Montana has no law requiring IVF coverage. Since 1987, HMOs must include "infertility services" among basic health care services, but neither the statute nor regulations define them. In 2023, SB 516, the Preserving Fertility Act, required insurers to cover fertility preservation for people with cancer. This is the picture as of October 2026.
| Law | Who it applies to | What it covers |
|---|---|---|
| Mont. Code Ann. §33-31-102 (1987) | Health maintenance organizations (HMOs) only; self-insured employers are exempt | "Infertility services" as a basic health care service, with no definition of what that includes |
| SB 516, Preserving Fertility Act (2023) | Insurance providers | Fertility preservation for people with cancer, including egg retrieval (KPAX) |
Sources: ASRM ReproductiveFacts.org (Montana); Office of the Governor of Montana; KPAX; Triage Cancer (September 2025).
The Governor ceremonially signed SB 516 on August 22, 2023. Sources describe its scope a little differently: the Governor's office speaks of fertility preservation for cancer survivors, while Triage Cancer lists coverage for cancer or other treatment that may cause infertility. The start date is also reported inconsistently: Triage Cancer gives July 1, 2023, while a patient quoted by KPAX said January 2024. Treat both details as unconfirmed and ask your insurer.
If you want IVF, Montana law does not require any plan to pay for it. If you are on an HMO, the plan must offer "infertility services", but you will need to ask what it counts as such. If you face cancer treatment, ask about fertility preservation under SB 516 before treatment starts.
State mandates do not apply to self-insured employer plans, which cover 67% of workers with employer coverage nationwide (healthinsurance.org, June 2026). Check your plan documents for "self-funded" or ask HR.
Confirm current rules with your insurer before treatment, especially the SB 516 details sources disagree on.
Map to the Positive lists situations in which you should not wait the usual 12 or 6 months before an evaluation. Among them:
If any of these apply, the book's advice is to see a specialist right away.
The full list of red flags, with the age cutoffs, is in Chapter 29 of Map to the Positive, which opens Station IV. The same station explains how to choose the right doctor and what each level of treatment involves.
Take 30 days. If it does not give you more clarity than everything you have read for free so far, ask for a refund and you get every cent back. We cannot promise you a pregnancy. We can promise you will not be guessing.
References: State and Territory Infertility Insurance Laws: Montana (ReproductiveFacts.org, American Society for Reproductive Medicine) (accessed 2026-10-30) · Governor Gianforte Strengthens Montana Law for Cancer Survivors To Have Children (Office of the Governor, Montana) (2023-08-23) · Gov. Gianforte signs bill safeguarding fertility preservation for cancer patients (KPAX) (2023-08-23) · Health Insurance & Fertility Services: State Laws (Triage Cancer) (2025-09) · Does the ACA require infertility treatment to be covered by health insurance? (healthinsurance.org) (2026-06-18)