Medicaid covers pregnancy-related care for millions of women each year, but the income cutoff depends entirely on which state you live in. Eligibility is measured as a percentage of the Federal Poverty Level (FPL), and the range across states is wide: some states set the limit as low as 138% FPL while others go up to 380% FPL. This guide gives you the 2025 income limits for every state, explains what Medicaid covers during pregnancy, and walks you through how to apply.
What Is the Federal Poverty Level in 2025?
Medicaid eligibility for pregnant women is based on Modified Adjusted Gross Income (MAGI) rules and compared against the Federal Poverty Level. For 2025, the FPL guidelines for the contiguous 48 states are:
| Household Size | 100% FPL (Annual) | 100% FPL (Monthly) |
|---|---|---|
| 1 | $15,650 | $1,304 |
| 2 | $21,150 | $1,763 |
| 3 | $26,650 | $2,221 |
| 4 | $32,150 | $2,679 |
| 5 | $37,650 | $3,138 |
Alaska and Hawaii have higher FPL thresholds. Most states also apply a 5% FPL income disregard when calculating your countable income, which effectively raises the real cutoff slightly above the listed percentage.
During pregnancy, your household size automatically increases by one because the unborn child counts. If you live alone and are pregnant, you count as a household of two for Medicaid eligibility purposes.
2025 Medicaid Income Limits for Pregnant Women by State
The table below shows each state's income limit for pregnant women as a percentage of the FPL, based on data from KFF as of January 2025.
| State | Income Limit (% FPL) |
|---|---|
| Alabama | 146% |
| Alaska | 230% |
| Arizona | 161% |
| Arkansas | 214% |
| California | 213% |
| Colorado | 195% |
| Connecticut | 263% |
| Delaware | 217% |
| District of Columbia | 324% |
| Florida | 196% |
| Georgia | 225% |
| Hawaii | 196% |
| Idaho | 138% |
| Illinois | 213% |
| Indiana | 213% |
| Iowa | 380% |
| Kansas | 171% |
| Kentucky | 195% |
| Louisiana | 138% |
| Maine | 214% |
| Maryland | 264% |
| Massachusetts | 205% |
| Michigan | 200% |
| Minnesota | 283% |
| Mississippi | 199% |
| Missouri | 196% |
| Montana | 162% |
| Nebraska | 199% |
| Nevada | 190% |
| New Hampshire | 201% |
| New Jersey | 194% |
| New Mexico | 255% |
| New York | 223% |
| North Carolina | 201% |
| North Dakota | 175% |
| Ohio | 205% |
| Oklahoma | 210% |
| Oregon | 190% |
| Pennsylvania | 220% |
| Rhode Island | 190% |
| South Carolina | 199% |
| South Dakota | 138% |
| Tennessee | 255% |
| Texas | 203% |
| Utah | 144% |
| Vermont | 213% |
| Virginia | 143% |
| Washington | 215% |
| West Virginia | 185% |
| Wisconsin | 306% |
| Wyoming | 159% |
The national median is 201% FPL. States like Iowa (380%), Wisconsin (306%), and DC (324%) offer significantly more generous coverage than states like Idaho, Louisiana, and South Dakota, which sit at the federal minimum of 138%.
Monthly Dollar Amounts at Common Thresholds
To help you quickly estimate whether you might qualify, here are approximate monthly gross income limits at common FPL percentages for a household of two (pregnant woman plus one other person):
| FPL % | Monthly Income Limit (Household of 2) |
|---|---|
| 138% | $2,433 |
| 150% | $2,644 |
| 175% | $3,086 |
| 200% | $3,525 |
| 213% | $3,757 |
| 250% | $4,406 |
| 300% | $5,288 |
| 380% | $6,698 |
These are rough estimates. Actual eligibility depends on your state's specific rules, any income disregards, and how your state counts household members. Use our free eligibility screener to get a personalized estimate based on your income and household.
What Medicaid Covers During Pregnancy
Pregnancy Medicaid provides comprehensive coverage. Federal law requires every state to cover at minimum:
- Prenatal visits and checkups throughout all three trimesters
- Lab work, blood tests, and urinalysis
- Ultrasounds and prenatal screenings
- Prescription medications related to pregnancy
- Labor and delivery (vaginal birth and cesarean section)
- Hospital stays for delivery
- Postpartum care after birth
- Family planning counseling and services
- Medically necessary services that could affect the health of the pregnancy
Many states also cover mental health services, dental care, and nutrition counseling for pregnant women, though this varies by state.
Postpartum Coverage Extension
A major change that became permanent under the Consolidated Appropriations Act of 2023 allows states to extend Medicaid coverage for 12 months after delivery rather than just 60 days. As of early 2025, the majority of states have adopted this 12-month postpartum extension. Check your state Medicaid agency to confirm whether your state has implemented this option.
CHIP Perinatal Coverage
If your income is too high for pregnancy Medicaid but you still cannot afford private insurance, some states offer CHIP Perinatal coverage. CHIP Perinatal covers prenatal care and limited postpartum visits. In states like Texas, this program covers pregnancy care for women whose income falls above the Medicaid limit but below the CHIP income threshold (typically up to 203% FPL for Medicaid and somewhat higher for CHIP Perinatal).
Note that CHIP Perinatal is distinct from the 12-month postpartum extension. CHIP Perinatal coverage generally ends at the conclusion of the month the pregnancy ends plus two postpartum visits.
How to Apply for Pregnancy Medicaid
Step 1: Gather Your Documents
Before you apply, collect the following:
- Proof of identity (driver's license, state ID, or passport)
- Proof of pregnancy (a note from your doctor or a positive pregnancy test)
- Social Security number (or documentation if you do not have one)
- Proof of income for all household members (pay stubs, tax returns, employer letter)
- Proof of state residency (utility bill, lease, bank statement)
- Information about any other health insurance you currently have
Some states have simplified rules for pregnancy applications and may not require all of these documents upfront.
Step 2: Choose How to Apply
You can apply through any of these channels:
- Online: Visit your state Medicaid agency's website or Healthcare.gov. Most states have an online portal where you can submit an application directly.
- By phone: Call your state Medicaid office. Many states have dedicated pregnancy Medicaid lines with shorter wait times.
- In person: Visit your local Medicaid or Department of Social Services office.
- Through your provider: Your doctor's office, a community health center, or a hospital can often help you apply on the spot.
- By mail: Download and mail a paper application to your state Medicaid office.
Step 3: Ask About Presumptive Eligibility
If you need coverage right away, ask your provider about Presumptive Eligibility (PE). Many states allow qualified providers (called Qualified Entities) to grant you temporary Medicaid coverage on the spot based on a quick income screening. This coverage kicks in immediately and continues until your full application is processed, so you do not have to wait weeks before your first prenatal appointment is covered.
Step 4: Submit Your Application
Complete the application thoroughly and submit it with your supporting documents. If applying online, most states allow you to upload documents directly. If applying by mail or in person, make copies of everything you submit.
Step 5: Respond to Any Requests
After submitting, your state may request additional information or verification. Respond to these requests promptly to avoid delays. Processing times vary by state, but many states prioritize pregnancy applications.
Step 6: Receive Your Determination
Once approved, you will receive a Medicaid card or enrollment notice. Coverage is often retroactive to the date of application or the date your doctor confirmed your pregnancy. Keep all correspondence from your state Medicaid office.
States With Lower Income Limits: What Are Your Options?
If you live in a state with a lower income limit (like Alabama at 146%, Virginia at 143%, or Idaho at 138%) and your income exceeds the Medicaid threshold, you have other options:
- ACA Marketplace plans: Pregnant women qualify for a Special Enrollment Period when they become pregnant. Premium tax credits are available for incomes between 100% and 400% FPL.
- CHIP Perinatal: Available in many states for incomes slightly above the Medicaid cutoff.
- Community Health Centers: Federally Qualified Health Centers (FQHCs) offer prenatal care on a sliding fee scale regardless of insurance status.
- State-specific programs: Some states have state-funded programs for uninsured pregnant women that operate separately from Medicaid.
Run your numbers through our eligibility screener to see all the programs you might qualify for based on your income, household size, and state.
Immigration Status and Pregnancy Medicaid
U.S. citizens and most lawfully present immigrants qualify for full-scope pregnancy Medicaid if they meet the income requirements. Federal law requires a five-year waiting period for most lawfully present immigrants before they can receive federally funded Medicaid, but pregnancy is an exception in many states.
Emergency Medicaid covers labor and delivery costs for individuals who do not meet immigration requirements for full Medicaid. Some states have also chosen to use state funds to cover prenatal care for undocumented immigrants, including California (through Medi-Cal) and several others.
If immigration status is a concern, contact a local navigator or community health center for guidance specific to your state.
Frequently Asked Questions
How do I know if my income qualifies for pregnancy Medicaid?
Find your state in the table above and note the FPL percentage. Then compare your gross monthly income to the FPL thresholds for your household size (remember to count your unborn child as an additional household member). If your income falls below that percentage, you likely qualify. Use our free screener for a more precise estimate.
Does pregnancy Medicaid cover the father or partner?
Pregnancy Medicaid covers the pregnant woman's medical care specifically. The father or partner would need to apply separately based on their own income and the standard Medicaid eligibility rules for their state.
Can I apply if I am in my second or third trimester?
Yes. You can apply at any point during your pregnancy. Medicaid may also provide retroactive coverage going back up to three months before your application date if you had qualifying expenses during that time.
What happens to my Medicaid coverage after I give birth?
In states with the 12-month postpartum extension, your coverage continues for a full year after delivery. In states without this extension, coverage typically ends 60 days after delivery. Your baby qualifies for separate Medicaid or CHIP coverage from the date of birth.
Does my immigration status affect eligibility?
U.S. citizens and many lawfully present immigrants qualify for pregnancy Medicaid. Emergency Medicaid covers labor and delivery for others. Rules vary significantly by state, and some states extend broader coverage using state-only funds.
What if I have other health insurance?
Having other insurance does not automatically disqualify you. If your employer insurance is considered unaffordable or inadequate, you may still qualify for Medicaid. Medicaid will typically act as secondary coverage if you have private insurance.
How long does the application take?
Processing times vary by state and by how quickly you provide required documentation. Presumptive Eligibility provides immediate temporary coverage while your full application is reviewed. Once all documents are submitted, many states process pregnancy applications within a few days to a few weeks.
Is income the only eligibility requirement?
No. In addition to income, you must be a resident of the state where you apply, be pregnant (confirmed by a physician), and meet citizenship or immigration status requirements. Some states also have asset tests, though most states eliminated asset tests for pregnancy Medicaid.
