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A young, 20-something African American mother-to-be with her hand resting on her pregnant belly

Medicaid coverage for pregnant women and their babies

Posted: August 16, 2023

Last updated date: August 17, 2023

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.

Who can qualify for Medicaid pregnancy coverage?

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

What maternity care services does Medicaid cover?

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.

UnitedHealthcare offers extra services throughout pregnancy and beyond

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.

*NOTE: Benefits vary by plan and service area. 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.

Does Medicaid cover doulas?

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.

*Benefits, features, and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply.

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)

What type of plan am I eligible for?

Answer a few quick questions to see what type of plan may be a good fit for you.

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Medicaid or dual-eligible plan benefits can change depending on where you live. Search using your ZIP code to find the right plan to meet your health care needs.

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Disclaimer information
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Looking for the federal government’s Medicaid website? Look here at Medicaid.gov.

UnitedHealthcare Dual Complete plans

Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. Benefits, features and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.

Premium disclaimer

Dual Special Needs plans have a $0 premium for members with Extra Help (Low Income Subsidy).

Benefit disclaimer

Benefits, features, and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply.

Nurse Hotline disclaimer

This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only. The nurses cannot diagnose problems or recommend treatment and are not a substitute for your provider's care. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time. Nurse Hotline not for use in emergencies, for informational purposes only.

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid plan)

UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. 

UnitedHealthcare Connected® (Medicare-Medicaid plan)

UnitedHealthcare Connected® (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and Texas Medicaid to provide benefits of both programs to enrollees.

UnitedHealthcare Connected® for One Care (Medicare-Medicaid plan)

UnitedHealthcare Connected® for One Care (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and MassHealth (Medicaid) to provide benefits of both programs to enrollees. 

UnitedHealthcare Connected® general benefit disclaimer

This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the member handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected® Member Services or read the UnitedHealthcare Connected® member handbook. 

UnitedHealthcare Senior Care Options (HMO SNP) plan

UnitedHealthcare Senior Care Options (SCO) is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare and does not have any other comprehensive health Insurance, except Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our Senior Care Options (SCO) program.

Star ratings disclaimer

Every year, Medicare evaluates plans based on a 5-Star rating system. The 5-Star rating applies to plan year 2024.

Important provider information

The choice is yours

We will provide you with information to help you make informed choices, such as physicians' and health care professionals' credentials. This information, however, is not an endorsement of a particular physician or health care professional's suitability for your needs.

The providers available through this application may not necessarily reflect the full extent of UnitedHealthcare's network of contracted providers. There may be providers or certain specialties that are not included in this application that are part of our network. If you don't find the provider you are searching for, you may contact the provider directly to verify participation status with UnitedHealthcare's network, or contact Customer Care at the toll-free number shown on your UnitedHealthcare ID card. We also recommend that, prior to seeing any physician, including any specialists, you call the physician's office to verify their participation status and availability.

Some network providers may have been added or removed from our network after this directory was updated. We do not guarantee that each provider is still accepting new members.

Out-of-network/non-contracted providers are under no obligation to treat UnitedHealthcare plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services.

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In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 ("ADA"), UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.

Referrals

Network providers help you and your covered family members get the care needed. Access to specialists may be coordinated by your primary care physician.

Paper directory requests

Paper copies of the network provider directory are available at no cost to members by calling the customer service number on the back of your ID card. Non-members may download and print search results from the online directory.

Inaccurate information

To report incorrect information, email provider_directory_invalid_issues@uhc.com. This email box is for members to report potential inaccuracies for demographic (address, phone, etc.) information in the online or paper directories. Reporting issues via this mail box will result in an outreach to the provider’s office to verify all directory demographic data, which can take approximately 30 days. Individuals can also report potential inaccuracies via phone. UnitedHealthcare Members should call the number on the back of their ID card, and non-UnitedHealthcare members can call 1-888-638-6613 / TTY 711, or use your preferred relay service.

Declaration of disaster or emergency

If you’re affected by a disaster or emergency declaration by the President or a governor, or an announcement of a public health emergency by the Secretary of Health and Human Services, there is certain additional support available to you.

  • Part A, Part B, and supplemental Part C plan benefits are to be provided at specified non-contracted facilities (note that Part A and Part B benefits must be obtained at Medicare certified facilities);
  • Where applicable, requirements for gatekeeper referrals are waived in full;
  • Plan-approved out-of-network cost-sharing to network cost-sharing amounts are temporarily reduced; and
  • The 30-day notification requirement to members is waived, as long as all the changes (such as reduction of cost-sharing and waiving authorization) benefit the member.

If CMS hasn’t provided an end date for the disaster or emergency, plans will resume normal operation 30 days after the initial declaration.