Medicaid for Pregnant Women: Income Limits by State and How to Apply

Medicaid for pregnant women is free or very low-cost health coverage for prenatal care, labor and delivery, and the months after birth. Every state must offer it up to 138% of the federal poverty level, and most states go much higher. The median state Medicaid limit for 2026 is 201%.

That works out to about $3,625 a month for a pregnant person who lives alone, because Medicaid counts the baby you are expecting as part of your household. If you are pregnant and uninsured, or your current plan is too expensive, it is worth checking even if you were turned down for Medicaid before.

This guide gives the 2026 income limit for every state. It also explains how fast coverage starts, what it pays for, how long it lasts after birth, and what changed for immigrants on October 1, 2026. The limits come from KFF’s January 2026 state survey, and the rules come from federal regulations on eCFR.gov.

Key Takeaways

• Federal law sets the floor at 138% of the poverty level. In January 2026, 38 states covered pregnancy at 200% or more. The highest Medicaid limits were in DC (324%) and Wisconsin (306%).
• Your unborn baby counts in your household size. A pregnant person living alone is a household of two, and twins make it three.
• In states that use presumptive eligibility, a clinic can start your outpatient prenatal care right away while the state reviews your full application.
• Medicaid can pay bills from up to three months before you applied. For applications filed on or after January 1, 2027, CMS says that window shrinks to two months for pregnant women.
• Coverage now lasts 12 months after the pregnancy ends in every state except Arkansas, which still stops at about 60 days.

Who qualifies for Medicaid for pregnant women?

You qualify if your household income is at or below your state’s limit for pregnancy, you live in that state, and you are a U.S. citizen or have an eligible immigration status. The floor is 138% of the poverty level, and the January 2026 median Medicaid limit was 201%.

Federal rules require states to cover pregnant women up to at least 133% of the poverty level, which becomes 138% once a standard 5-point income disregard is added.

The federal rule sits in 42 CFR 435.116. It says the minimum income standard is 133% of the poverty level “for the applicable family size,” or a higher level up to 185% if a state already used one in 1989. States can set their limit higher than that, and most do.

The pregnancy group is separate from the adult Medicaid group. That matters most in the 10 states that have not expanded Medicaid to low-income adults. In those states a woman who does not qualify today can qualify once she is pregnant, because the pregnancy limit is far above the adult limit.

Georgia shows the gap. It has not adopted the adult expansion, yet its pregnancy limit is 225% of the poverty level, according to KFF. If you want to see how the adult and child rules work in your state, our Medicaid income limits guide covers those groups in detail.

There is no asset test for this group. Pregnancy Medicaid uses Modified Adjusted Gross Income (MAGI), the same tax-based income measure the Marketplace uses, so savings, a car or a home do not count against you.

How does Medicaid count an unborn baby in household size?

Medicaid counts a pregnant woman as herself plus the number of babies she is expected to deliver. A woman who lives alone and is expecting one baby is a household of two. If she is expecting twins, she is a household of three. This raises the dollar limit she is measured against.

The rule is in 42 CFR 435.603: “In the case of determining the family size of a pregnant woman, the pregnant woman is counted as herself plus the number of children she is expected to deliver.”

Other people in the home, such as a partner or an older child, may apply for their own coverage. For their cases, states can count the pregnant woman as one person, two people, or herself plus her expected babies. So your household size can differ from your partner’s.

Here is what that does to the dollar amount. The 2026 HHS poverty guideline is $21,640 for two people and $27,320 for three in the 48 contiguous states and DC (ASPE, 2026):

• Living alone, one baby expected (household of 2): about $2,489 a month at the 138% floor, and about $3,625 a month at the 201% median.
• Living alone, twins expected (household of 3): about $3,142 a month at 138%, and about $4,576 a month at 201%.
• Married, one baby expected (household of 3 for her case): the same $3,142 and $4,576 figures, measured against both spouses’ income.

Your income is counted before taxes. Alaska and Hawaii use higher poverty guidelines, so their dollar limits are higher at the same percentage. Our federal poverty level calculator converts any percentage and household size into a yearly and monthly figure.

Medicaid for pregnant women: income limits by state for 2026

In January 2026, Medicaid limits for pregnancy ranged from 138% of the poverty level in Idaho, Louisiana and South Dakota to 324% in DC. The median Medicaid limit was 201%. Seven states also cover pregnant women through CHIP, and 25 use CHIP’s unborn child option, which can reach higher incomes.

The table lists each state’s limit as a percent of the poverty level for three pathways. The last column turns the higher of the Medicaid or CHIP limit into a rough monthly income for a household of two. That is a pregnant woman who lives alone and expects one baby.

Medicaid and CHIP income limits for pregnant women by state, January 2026

State	Medicaid limit	CHIP limit	Unborn child option (CHIP)	Monthly income, household of 2
Alabama	146%	None	317%	$2,633
Alaska	230%	None	None	$5,185
Arizona	161%	None	None	$2,903
Arkansas	214%	None	214%	$3,859
California	213%	None	322%	$3,841
Colorado	195%	260%	265%	$4,689
Connecticut	263%	None	263%	$4,743
Delaware	217%	None	None	$3,913
District of Columbia	324%	None	324%	$5,843
Florida	196%	None	None	$3,535
Georgia	225%	None	None	$4,058
Hawaii	196%	None	None	$4,065
Idaho	138%	None	None	$2,489
Illinois	213%	None	213%	$3,841
Indiana	213%	None	None	$3,841
Iowa	220%	None	None	$3,967
Kansas	171%	None	None	$3,084
Kentucky	195%	218%	None	$3,931
Louisiana	138%	None	214%	$2,489
Maine	214%	None	213%	$3,859
Maryland	264%	None	264%	$4,761
Massachusetts	205%	None	205%	$3,697
Michigan	200%	None	200%	$3,607
Minnesota	283%	None	283%	$5,103
Mississippi	199%	None	None	$3,589
Missouri	196%	305%	305%	$5,500
Montana	162%	None	None	$2,921
Nebraska	199%	None	202%	$3,589
Nevada	205%	None	None	$3,697
New Hampshire	201%	None	None	$3,625
New Jersey	194%	205%	None	$3,697
New Mexico	255%	None	None	$4,599
New York	223%	None	223%	$4,021
North Carolina	201%	None	None	$3,625
North Dakota	175%	None	None	$3,156
Ohio	205%	None	None	$3,697
Oklahoma	210%	None	210%	$3,787
Oregon	190%	None	190%	$3,426
Pennsylvania	220%	None	None	$3,967
Rhode Island	190%	258%	258%	$4,653
South Carolina	199%	None	None	$3,589
South Dakota	138%	None	138%	$2,489
Tennessee	255%	None	255%	$4,599
Texas	203%	None	207%	$3,661
Utah	144%	None	None	$2,597
Vermont	213%	None	None	$3,841
Virginia	143%	205%	205%	$3,697
Washington	215%	None	215%	$3,877
West Virginia	185%	305%	None	$5,500
Wisconsin	306%	None	306%	$5,518
Wyoming	159%	None	None	$2,867

Limits are percent of the federal poverty level as of January 2026 from KFF, including the 5-point disregard. Monthly income is the higher of the Medicaid or CHIP limit times the 2026 HHS poverty guideline for two people ($21,640; Alaska $27,050; Hawaii $24,890), divided by 12 and rounded.

Read the CHIP and unborn child columns as extra routes, not as your only option. Virginia is a good example: its Medicaid limit for pregnancy is 143%, but its CHIP program covers pregnant women up to 205%. Missouri and West Virginia reach 305% the same way.

KFF notes that Florida did not answer the 2026 survey, so its figure comes from the prior year. Two states moved recently. Iowa lowered its limit from 375%, and Nevada raised its limit from 190% to 205% on July 1, 2025.

Why your state’s chart may show a lower number

KFF’s percentages include the 5-point income disregard. Many state agencies post the limit before that disregard. So the dollar amount on your state’s website can look a little lower than the figure in this table, even though both are correct.

Texas shows how this plays out. The Texas Health and Human Services chart lists $3,571 a month for a family of two, which is 198% of the poverty level. KFF lists Texas at 203%, which is 198% plus the disregard, or about $3,661.

The practical point: if your income lands within about 5 points above your state’s posted limit, apply anyway. Under the same household rule (42 CFR 435.603), the 5-point disregard is used for the group with the highest income limit you could qualify for, which for most pregnant applicants is the pregnancy group.

Can you get Medicaid the same day you find out you are pregnant?

You can, if your state uses presumptive eligibility. It lets a qualified clinic, health department or hospital enroll you on the spot based on what you tell them about your income. That temporary coverage pays for outpatient prenatal care while the state reviews your full application.

The federal rules for this are in 42 CFR 435.1103, and they come with real limits you should know before you rely on them:

• Outpatient prenatal care only. The rule limits presumptive coverage for pregnant women to “ambulatory prenatal care.” A hospital stay or delivery during this period is not covered by the presumptive period itself.
• One period per pregnancy. You cannot restart it if it lapses.
• A deadline to file. You must file a full application by the last day of the month after the month you were found presumptively eligible. If you miss it, the temporary coverage ends on that day.
• No gap if you apply on time. If you do file by then, the temporary coverage continues until the state makes its decision.

To use it, ask the clinic that confirms your pregnancy whether it is a “qualified entity” for presumptive eligibility. Depending on your state, that may be a county health department or a community health center. If your state does not offer it, go straight to the full application described below.

Will Medicaid pay prenatal bills from before you applied?

Usually, for up to three months. Federal rules make Medicaid effective as early as the third month before the month you apply, if you received covered care in that period and would have qualified then. For applications filed on or after January 1, 2027, that look-back drops to two months for pregnant women.

The current rule is 42 CFR 435.915. It requires states to make eligibility effective “no later than the third month before the month of application” for people who got covered services in those months and would have qualified.

Section 71112 of the 2025 budget law shortens the window.

A CMS bulletin dated November 18, 2025 says that for applications made on or after January 1, 2027, adults in the expansion group get one month. For everyone else, including pregnant women, “the retroactive eligibility period will be limited to two months prior to the month of application.”

Minnesota is an exception for one year. Its human services agency says the legislature voted to keep three months of retroactive coverage through 2027, so the cut there starts January 1, 2028. Ask your state agency whether it is doing anything similar.

One common belief is that pregnancy Medicaid reaches back to the month you conceived. It does not. The retroactive window is tied to your application date, not your due date.

What does start at conception is the unborn child option in CHIP, where federal rules define a child as “an individual under the age of 19 including the period from conception to birth” (42 CFR 457.10).

The takeaway is simple: apply as early in the pregnancy as you can. Each month you wait is a month of visits, lab work or scans that may fall outside the look-back. And the window gets shorter in 2027.

What does pregnancy Medicaid cover, and what will you pay?

You generally get full Medicaid benefits, not just pregnancy care. That includes prenatal visits, lab tests, prescriptions, labor and delivery, and postpartum care. Federal rules also bar copays and other cost sharing for pregnancy-related services, so most pregnant enrollees pay nothing at the point of care.

Under the same pregnancy rule, 42 CFR 435.116, pregnant women get “full Medicaid coverage.” A state may limit coverage to pregnancy-related services only for women whose income is above a lower, older limit the state has set.

Federal rules define pregnancy-related services as those “necessary for the health of the pregnant woman and fetus, or that have become necessary as a result of the woman having been pregnant” (42 CFR 440.210).

On cost, 42 CFR 447.56 bars cost sharing for pregnant women during pregnancy and through the month the 60-day postpartum period ends. The only exception is care the state plan lists as not related to pregnancy. All other care for pregnant women counts as pregnancy-related.

Texas spells out what its program includes: prenatal doctor visits, prenatal vitamins, labor and delivery, and checkups for the baby after leaving the hospital. Dental coverage during pregnancy varies by state, and our guide to Medicaid dental coverage by state explains how to check yours.

Your baby is covered too. HealthCare.gov says that if you have Medicaid when you give birth, “your newborn is automatically enrolled in Medicaid coverage and will remain eligible for at least a year.” Report the birth to your state agency quickly so the baby’s card is issued.

Medicaid is a big part of how Americans have babies. KFF reports that the program pays for about 4 in 10 births in the United States. Ask your state’s Medicaid plan which doctors and hospitals near you are in its network.

How long does Medicaid last after the baby is born?

In every state except Arkansas, pregnancy Medicaid now continues for 12 months after the pregnancy ends. Wisconsin was the last state to switch, starting July 1, 2026. Arkansas still ends coverage at the federal minimum, which runs through the end of the month in which the 60-day postpartum period ends.

The federal floor is in 42 CFR 435.170. It also protects you if your income goes up while you are pregnant. The state must keep you covered through the postpartum period even if a raise would otherwise end your eligibility.

The longer option came from the American Rescue Plan Act. It let states extend postpartum coverage to 12 months starting April 1, 2022, and the Consolidated Appropriations Act of 2023 made the option permanent.

KFF’s postpartum coverage tracker shows 50 states, counting DC, with the 12-month extension in place as of July 15, 2026.

A few states run the extension through a waiver rather than the standard state plan option. KFF lists Florida, New Jersey and Virginia that way, and Tennessee used authority under its existing waiver. For you, the result is the same 12 months.

CHIP’s unborn child pathway can be shorter. Texas’s CHIP Perinatal program, for example, covers care during pregnancy and “two doctor visits within 60 days after the pregnancy ends.” If your prenatal care came through a program like that, ask the state what postpartum options you have before those visits run out.

When your postpartum coverage ends

Before your coverage ends, ask the state whether you qualify in another Medicaid group, such as the adult group in expansion states. If not, HealthCare.gov says losing other coverage qualifies you for a Special Enrollment Period, so you can enroll in a Marketplace plan.

Our ACA open enrollment guide explains Marketplace savings if you end up needing a private plan after the 12 months.

What if your income is too high for Medicaid?

Check CHIP. As of January 2026, seven states covered pregnant women through CHIP at limits above their Medicaid line, and 25 states used CHIP’s “From Conception to the End of Pregnancy” option. That option, formerly called the unborn child option, covers prenatal care by enrolling the baby before birth.

KFF defines the option this way: it “permits states to cover ‘targeted low-income children’ from conception to birth in CHIP, regardless of the pregnant person’s immigration status.” Because the enrolled person is the unborn child, the mother’s immigration status is not the test.

In some states this pathway reaches well above the Medicaid line. California’s Medicaid limit is 213%, but its unborn child coverage goes to 322%. Alabama shows an even bigger gap: 146% for Medicaid and 317% through the unborn child option, according to the KFF table.

The trade-off is the benefit package. Coverage through this option centers on prenatal care and pregnancy-related services, and the postpartum part can be short, as the Texas example shows.

Illinois is one state that uses a CHIP health services initiative to give these mothers 12 months of postpartum coverage, according to KFF.

If your older children need coverage too, our CHIP income limits guide has the 2026 limits for kids by state. The CHIP program page explains what the program covers and how enrollment works.

Can immigrant pregnant women get Medicaid after October 1, 2026?

Some can. From October 1, 2026, federal Medicaid and CHIP funding is mostly limited to citizens, green card holders (most after a 5-year wait), Cuban and Haitian entrants, and COFA migrants. Refugees and asylees lose that standard path, but states can still cover lawfully residing pregnant women.

The change comes from section 71109 of the 2025 budget law.

CMS explained it in a State Health Official letter dated April 8, 2026, which says federal funding “will no longer be available for full Medicaid or CHIP benefits” for qualified noncitizens such as “asylees, refugees, parolees, or victims of trafficking” unless an exception applies.

The letter names three exceptions. The third, Health Services Initiatives, is the CHIP tool Illinois uses for postpartum care. Two apply directly to pregnancy:

• The lawfully residing option (CHIPRA 214). States can cover pregnant women who are lawfully residing in the U.S., including during the usual 5-year waiting period. KFF counted 32 states covering lawfully residing pregnant immigrants through Medicaid in January 2026, and the 2025 law did not remove this option.
• Emergency Medicaid. People who meet every rule except immigration status can still get Medicaid for treatment of an emergency medical condition. The letter says the law made no change to this coverage.

The unborn child option in CHIP also continues, and KFF notes it still covers prenatal care “regardless of their parent’s immigration status.” So a pregnant woman who cannot get Medicaid herself may still get prenatal care this way. Twenty-five states use the option.

Medicaid.gov keeps a list of states using the lawfully residing option, last updated April 2, 2026. KFF also reports that New York and Oregon plan to move immigrants who lose federal coverage to state-funded coverage.

If you are already enrolled and your status no longer qualifies, the state must check every other way you might be eligible and send advance notice before ending coverage. A local legal aid office or community health center can help you read the notice.

How do you apply for Medicaid for pregnant women?

Apply through your state Medicaid agency or through HealthCare.gov, at any time of year. There is no enrollment period for Medicaid or CHIP, and coverage can begin as soon as you are found eligible. Report your pregnancy, your due date and how many babies you expect, because those answers set your household size.

1. Find your state agency. Medicaid.gov has a state-by-state contact list with each agency’s application link and phone number. Our state benefits hubs cover other programs in your state.
2. Or start at HealthCare.gov. Choose that you want help paying for coverage. If it looks like you qualify for Medicaid or CHIP, HealthCare.gov sends your information to the state agency.
3. Answer the pregnancy questions. Say you are pregnant, give your due date, and list the number of babies expected. Leaving this out can make your household look smaller than it is.
4. Report income for everyone in your tax household. Use gross income before taxes. Include your spouse’s income if you are married.
5. Have proof ready. States commonly ask for proof of identity, citizenship or immigration status, income such as recent pay stubs, and sometimes proof of pregnancy from a clinic. Check your state’s list so you are not waiting on a missing document.
6. Ask about presumptive eligibility at your first prenatal visit. If your clinic can grant it, you can start care while the state reviews your case.

If you already have a Marketplace plan, be careful with the pregnancy question.

HealthCare.gov warns that if you report it and are found eligible for Medicaid or CHIP, your case goes to the state and “you won’t be given the option to keep your Marketplace plan.” That is often a good trade, since Medicaid charges no copays for pregnancy-related care.

Pregnancy alone does not open a Special Enrollment Period for a Marketplace plan, but the birth of a baby does. Medicaid and CHIP have no such limit, which is why they are often the fastest way to get covered mid-pregnancy.

After approval, watch your mail for your card and any managed care plan choice. Keep your contact details current with the agency so you do not miss a renewal or a request for information during the 12 months after birth.

Many families who qualify for pregnancy Medicaid also qualify for WIC, which provides food, breastfeeding support and nutrition help. Our WIC income limits guide shows the cutoffs, and federal WIC rules accept Medicaid enrollment as proof that you meet WIC’s income test.

Related reading

• Medicaid explained: what it covers and how to sign up
• WIC for pregnant women, babies and young children
• Benefits for low-income families: SNAP, TANF, WIC and Medicaid
• What WIC provides during pregnancy and after birth
• Medical assistance programs: Medicaid, CHIP, ACA and discount drugs