If You’re Pregnant and Uninsured, Medicaid Might Be Your Answer

LISTEN: If you are newly pregnant and can’t afford health insurance, you may qualify for Medicaid. Journalists Cara Anthony and Blake Farmer – hosts of the new series “HealthQ” – explain that each state has a program aimed at providing coverage for pregnant people.

When she noticed an unusual craving for hot dogs, Matte’a Brooks suspected her body was telling her something, so she decided to take a pregnancy test. She took two, just to be sure. Both were positive.

“I was really scared,” said Brooks, 23, who was uninsured. “I was like, OK…I’m pregnant, so where do I go from here?”

Until then, she hadn’t thought much about health care, but that all changed when she learned her daughter was on the way.

Brooks learned this news last winter. The mix of joy, anxiety and excitement she felt reflects what many new parents feel at this time of year. Many Americans discover that they are expecting a child in January or February, because in the United States the birth rate is consistently high in August.

More and more research shows that prenatal care can make a huge difference to the long-term health of parents and baby. That’s part of why every state offers health coverage to pregnant women who meet income requirements and who might otherwise be uninsured.

As a result, Medicaid funds more than 40 percent of births in the United States and an even higher percentage in rural areas, according to KFF. But Medicaid also has limits, and providers can restrict the number of Medicaid patients they accept because payments are significantly lower than other insurers.

Here are three things to know about enrolling in Medicaid while pregnant.

1. Pregnancy makes you a priority

To enroll in government health care, you must meet a number of requirements that vary widely by state. Most importantly, your income must be below a certain threshold. In many states, most adults cannot qualify, regardless of income, if they are not disabled or the parents of a child.

But the calculation is different for pregnancy. In Tennessee, for example, the pregnancy eligibility threshold is more than double the income threshold for some other residents. So if you weren’t eligible for Medicaid before and are now pregnant, it’s worth checking your state’s requirements.

2. Getting Covered Can Be Surprisingly Easy

To apply, you will likely need to provide proof of income, your Social Security number, and proof of residency. Brooks, an Illinois resident, told HealthQ she found the sign-up process surprisingly simple. She learned about Medicaid from the provider during her first prenatal visit.

“They asked me if I had insurance. I didn’t know anything at the time,” she said. The nonprofit clinic gave him phone numbers for the state Medicaid agency. She called and went to an in-person appointment to complete her application. She came out of the office with a blanket. In 28 states, pregnancy gives rise to “presumptive eligibility,” which provides immediate coverage – even without confirmation of pregnancy – while the application goes through the approval process.

3. Coverage can go beyond standard medical care

Medicaid provides all prenatal care at no cost and usually a full year of postpartum care. This is what happened to Brooks: his appointments, medications and delivery were free.

States cover dental, vision, and mental health care to varying degrees. Ashley Farrell, who lost her job while pregnant and applied for Medicaid in Georgia, said she received “rewards for getting to your appointments” including grocery cards and a breast pump. Benefits vary by state.

People and politics

Some maternal health advocates worry about how the Medicaid cuts in the One Big Beautiful Bill Act will affect pregnancy coverage. Although it is unclear when and how, states could reduce eligibility or offerings to pregnant women.

Katherine Ruppelt of Nashville Public Radio contributed to this report.

HealthQ is a health series from journalists Cara Anthony and Blake Farmer – accessible guides to an inaccessible health care system. This is a collaboration between Nashville Public Radio and KFF Health News.

KFF Health News is a national newsroom that produces in-depth journalism on health issues and is one of KFF’s primary operating programs, an independent source of health policy research, polling and journalism. Learn more about KFF.

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