Medicaid for pregnant women: limits, coverage and how to apply
Pregnancy Medicaid limits are higher than for most adults, and your unborn baby counts in your household. Many moms who qualify never apply. Check in five minutes.
Updated October 13, 2026 · sources checked October 13, 2026
In short
Every state must cover pregnant women with household income up to at least 133% of the federal poverty level, and most go higher (up to 375% in Iowa). Your household counts you plus the babies you expect. You can apply any day of the year, coverage lasts at least 60 days after birth (12 months in many states), and your newborn is automatically covered for a year.
Who qualifies
You may qualify for pregnancy Medicaid if you are pregnant, live in the state where you apply, meet the citizenship or immigration rules, and have a household income at or below your state's limit. Two rules work in your favor:
- A higher income limit. Federal regulations (42 CFR 435.116) require states to cover pregnant women up to at least 133% of the federal poverty level (FPL). Medicaid's income method usually adds a disregard worth 5 points of the FPL, which is why "138%" is often quoted. Most states go well above the floor.
- Your baby counts. Under 42 CFR 435.603, a pregnant woman's family size is herself plus the number of children she is expected to deliver.
HealthCare.gov's own advice: even if you don't think you'll qualify, apply, especially if you are pregnant.
Pregnancy Medicaid limits by state
This is the latest official state-by-state table on Medicaid.gov, showing state decisions as of December 1, 2023 (checked 13 October 2026). States can change their limits: your state agency has the final word.
| State | Medicaid | CHIP (pregnancy) |
|---|---|---|
| Alabama | 141% | — |
| Alaska | 200% | — |
| Arizona | 156% | — |
| Arkansas | 209% | — |
| California | 208% | — |
| Colorado | 195% | 260% |
| Connecticut | 258% | — |
| Delaware | 212% | — |
| District of Columbia | 319% | — |
| Florida | 191% | — |
| Georgia | 220% | — |
| Hawaii | 191% | — |
| Idaho | 133% | — |
| Illinois | 208% | — |
| Indiana | 208% | — |
| Iowa | 375% | — |
| Kansas | 166% | — |
| Kentucky | 195% | 213% |
| Louisiana | 133% | — |
| Maine | 209% | — |
| Maryland | 259% | — |
| Massachusetts | 200% | — |
| Michigan | 195% | — |
| Minnesota | 278% | — |
| Mississippi | 194% | — |
| Missouri | 196% | 300% |
| Montana | 157% | — |
| Nebraska | 194% | — |
| Nevada | 160% | — |
| New Hampshire | 196% | — |
| New Jersey | 194% | 200% |
| New Mexico | 250% | — |
| New York | 218% | — |
| North Carolina | 196% | — |
| North Dakota | 170% | — |
| Ohio | 200% | — |
| Oklahoma | 205% | — |
| Oregon | 185% | — |
| Pennsylvania | 215% | — |
| Rhode Island | 190% | 253% |
| South Carolina | 194% | — |
| South Dakota | 133% | — |
| Tennessee | 195% | — |
| Texas | 198% | — |
| Utah | 139% | — |
| Vermont | 208% | — |
| Virginia | 143% | 200% |
| Washington | 193% | — |
| West Virginia | 185% | 300% |
| Wisconsin | 301% | — |
| Wyoming | 154% | — |
From percentages to dollars (2026)
The 2026 HHS poverty guidelines for the 48 contiguous states and DC, with two common limits calculated from them:
| Household size | 100% FPL per year | 138% (calculated) | 200% (calculated) |
|---|---|---|---|
| 2 | $21,640 | $29,863 | $43,280 |
| 3 | $27,320 | $37,702 | $54,640 |
| 4 | $33,000 | $45,540 | $66,000 |
| 5 | $38,680 | $53,378 | $77,360 |
Add $5,680 to the 100% column for each extra person. Alaska and Hawaii have higher guidelines. States update their dollar tables on their own schedule and usually count monthly income, so small differences are normal.
Example. Single, expecting one baby, in Texas: household of 2, state limit 198%. 198% of $21,640 is about $42,847 a year, or about $3,571 a month. Below that? Apply.
What it covers, and for how long
- During pregnancy: prenatal care, the birth and related services. Depending on your income group, your state gives either full Medicaid coverage or pregnancy-related services.
- Back in time: federal rules (42 CFR 435.915) generally let coverage start as early as the third month before the month you apply, if you were eligible then; some states differ under waivers.
- After the birth: at least 60 days, and 12 months in states that took up the permanent extension; KFF tracks which states have. Ask your agency how long it lasts where you live.
- Your newborn: automatically enrolled if you have Medicaid at the birth, and eligible for at least a year.
A 2024 study in JAMA Health Forum (Daw and colleagues, 47,716 survey respondents) found that continuous Medicaid eligibility during the COVID-19 emergency was associated with significantly less postpartum uninsurance after a Medicaid-paid birth, which the authors put at a 40% reduction from a 16.7% baseline. In plain words: coverage that lasts after the birth keeps moms insured.
How to apply, in order
- Pick a door: your state Medicaid agency (online, phone, mail or in person) or a HealthCare.gov application where you ask for help paying for coverage; if you look eligible, your file goes to the state.
- Ask about presumptive eligibility at your clinic or hospital: in many states, qualified providers can give temporary coverage while your application is processed.
- Gather documents: ID, recent pay stubs or tax return, proof of address, Social Security numbers for those who have one, immigration papers if applicable, and proof of pregnancy if asked (a clinic note).
- Say you are pregnant, give your due date and the number of babies.
- Answer every letter quickly. Missing a request for information is a common reason for delays.
- Choose a plan or provider if your state uses managed care, and check that your OB or midwife accepts it.
- After the birth, report your baby's name and date of birth so they get their own Medicaid number.
Good to know
Your income is too high for Medicaid? Check CHIP: several states cover pregnant women or the unborn child through CHIP, and children's CHIP limits reach 300% of the poverty level or more in several states. Then read pregnant without insurance.
Related help
- WIC: if you have Medicaid, you may already be income-eligible for WIC.
- Adding your baby to insurance, if you are not on Medicaid at the birth.
- Coverage rules for immigrants, including the pregnancy exception some states offer.
Questions parents ask
What is the income limit for pregnancy Medicaid?
It depends on your state. The federal floor is 133% of the poverty level; in the Medicaid.gov table, state limits for pregnant women range from 133% to 375%. For a household of two in 2026, 100% of the poverty level is $21,640 a year.
Does my unborn baby count in my household size?
Yes. Federal rules count a pregnant woman as herself plus the number of children she is expected to deliver. A single woman expecting one baby is a household of two.
How long does pregnancy Medicaid last after birth?
At least 60 days after you give birth, and a full 12 months in states that have adopted the extension. Your newborn is automatically enrolled and stays eligible for at least a year.
Can I get Medicaid if I already have bills from earlier in my pregnancy?
Often yes. Federal rules generally let Medicaid start as early as the third month before the month you apply, if you were eligible then. Tell the agency about unpaid bills when you apply.
Sources
- Medicaid.gov — Medicaid, CHIP and BHP eligibility levels by state (as of December 1, 2023) checked October 13, 2026
- eCFR — 42 CFR 435.116, Pregnant women checked October 13, 2026
- eCFR — 42 CFR 435.603, household and family size checked October 13, 2026
- ASPE (HHS) — 2026 Poverty Guidelines checked October 13, 2026
- HealthCare.gov — Coverage if you're pregnant or recently gave birth checked October 13, 2026
- HealthCare.gov — How to apply for Medicaid and CHIP checked October 13, 2026
- KFF — Medicaid Postpartum Coverage Extension Tracker (updated July 15, 2026) checked October 13, 2026
- Daw JR et al. Continuous Medicaid Eligibility During the COVID-19 Pandemic and Postpartum Coverage, Health Care, and Outcomes. JAMA Health Forum 2024 (PMID 38457131, DOI 10.1001/jamahealthforum.2024.0004) checked October 13, 2026
Mamavela explains; it does not replace your midwife, doctor or pediatrician, who know your situation. If something worries you, call them. In an emergency, call 911 (US), 999 (UK) or 112.