Eligibility Levels for Coverage of Pregnant Women in Medicaid and CHIP
*Updated January 2019
This National Academy for State Health Policy (NASHP) map provides eligibility levels for states’ Medicaid and Children’s Health Insurance Program (CHIP) coverage for pregnant women. Please see the accompanying chart for eligibility levels for states’ coverage in 2013, 2015, and 2017. Coverage levels for 2015 and 2017 include states’ modified adjusted gross income-converted eligibility levels. Every state provides “pregnancy-related Medicaid” coverage to pregnant women at income levels above the historic Aid to Families with Dependent Children 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 is mandatory for women earning up to 133 percent of the federal poverty level (FPL), but some states provide optional coverage up to or exceeding 185 percent of FPL. States that opt out of these higher Medicaid coverage levels are also allowed to cover pregnant women through CHIP. Under 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 NASHP from multiple sources. To learn more about some of the eligibility and enrollment policy considerations related to pregnant women’s coverage, explore these NASHP infographics that depict coverage options for pregnant women.
The development of the original map and chart was supported by the Health Resources and Services Administration (HRSA) of the US 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 US government.