Montana Infertility Insurance Mandate

There are just 15 states that have infertility insurance mandates in place, which are laws that require insurance plans to either offer coverage or provide coverage for fertility treatments or IVF costs. Montana is one of the states that has an mandate for fertility treatment coverage, though it is required only under limited conditions.

Montana’s fertility treatment insurance coverage law, which was enacted in 1987, is found under Section 33-31-102 of the Montana Code Annotated. Under this law, health maintenance organizations (HMOs) are required to provide coverage for “infertility services.” As defined by this law, infertility services are listed under the “basic health care services” that must be covered.

However, the Montana Code Annotated does not provide any further clarification of infertility services, including what fertility treatments, fertility drugs, or fertility procedures are required to be covered. The Montana infertility insurance law also does not clarify whether IVF costs are included under “infertility services.”

It is important to recognize that Montana only requires that HMOs offer coverage for these “infertility services.” According to Section 33-22-1521, the law specifically exempts health insurers other than HMOs from the infertility services requirement. In fact, other insurers are explicitly exempt from providing coverage for reversal of sterilization, artificial insemination, or treatment for infertility. Like in the HMO section, there is no further definition of these fertility treatments.