Can I Qualify for Medicaid if I Am Pregnant?

The Medicaid program is a state-run option for low-income families to obtain access to affordable health care. Each state sets its own guidelines for Medicaid benefits but eligibility is always based on need. Because of their special health requirements, pregnant women get priority access to Medicaid benefits once they apply.

Applying

• Pregnant women need to apply for Medicaid according to state regulations before receiving any benefits. You can apply at your local social services office, by submitting an application through the mail or over the phone. An application asks for basic information and copies of documents such as a birth certificate, or proof of citizenship or alien status, and proof of address, such as a piece of official mail. Pregnant women who are currently employed also need to supply a recent pay stub as proof of income.

Presumptive Eligibility

• Medicaid includes a feature called presumptive eligibility that is specifically for pregnant women. This feature allows women who apply for Medicaid only once they realize that they're pregnant to receive care more quickly without waiting for their applications to be approved. Presumptive eligibility allows pregnant women to get a Medicaid card within a matter of a few weeks and a temporary card can get them access to free care even sooner.

Benefits

• Pregnant women fall into a Medicaid benefits category known as expanded eligibility. This means that they can earn more than the typical income limits and still qualify for benefits. For example, in New York a pregnant woman who is single and has no other children can earn up to $1,805 each month, compared to the $903 limit that applies to households of one. New York's expanded eligibility maximum income is double the federal poverty level and applies to pregnant women and their new babies until the child's first birthday.

Coverage

• Once the state social services department approves a pregnant woman's application for Medicaid, or once she qualifies for presumptive coverage, she can receive the full slate of Medicaid benefits. This includes essential prenatal care including check-ups and prenatal vitamins. She can also take advantage of Medicaid programs that will help improve her chances of a healthy birth, including smoking cessation programs, home health care (if she becomes incapacitated or immobile), reimbursement of transportation costs to and from medical appointments and hospital services surrounding the birth itself.