Are Pregnant People Eligible for Medicaid?

Pregnant women have better birth outcomes when they receive comprehensive prenatal care. Pregnant women who cannot afford the costs of insurance or out-of-pocket doctor fees may be able to qualify for the state-run health insurance program Medicaid. Medicaid is run by each state, but the federal government sets the federal poverty income level and the basic coverage requirements of each state's program. States determine their own specific eligibility criteria.

Income Eligibility

• All state Medicaid programs have a minimum mandatory income threshold of 133 percent of the federal poverty level. Some states approve women with family incomes up to 200 percent of the federal poverty level.

Eligibility After Pregnancy

• Once a woman gives birth, Medicaid will continue to cover birth-related expenses such as postnatal ob/gyn visits for up to one year, depending on the state. If a mother's income is low enough, she may be able to stay on Medicaid and receive assistance with regular health expenses.

Proof of Pregnancy

• Medicaid will not approve an application without proof of the pregnancy from a doctor, nurse, certified nurse midwife or other authoritative medical worker. The applicant must provide a signed statement or medical records detailing if the test used urine or blood and the estimated due date. Although state Medicaid programs do not prefer blood over urine test, no programs will accept a home pregnancy test.

Applying

• Potential applicants must contact the department of health in their county or local municipality. Some state Medicaid programs allow people to complete applications online, but most require a paper application. Applicants will need to supply Medicaid with their birth certificate, social security card, pay stubs or other proof of income and the proof of pregnancy.