Medical care can be expensive, especially if you don’t have health insurance. And pregnancy, delivery, and postpartum rank amongst some of the highest medical costs, with care running tens of thousands of dollars. Luckily, your state may offer coverage so you don’t have to go into debt to have a child.
State Medicaid is available to adult residents who have a low income. And many states expanded coverage to pregnant women even if their household earnings are more than the maximum threshold. Here’s what you need to know.
Income Limits for Medicaid When Pregnant
Federal law requires states to cover adult applicants with household incomes less than 138% of the federal poverty level (FPL). However, many states have increased this percentage for pregnant women to ensure they have access to prenatal care.
As of writing, these are the state income limits for pregnant women:
| State | % of FPL |
| Alabama | 146% |
| Alaska | 225% |
| Arizona | 156% |
| Arkansas | 214% |
| California | 213% |
| Colorado | 195% |
| Connecticut | 263% |
| Delaware | 212% |
| District of Columbia | 324% |
| Florida | 196% |
| Georgia | 211% |
| Hawaii | 196% |
| Idaho | 138% |
| Illinois | 213% |
| Indiana | 208% |
| Iowa | 220% |
| Kansas | 171% |
| Kentucky | 200% |
| Louisiana | 138% |
| Maine | 214% |
| Maryland | 264% |
| Massachusetts | 200% |
| Michigan | 200% |
| Minnesota | 278% |
| Mississippi | 194% |
| Missouri | 196% |
| Montana | 162% |
| Nebraska | 194% |
| Nevada | 165% |
| New Hampshire | 196% |
| New Jersey | 205% |
| New Mexico | 250% |
| New York | 223% |
| North Carolina | 201% |
| North Dakota | 175% |
| Ohio | 205% |
| Oklahoma | 210% |
| Oregon | 190% |
| Pennsylvania | 215% |
| Rhode Island | 253% |
| South Carolina | 199% |
| South Dakota | 138% |
| Tennessee | 195% |
| Texas | 198% |
| Utah | 144% |
| Vermont | 213% |
| Virginia | 205% |
| Washington | 198% |
| West Virginia | 185% |
| Wisconsin | 306% |
| Wyoming | 159% |
Why is Medicaid’s income limit set as a percentage? Well, the federal government sets the FPL by household size since it understands that bigger families have higher expenses. Each additional person increases the cap.
2026 Federal Poverty Guidelines
| Persons in family / household | 48 contiguous states and DC | Alaska | Hawaii |
| 1 | $15,650 | $19,550 | $17,990 |
| 2 | $21,150 | $26,430 | $24,320 |
| 3 | $26,650 | $33,310 | $30,650 |
| 4 | $32,150 | $40,190 | $36,980 |
| 5 | $37,650 | $47,070 | $43,310 |
| 6 | $43,150 | $53,950 | $49,640 |
| 7 | $48,650 | $60,830 | $55,970 |
| 8 | $54,150 | $67,710 | $62,300 |
| 9+ | Add $5,500 per additional person. | Add $6,880 per additional person. | Add $6,330 per additional person. |
So, percentages help keep income requirements flexible when Medicaid calculates your eligibility.
How Medicaid Calculates Your Income
As mentioned, the FPL increases for each member of your family. And unlike most other welfare programs, Medicaid counts a fetus as a member of the household. So, a pregnant woman is already considered a family of two.
Medicaid also considers the following people as part of the household:
- Spouses (if living together)
- Unmarried partners (based on who claims shared children as dependents)
- Dependent children
- Anyone claimed as a tax dependent
Basically, whoever is on your tax filing is part of your household. Generally, Medicaid doesn’t include the income from other adults who live in the same house, such as roommates and extended family members.
To determine if your income is under the limit for your household size, Medicaid takes your adjusted gross income from your most recent tax filing and adds back any untaxed income or benefits. However, Medicaid does not include child support, Temporary Assistance for Needy Families, or Supplemental Security Income.
What Does Medicaid Cover for Pregnancy
Medicaid covers any medically necessary care related to the pregnancy, labor and delivery, and postpartum. In fact, you may keep Medicaid coverage for 12 months after delivery even if your income increases. Additionally, your newborn is automatically eligible for Medicaid until their first birthday, regardless of household income.
Medicaid pays for all pregnancy-related care, which means your out-of-pocket costs are $0. The Federal Government prohibits the program from having copayments, coinsurance, or deductibles for these services.
- Routine doctor visits
- Ultrasounds
- Lab work
- Hospital stays
For your newborn, this includes all medically necessary care, scheduled doctor visits, developmental screenings, immunizations, prescriptions, and more.
Medicaid will not help you get pregnant through fertility treatments. Likewise, it will not cover non-medically necessary items or services. Depending on the state, pregnancy-related educational classes may not be covered.
Similarly, you may have a copayment for care not related to your pregnancy, such as a broken arm.
Pregnant Women on Medicaid May Be Eligible for Food Benefits
If you’re eligible for Medicaid due to pregnancy, then you are likely “adjunctively eligible” for additional help from the Women, Infants, and Children (WIC) program. This means that you can apply for WIC and skip the income verification portion.
Through WIC, you can:
- Get free healthy food. The WIC program provides an eWIC card preloaded to pay for fresh produce, dairy, proteins, whole grains, and more. Once the baby is born, benefit packages may change to include formula, baby food, etc.
- Get breastfeeding support. WIC can get you in contact with lactation consultants and obtain a free breast pump.
Like Medicaid’s postpartum and newborn coverage, you or your child may continue to receive WIC benefits after delivery. Depending on your ongoing eligibility, you could receive benefits for weeks, months, or years on behalf of your child.
Government Help When You’re Pregnant Could Save You Thousands
The total average cost of prenatal care, labor, and delivery in the U.S. without insurance ranges between $18,000 and well over $50,000. Enrollment in Medicaid means you have no out-of-pocket expenses to welcome your child into the world. And with coverage for 12 months after delivery, you could save a total average of $3,100 on postpartum medical care.
Once the baby is born, they become another patient with their separate medical bills. The average cost of a Neonatal Intensive Care Unit is thousands a day. Automatic Medicaid enrollment for the newborn means saving on their portion of the hospital stay.
Plus, the total average cost of health care for a baby in their first year is about $5,820. Babies usually go to well-child pediatrician visits a week after hospital discharge and then every other month. Medicaid covers these scheduled routine checkups and sudden visits for accidents, illness, or other concerns.
