Montana State-Regulated Insurance Coverage

Montana requires meaningful coverage for autism under state regulated plans.

Montana’s autism insurance bill, SB 234 was enacted in 2009 and became effective January 1, 2010.

To which plan types does the STATE autism insurance law apply?

  • State Employee Health Plans - YES
  • Individual Plans - YES
  • Fully Insured Large Group Plans - YES
  • Fully Insured Small Plans - YES

What services are covered by law?

  • Diagnosis
  • Habilitative or rehabilitative (e.g. Applied Behavior Analysis)
  • Medications
  • Psychiatric or psychological care
  • Therapeutic care (Speech, occupational and physical therapy)

Does Montana have caps on ABA coverage?

Yes. Coverage is limited to individuals with autism through 18 years of age. Coverage for the treatment of autism is subject o annual dollar caps:

  • 8 years of age or younger = $50,000/year
  • 9 through 18 years of age = $20,000/year

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is a federal law that generally prevents group health plans and health insurance issuers that provide mental health or substance use disorder (MH/SUD) benefits from imposing less favorable benefit limitations on those benefits than on medical/surgical benefits.  This includes quantitative treatment limits like age and dollar caps.  Learn more here.

Where can I find more details about the Mississippi autism insurance law?

A copy of SB 234 as enrolled can be found here.

If you have additional questions, please email advocacy@autismspeaks.org.

 

Last Updated: December 2019

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