Medicaid and Pregnancy: What’s Covered and How to Apply

Pregnancy can be one of the most exciting—and expensive—times in a person’s life. Regular doctor visits, prenatal testing, ultrasounds, labor and delivery, and postpartum care add up quickly. Fortunately, Medicaid offers comprehensive coverage for pregnant individuals, ensuring access to care before, during, and after childbirth, often at little or no cost.

Yet many expectant parents don’t realize they may qualify, even if their household income is higher than typical Medicaid limits. Coverage rules, benefits, and timelines vary by state, so knowing what to expect can help you avoid gaps in care and costly bills.

Here’s a practical guide to how Medicaid covers pregnancy, what services are included, and how to apply smoothly for coverage when you need it most.

Understanding Medicaid Pregnancy Coverage

Medicaid is a joint federal and state program that provides health insurance to low-income individuals and families. Each state manages its own version, which means eligibility and benefits can differ slightly.

However, federal law requires all states to cover pregnant individuals whose incomes fall below certain thresholds—usually higher than those for non-pregnant adults. Many states also provide automatic postpartum coverage to help with recovery and newborn care.

In most states, pregnant people qualify for Medicaid if their household income is between 138% and 200% of the federal poverty level (FPL), though a few extend eligibility even higher. For example, a single pregnant person earning around $2,800 per month could qualify in many states.

Even better, many states count a pregnant person as having two (or more) people in the household for eligibility purposes, which expands income thresholds further.

What Medicaid Covers During Pregnancy

Medicaid’s pregnancy coverage is designed to support both mother and baby from early pregnancy through postpartum care. The specific benefits vary slightly by state, but coverage typically includes:

• Prenatal care: Office visits, blood tests, ultrasounds, prenatal vitamins, and genetic or gestational screenings.

• Labor and delivery: Hospital or birthing center costs, anesthesia, and certified midwife services.

• Postpartum care: Doctor visits for recovery, follow-up screenings, mental health support, and lactation counseling.

• Newborn care: Coverage for the baby’s first checkups and immunizations, often with automatic newborn enrollment in Medicaid.

• Transportation: Non-emergency rides to and from medical appointments for eligible members.

• Specialty care: High-risk pregnancy management, obstetric specialists, and maternal-fetal medicine when medically necessary.

Many states also include mental health and substance use treatment, recognizing that pregnancy and postpartum are critical windows for mental well-being.

Here’s a quick overview of typical covered services:

Most services are covered with no copayments or deductibles for pregnant Medicaid beneficiaries.

Extended Postpartum Coverage: What’s Changed

Traditionally, Medicaid pregnancy coverage ended 60 days after delivery, but recent federal policy changes have expanded that window.

As of 2025, nearly every state offers at least 12 months of postpartum coverage for women and birthing individuals. This extension helps address rising maternal mortality rates and ensures ongoing access to care for physical and mental health needs.

That means once you’re approved for Medicaid as a pregnant person, your coverage generally continues for an entire year after your baby is born—without reapplying.

How to Apply for Medicaid When Pregnant

Applying for pregnancy Medicaid is usually quick and can be done online, by phone, or in person through your state’s Medicaid agency or local social services office.

Here’s a step-by-step overview:

1. Gather your information: You’ll need proof of identity, income (like pay stubs or tax returns), Social Security numbers for household members, and confirmation of pregnancy (sometimes from a doctor’s note).

2. Apply online or through your state marketplace: Visit your state’s Medicaid website or healthcare marketplace. Many states also process applications through HealthCare.gov.

3. Get expedited review: Pregnant individuals often receive priority processing—in some states, approval can happen within days.

4. Start prenatal care immediately: Some states offer presumptive eligibility, allowing you to receive care while your application is processed.

5. Enroll your baby: After delivery, your newborn is typically eligible for Medicaid automatically for at least one year.

Tip: Even if you think you earn too much, apply anyway—many states use pregnancy-specific income rules that are far more generous than for other adults.

What Happens if You Already Have Private Insurance

If you already have private or employer coverage, you can still apply for Medicaid. In these cases, Medicaid often acts as secondary insurance, covering costs your primary plan doesn’t, such as copays, deductibles, or out-of-network fees for maternity care.

This coordination can save families thousands of dollars on childbirth and postpartum care.

Immigration Status and Pregnancy Coverage

Even if you’re not a U.S. citizen, you may still qualify for pregnancy-related Medicaid coverage. Many states extend benefits to lawfully present immigrants, and several—including California, Illinois, and New York—offer state-funded pregnancy Medicaid regardless of immigration status.

Additionally, Emergency Medicaid can cover labor and delivery for individuals who don’t qualify for full-scope coverage due to immigration restrictions.

Special Programs for Moms and Babies

Medicaid is connected to several other programs that support new and expectant parents:

• WIC (Women, Infants, and Children): Provides nutritious food and formula vouchers for pregnant and postpartum people and young children.

• CHIP Perinatal Programs: In some states, if you earn slightly too much for Medicaid, you may qualify for pregnancy coverage under the Children’s Health Insurance Program (CHIP).

• Healthy Start and Home Visiting Programs: Offer prenatal education, postpartum support, and infant care guidance for Medicaid-eligible families.

Ask your local Medicaid office which supplemental services are available in your area—they’re often underused but highly beneficial.

Common Pitfalls to Avoid

• Delaying your application: Medicaid can retroactively cover medical expenses up to 90 days before approval, but applying late could delay care.

• Not updating your address or contact info: Missed mail or messages can cause lapses in postpartum coverage.

• Assuming you’re not eligible: Many middle-income families mistakenly think they earn too much. Eligibility thresholds are higher for pregnancy.

• Forgetting to enroll your baby: In most states, this happens automatically, but always confirm newborn coverage within the first month.

Why Early Enrollment Matters

Early enrollment means earlier access to prenatal care, which improves health outcomes for both parent and baby. According to federal data, consistent prenatal care lowers the risk of preterm birth, low birth weight, and maternal complications.

It also protects you financially—Medicaid can cover pregnancy-related services retroactively, but the sooner you apply, the fewer billing headaches you’ll face.