Published 11/09/2024
Updated 08/13/2025
8-minutes read!
Medicaid is a public health insurance program in the U.S. that offers free or low-cost healthcare coverage to low-income individuals — and it plays a vital role during pregnancy. In 2025, Medicaid continues to be the largest single payer of maternity care in the country, covering nearly 42% of all births in the U.S(1). Pregnancy Medicaid is a specialized form of Medicaid that provides:
Prenatal care (checkups, lab tests, ultrasounds)
Labor and delivery
Postpartum care (now up to 12 months in most states)
Other essentials like vitamins, mental health support, and breastfeeding resources
It’s available to pregnant individuals who meet income and residency requirements, even if they wouldn’t normally qualify for standard Medicaid. Many states have higher income limits during pregnancy, and some offer benefits regardless of immigration status.
Medicaid gives pregnant individuals access to the care they need at every stage — before, during, and after birth.
In 2025, most Medicaid plans include(2):
Prenatal care: Checkups, labs, ultrasounds, and screenings
Labor and delivery: Hospital birth, emergency care, and pain relief
Postpartum care: Mental health support, birth control, and recovery visits (now for 12 months in most states).
For many, Medicaid is the only way to afford safe pregnancy care — especially in states that extend coverage regardless of immigration status.
Medicaid eligibility during pregnancy depends on where you live, how much you earn, and your immigration status. Most states offer more flexible rules during pregnancy, so even if you don’t usually qualify, you might now.
Income Limits
Most states cover pregnant people earning 138% to 300% of the Federal Poverty Level (FPL).
Such as:
California: up to 213% FPL
Texas: up to 198% FPL
Iowa: 215% FPL
Income rules depend on household size and state-specific guidelines.
Immigration Status
Lawfully present immigrants may qualify right away — no 5-year wait in over 30 states. Some states (like California and New York) offer coverage to all pregnant people, regardless of immigration status.
State-by-State Differences
Benefits, application steps, and postpartum coverage vary (3).
Many states now offer 12 months postpartum coverage, but not all.
Always check your state’s Medicaid site for exact info
Texas offers two main options for pregnancy coverage: Medicaid for Pregnant Women and CHIP Perinatal. Both programs provide prenatal and delivery services, but there are key differences in who qualifies and what’s covered.
CHIP Perinatal | Texas Pregnancy Medicaid |
|---|---|
For those who don’t qualify for Medicaid, but still need prenatal care. | Covers prenatal care, labor and delivery, and postpartum care for 12 months (as of 2024). |
Covers limited prenatal services and delivery, but does NOT include postpartum care for the mother. | Income limit: up to 198% of the Federal Poverty Level (FPL). |
Available regardless of immigration status. | Available to U.S. citizens and certain lawfully present immigrants. |
Key takeaway: If you’re pregnant in Texas, apply for Medicaid first. If you don’t qualify, CHIP Perinatal may still offer partial support — but with more limited benefits.
As of 2025, here's an overview of the benefits typically provided:
| Prenatal Care | Labor and Delivery | Postpartum Care | Additional Benefits |
Regular Check-Ups: Routine visits to monitor the health of both mother and baby. Screenings and Lab Tests: Assessments for potential health issues, including gestational diabetes and infections. Ultrasounds: Imaging to track fetal development and detect anomalies. | Hospital Stays: Coverage for labor, delivery, and postpartum recovery. Birthing Options: Access to various delivery methods, including cesarean sections when medically necessary. | Extended Coverage: Many states now offer Medicaid coverage for up to 12 months after childbirth, ensuring continued health support during the postpartum period. Mental Health Services: Access to counseling and treatment for postpartum depression and anxiety. | Family Planning: Counseling and services to assist with birth spacing and future pregnancies. Substance Use Treatment: Programs to support pregnant women dealing with substance use disorders. Dental Care: Some states provide dental services during pregnancy, recognizing the link between oral health and overall pregnancy outcomes. |
Regular Check-Ups:
Routine visits to monitor the health of both mother and baby.
Screenings and Lab Tests:
Assessments for potential health issues, including gestational diabetes and infections.
Ultrasounds:
Imaging to track fetal development and detect anomalies.
Hospital Stays:
Coverage for labor, delivery, and postpartum recovery.
Birthing Options:
Access to various delivery methods, including cesarean sections when medically necessary.
Extended Coverage:
Many states now offer Medicaid coverage for up to 12 months after childbirth, ensuring continued health support during the postpartum period.
Mental Health Services:
Access to counseling and treatment for postpartum depression and anxiety.
Family Planning:
Counseling and services to assist with birth spacing and future pregnancies.
Substance Use Treatment:
Programs to support pregnant women dealing with substance use disorders.
Dental Care:
Some states provide dental services during pregnancy, recognizing the link between oral health and overall pregnancy outcomes.
It's important to note that specific benefits and coverage durations can vary by state. For the most accurate and personalized information, consult your state's Medicaid office or official website (4).
Applying for Medicaid while pregnant is usually fast and straightforward — and you may even qualify for retroactive coverage to help with earlier prenatal costs. Each state has its own process, but most follow the same basic steps.
Steps | What To Do | Details / Notes |
1. | Check Eligibility | Review your state’s income limits and residency rules for pregnancy Medicaid |
2. | Gather Documents | Needed: Proof of pregnancy, ID, income, and household size |
3. | Choose Application Method | Options: Online, phone, mail, or in person through your state’s Medicaid office |
4. | Submit Your Application | Follow your state’s process — many have fast-track systems for pregnant applicants |
5. | Track Application Status | You’ll usually get a response in 1–4 weeks; some states offer real-time updates |
6. | Use Temporary Coverage (If Eligible) | Ask about “Presumptive Eligibility” to get short-term coverage right away |
7. | Receive Medicaid Card / Number | Once approved, you’ll get your Medicaid ID to use at medical appointments |
If you're unsure where to start, call your OB or local clinic — many providers can walk you through the process or even submit the application on your behalf.
Download this step-by-step Pregnancy Medicaid Application Guide as a printable PDF — perfect for keeping on hand during appointments or sharing with a friend!
Many states offer Presumptive Eligibility (PE), allowing pregnant individuals to receive immediate, temporary Medicaid coverage while their full application is processed. This ensures timely access to prenatal care.
California's Presumptive Eligibility for Pregnant Women (PE4PW) Program: Provides immediate, temporary coverage for ambulatory prenatal care to low-income pregnant individuals (5).
Medicaid Presumptive Eligibility Overview: Offers general information on how presumptive eligibility facilitates prompt access to Medicaid services for eligible individuals (6).
Understanding your state's specific Medicaid application procedures can expedite approval. For instance, California's Medi-Cal Access Program (MCAP) provides comprehensive coverage for pregnant individuals who meet certain criteria.
Medicaid plays a pivotal role in ensuring access to comprehensive maternal health services, covering a significant portion of births in the U.S. It provides essential prenatal, delivery, and postpartum care, contributing to improved health outcomes for mothers and infants.
Eligibility for Medicaid during pregnancy varies by state, with income thresholds typically set as a percentage of the Federal Poverty Level (FPL). For example:
California: Covers pregnant individuals with household incomes up to 213% of the FPL.
Iowa: As of January 1, 2025, eligibility for pregnancy coverage is reduced to 215% of the FPL.
It's essential to check your state's specific income limits, as they can range from 138% to over 300% of the FPL.
Medicaid & CHIP Coverage of Pregnancy-Related Services. [Medicaid.gov]
Postpartum Coverage by State. [Medicaid.gov]
Eligibility Levels for Pregnancy-Related Coverage in Medicaid and CHIP. [NASHP]
Medicaid: What to Watch in 2025. [KFF]
Information on the Presumptive Eligibility for Pregnant Women. [DHCS]
Presumptive Eligibility. [Medicaid.gov]
The information provided in our blogs regarding supplements, medicine, and their ingredients is intended for educational and informational purposes only. While we strive to ensure the accuracy and reliability of the content, it should not be considered a substitute for professional medical advice, diagnosis, or treatment. Our blogs are based on scientific research and reputable sources available at the time of writing. However, the field of medicine and nutritional science is constantly evolving, and new evidence may emerge that could affect the accuracy or relevance of the information provided. Therefore, we cannot guarantee the completeness, accuracy, or currency of the information presented in our blogs. Readers are encouraged to consult with qualified healthcare professionals or medical experts before making any decisions or taking any actions based on the information contained in our blogs. Furthermore, the opinions expressed in our blogs are those of the authors and do not necessarily reflect the views of the company. We disclaim any liability for any loss, injury, or damage incurred as a result of reliance on the information provided in our blogs. We reserve the right to update, modify, or remove content from our blogs at any time without prior notice. We also reserve the right to correct any errors or inaccuracies that may be identified in our blogs. By accessing and using our blogs, you acknowledge and agree to the terms of this disclaimer. If you have any questions or concerns about the information presented in our blogs, please contact us for clarification. Thank you for your understanding.
LinkedIn
Shiami is a seasoned digital and content marketing professional with over a decade of experience. Passionate about storytelling, she specializes in transforming complex topics into easy-to-understand, conversational, and bite-sized pieces that resonate with readers. A relentless advocate for exceptional user experience, Shiami stays at the forefront of trends through continuous research and learning, ensuring her content educates, inspires, and builds meaningful connections. As a mother, she draws from her personal experiences to create content that is not only informative but deeply valuable to her audience.
Shiami is a seasoned digital and content marketing professional with over a decade of experience. Passionate about storytelling, she specializes in transforming complex topics into easy-to-understand, conversational, and bite-sized pieces that resonate with readers. A relentless advocate for exceptional user experience, Shiami stays at the forefront of trends through continuous research and learning, ensuring her content educates, inspires, and builds meaningful connections. As a mother, she draws from her personal experiences to create content that is not only informative but deeply valuable to her audience.
Save
Save
Save
Save
