Medicaid coverage for pregnant women and their babies

Medicaid covers nearly half of all births in the United States each year. It's the main source of health care coverage for low-income pregnant women. Medicaid coverage for mothers starts during pregnancy and lasts for at least 60 days after giving birth.

In 2023, Congress provided a way for states to extend Medicaid coverage to mothers for 12 months after giving birth. More than half of U.S. states have chosen to do this.¹ More states are expected to do it in 2023.

The exact eligibility requirements for Medicaid depend on where you live. State Medicaid programs must cover pregnant women who earn 133% of the federal poverty level (FPL) or less. But some states may still cover people who earn more than that. Women who earn too much to qualify for Medicaid but not enough to afford private health insurance may be able to get maternity coverage through the Children's Health Insurance Program (CHIP). Lawful immigrants may also be able to get health coverage through CHIP.

Women should apply for Medicaid as soon as they find out they're pregnant. That way, they'll get coverage as soon as possible.

Medicaid covers pregnant women before, during and after giving birth. Prenatal care is the period leading up to giving birth. Good prenatal care is important. It’s to check the health of the mother and the baby during pregnancy. It also helps doctors address problems that may come up.

Medicaid covers routine checkups. Most states also cover pre-natal vitamins and ultrasound exams. If a woman needs other medically necessary care during pregnancy, Medicaid will cover those services.

Medicaid covers all care during delivery, including the cost of the hospital stay or birth center. Medicaid also covers care after giving birth. This is called the postpartum period. It can be a risky time for mothers and their babies. So good follow-up care is important.

State Medicaid health plans include standard benefits. But UnitedHealthcare may also provide extra programs for our female Medicaid members.* Some of these programs help make sure women have a safe and healthy pregnancy. Others help moms take care of their newborns after birth.

Our value-added programs may include*:

• UnitedHealthcare Healthy First Steps® — Helps all pregnant women find providers and connect to local resources. Also provides extra help during high-risk pregnancies and for at least 2 months after delivery.
• Digital Education & Rewards — Delivers customized education through each stage of pregnancy. And rewards moms for going to visits during pregnancy and after giving birth.
• Home Delivered Meals — Brings meals to women after leaving hospital.
• In-Home Care Services — Offers home visits and medical support if needed.
• Breastfeeding Support — Gives new moms up to 6 virtual visits to help with nursing.
• Wellhop for Mom & Baby — Enables moms to share tips and stories with other women throughout pregnancy via an online community.
• Supplies — Provides diapers, car seats, breast pumps and other key supplies needed during pregnancy and in caring for new babies.

*NÒT: Avantaj yo varye selon plan an ak zòn sèvis la. Limitations and exclusions apply. For details about the exact benefits available in Medicaid plans in your area, please search plans using the ZIP code where you live.

A doula is a non-clinical person who provides support for women before, during and after labor. Doulas explain medical procedures in plain language. They help with nursing. They provide comfort during labor. They also teach women about coping skills and infant care. Doula care results in fewer C-sections, less use of pain medication and lower rates of maternal death.²

Today, more than half of all states either provide Medicaid coverage for doula care or are working toward offering it.³ UnitedHealthcare is also working to offer doula care in states where it’s not covered by Medicaid. We're partnering with The Doula Network (TDN). Together, we're testing doula care programs in 5 states — Arizona, Kansas, Kentucky, Texas and Washington.

By offering Doula care, UnitedHealthcare is at the forefront of new trends in Medicaid managed care.

¹ Medicaid Postpartum Coverage Extension Tracker (KFF, June 2, 2023)
² Overdue: Medicaid and Private Insurance Coverage of Doula Care to Strengthen Maternal and Infant Health (National Library of Medicine (NLM), 2016)
³ Current State of Doula Medicaid Implementation Efforts in November 2022 (National Health Law Program, November 14, 2022)