Montana Insurance Requirements for Autism
The information below is collected from state statutes and regulations. The information is reviewed on an annual basis. Please be advised that laws, regulations, and policies may change at any time, so always check with your state for the most up-to-date information.
Note: Certain insurance plans are exempt from state
mandates. Please contact your plan administrator to see if your plan includes
state mandated autism spectrum disorder benefits.
Specific Insurance Mandate
The state of Montana has a specific autism mandate, which requires each group disability policy, certificate of insurance, or membership contract that is delivered, issued for delivery, renewed, extended, or modified in this state must provide coverage for diagnosis and treatment of
autism spectrum disorders for a covered child 18 years of age or younger.
- habilitative or rehabilitative care that is prescribed, provided, or ordered by a licensed physician or licensed psychologist, including but not limited to professional, counseling, and guidance services and treatment programs that are medically necessary to develop and restore, to the maximum extent practicable, the functioning
of the covered child
- medications prescribed by a physician
- psychiatric or psychological care
- therapeutic care that is provided by a speech-language pathologist, audiologist, occupational therapist, or physical therapist licensed in this state
Coverage for treatment of autism spectrum disorders under this section may be limited to a maximum benefit of:
- $50,000 a year for a child 8 years of age or younger; and
- $20,000 a year for a child 9 years of age through 18 years of age
For further information on insurance mandates for autism spectrum disorder, please visit this website:
Mont. Code Ann. § 33-22-515
Questions regarding state affairs
issues? Call ASHA at 800-498-2071 and ask for the State Affairs Team.