuana.

https://webserver.rilegislature.gov//Statutes/TITLE21/21-28.6/21-28.6-4.htm

3) § 21-28.6-12. Compassion centers

https://webserver.rilegislature.gov/Statutes/TITLE21/21-28.6/21-28.6-12.htm