Eligibility Levels for Coverage of Pregnant Women in Medicaid and CHIP

This map set provides eligibility levels for states’ coverage of services for pregnant women under Medicaid (Title XIX of the Social Security Act) and Children’s Health Insurance Program (Title XXI of the Social Security Act) in 2015. Please see the accompanying chart for eligibility levels for states’ coverage in 2013, 2014, and 2015. Coverage levels for  2014 and 2015 include states’ modified adjusted gross income (MAGI) converted eligibility levels. Every state provides “pregnancy-related Medicaid” coverage to pregnant women at income levels above the historic Aid of Families with Dependent Children (AFDC) levels in place on May 1, 1998. (Below this level states are required to provide full Medicaid benefits to pregnant women.) Pregnancy-related Medicaid coverage in mandatory up to 133 percent of the federal poverty level (FPL); some states provide optional coverage up to or exceeding 185 percent FPL. States that opt out of these higher coverage levels in Medicaid are also allowed to cover pregnant women through their state Children’s Health Insurance Program (CHIP). For CHIP, states also have the option to provide services to pregnant women through the CHIP “unborn child” coverage option, which may offer a more limited benefit package.

This chart is based on the information collected by the National Academy for State Health Policy (NASHP) from multiple sources.  To learn more about some of the eligibility and enrollment policy considerations related to pregnant women’s coverage, check out the NASHP infographics that depict coverage options for pregnant women.

Know of something we should add to the map set or chart? Eager to update a fact we’ve included? Your feedback is central to our ongoing, real-time analytical process, so please email Alex King (aking@nashp.org) with your suggestion and/or update.

This map set and chart is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UC4MC28037 Alliance for Innovation on Maternal and Child Health ($349,975). The information or content and conclusions are those of the researchers and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.

Pregnancy-related Medicaid coverage in mandatory up to 133 percent of the federal poverty level (FPL); some states provide optional coverage up to or exceeding 185 percent FPL. This map illustrates state eligibility levels for coverage of pregnant women by percent of the federal poverty level.