Montana requires fully insured plans (on/after Jan 1, 2024) — and Medicaid — to cover standard fertility preservation for members diagnosed with cancer whose treatment may cause infertility, with up to one year of storage. IVF is not required.
Your plan
What the law does
Fully insured plans
Must cover fertility preservation (egg/sperm/embryo freezing) when medically necessary treatment such as chemotherapy may cause infertility. IVF itself is not required.
Self-funded employer plan
Exempt from state law (ERISA).
Everyone else
No IVF requirement; see cash prices, packages, and grants below.
Free, 5 steps, nothing saved unless you choose to.
The one thing to check first: is your plan self-funded?
State fertility laws only reach fully insured plans. Most workers at large employers are in self-funded plans, which are governed by federal ERISA law and exempt from every state mandate — 67% of covered workers nationally, and about 80% at firms with 200+ employees (KFF 2025).
Look at your insurance card. If it says "administered by" (an insurer's name as the third-party administrator), your plan is probably self-funded. If it says "insured by" or "underwritten by," it is probably fully insured. The card is a strong hint, not proof — the only definitive answer comes from HR: "Is our medical plan self-funded or fully insured?"
This also decides where a denied claim goes: fully insured plans appeal to the state insurance regulator; self-funded plans appeal under ERISA rules to the U.S. Department of Labor.
Where people get surprised
Cancer diagnosis required — other iatrogenic causes (e.g., lupus, sickle cell) are not covered.
Storage beyond one year is out of pocket.
Religious organizations exempt (per RESOLVE).
Self-funded employer plans (the card usually says 'administered by') are exempt under federal ERISA — appeals go through the plan's internal process and the U.S. Department of Labor, not the state regulator.
IVF, IUI, and fertility medications for infertility treatment are not required — check your plan's fertility rider.
How to appeal a denial
Internal appeal — you have 180 days from the denial to file. The plan must decide within 30 days (before service) or 60 days (after service); 72 hours if urgent.
External review — available for at least 4 months after the final internal denial, for medical-necessity and "experimental" denials (PGT-A, ICSI, step therapy). An independent reviewer decides within 45 days. Contractual exclusions are not eligible for external review — those go to the regulator as a complaint.
Regulator — Montana Commissioner of Securities and Insurance (CSI). Montana independent review (MCA 33-32-4 et seq.) via CSI File a complaint. Copy the regulator on every appeal letter; clinics report it speeds things up.
If your plan is self-funded, skip the state regulator: your appeal runs under ERISA and complaints go to the U.S. Department of Labor's Employee Benefits Security Administration.
Frequently asked
Is IVF covered by insurance in Montana?
Montana requires fully insured plans (on/after Jan 1, 2024) — and Medicaid — to cover standard fertility preservation for members diagnosed with cancer whose treatment may cause infertility, with up to one year of storage. IVF is not required.
My employer is large but my card says 'administered by' — does the state law apply?
Probably not. 'Administered by' usually means a self-funded plan, which federal ERISA law exempts from state insurance mandates. Confirm with HR.
What if my claim is denied?
File an internal appeal within 180 days, request the exact policy language relied on, and copy the regulator. Medical-necessity and 'experimental' denials can go to external review.
This page explains public coverage rules and typical prices as of the dates shown. It is an estimate and an interpretation, not a coverage decision by your plan, and not legal, medical, tax, or insurance advice. Your plan documents control. We never store what you enter here unless you choose to save a plan.