Maternal and child health services are programs that pay for medical care during pregnancy, birth, and early childhood
These services cover doctor visits, hospital stays, lab tests, and preventive care for pregnant people and children from birth through age five (or sometimes older, depending on the program). Some programs also cover dental care, vision care, and mental health services. The programs are run by state health departments and Medicaid, not by a single federal office, so what is covered and who can use the services depends on where you live and your household income.
Most maternal and child health services are free or very low-cost. You do not pay when you go to the doctor or hospital if you are enrolled in the program. Some programs ask for a small co-payment (usually $1 to $5) for certain visits, but pregnant people and young children are often exempt from co-payments entirely.
The most common maternal and child health programs are Medicaid (which covers low-income pregnant people and children), the Children's Health Insurance Program (CHIP, which covers children in families that earn too much for Medicaid but not enough to afford private insurance), and state-specific programs like maternal health hotlines and home visiting services. Many states also run programs that provide free or reduced-cost prenatal vitamins, breastfeeding support, and postpartum mental health counseling.
Key Takeaways
- Medicaid covers pregnant people and children under age 19 in most states, with income limits that vary by state and family size.
- CHIP covers uninsured children in families that earn between 133% and 400% of the federal poverty level, depending on your state.
- Prenatal care, delivery, postpartum visits, and well-child checkups are covered at no cost under these programs.
- You enroll through your state Medicaid office or health department, and the process usually takes one to two weeks.
- Many states offer additional services like home visiting nurses, lactation counseling, and mental health support that are separate from Medicaid or CHIP.
Medicaid coverage for pregnant people and children
Medicaid is a joint federal and state program that covers medical care for low-income people. Every state runs its own Medicaid program, so income limits and covered services vary. In most states, pregnant people are covered if their household income is at or below 138% to 200% of the federal poverty level (the exact percentage depends on your state). Children are typically covered up to age 19 if their household income is at or below 138% of the federal poverty level.
Medicaid covers all prenatal care, including doctor visits, ultrasounds, blood tests, and delivery at a hospital or birth center. It also covers postpartum care for the pregnant person (usually for 60 days after delivery) and well-child visits for the newborn. Medicaid covers vaccines, ear infections, broken bones, emergency room visits, and hospital stays. Many state Medicaid programs also cover dental care, vision care, hearing aids, and mental health services for children.
To enroll in Medicaid, contact your state Medicaid office or explore online through your state health department website. You will need to provide proof of income (recent pay stubs, tax returns, or a letter from your employer), proof of citizenship or immigration status, and proof of residency. Pregnant people can often enroll in Medicaid on the same day they explore, so they do not have to wait for approval to start receiving care.
CHIP and state programs for uninsured children
The Children's Health Insurance Program (CHIP) covers children whose families earn too much to may have access to for Medicaid but cannot afford private insurance. Income limits vary by state, but most states cover children in families earning between 200% and 400% of the federal poverty level. CHIP covers the same services as Medicaid: doctor visits, hospital care, vaccines, dental care, and vision care.
Some states run their own child health programs instead of or in addition to CHIP. These programs may have different names (like "Healthy Families" in California or "BadgerCare" in Wisconsin) and different income limits. Your state health department website will list all the programs available in your state and tell you which one your family may be able to use.
To enroll in CHIP, explore through your state health department or Medicaid office. The process is the same as Medicaid: you provide proof of income, citizenship, and residency. Many states allow you to enroll online, by phone, or by mail. Approval usually takes one to two weeks, though some states offer temporary coverage while they review your process.
Prenatal care and delivery coverage
Prenatal care includes all the doctor visits, tests, and counseling you receive during pregnancy. Medicaid and CHIP cover all prenatal visits at no cost, including the initial visit (where the doctor takes your medical history and does a physical exam), monthly visits during the first and second trimester, twice-monthly visits during the third trimester, and weekly visits in the final month. These visits include blood pressure checks, urine tests, weight checks, and fetal heart rate monitoring.
Medicaid and CHIP also cover ultrasounds, blood tests (including screening for gestational diabetes and anemia), and counseling about nutrition, exercise, and mental health during pregnancy. If you have a high-risk pregnancy (for example, if you have diabetes or high blood pressure), Medicaid covers additional specialist visits and monitoring.
Delivery and hospital care are fully covered. This includes labor and delivery at a hospital or birth center, pain management, emergency cesarean section if needed, and a three-day hospital stay after delivery (or longer if medically necessary). Medicaid also covers postpartum visits with your doctor or midwife at two weeks and six weeks after delivery, and it covers mental health screening and treatment for postpartum depression.
Well-child visits and preventive care for children
Medicaid and CHIP cover well-child visits at no cost. These are regular checkups where the doctor measures your child's height and weight, checks their hearing and vision, and asks about development and behavior. Well-child visits happen frequently in the first year of life (at two weeks, two months, four months, six months, nine months, and 12 months) and then annually or every other year after that.
All vaccines recommended by the CDC are covered at no cost under Medicaid and CHIP. This includes vaccines for measles, polio, whooping cough, chickenpox, and other diseases. Medicaid and CHIP also cover screening for developmental delays, hearing problems, and vision problems. If a screening shows a problem, the program covers the specialist visit and treatment.
Medicaid and CHIP cover treatment for common childhood illnesses and injuries: ear infections, strep throat, asthma, eczema, broken bones, and emergency room visits. They also cover mental health services, including counseling and therapy for anxiety, depression, and behavioral problems. Dental care, including cleanings and fillings, is covered for children under age 21 in most states.
Home visiting programs and postpartum support services
Many states run home visiting programs that send a nurse or social worker to your home during pregnancy and after your baby is born. These programs are separate from Medicaid and CHIP, and they are usually free. A home visitor helps with prenatal health, teaches you about newborn care, screens for postpartum depression, and connects you with other services like food information or housing help.
Home visiting programs vary by state. Some states run programs through the health department, others through community health centers, and others through nonprofit organizations. To learn about your state has a home visiting program, contact your local health department or search for "home visiting programs" plus your state name on the internet.
Many states also offer separate postpartum support services, including mental health counseling, breastfeeding support, and peer support groups. Some programs provide free or reduced-cost lactation consultants who help with breastfeeding problems. Others offer telephone hotlines where you can talk to a nurse or counselor about postpartum depression, anxiety, or other concerns. These services are often free and do not require enrollment in Medicaid or CHIP.
How to enroll and what documents you need
To enroll in Medicaid or CHIP, contact your state Medicaid office or health department. Most states allow you to explore online through their website, by phone, by mail, or in person at a local office. Pregnant people can often enroll when ready, even if their process is still being reviewed.
You will need to provide proof of income (recent pay stubs, tax returns, a letter from your employer, or a statement of benefits if you receive unemployment or Social Security), proof of citizenship or immigration status (a birth certificate, passport, or state ID), and proof of residency (a utility bill, lease, or bank statement with your current address). If you are explore for a child, you will also need the child's birth certificate.
After you submit your process, the Medicaid office will review it and send you a letter telling you whether you are enrolled. This usually takes one to two weeks. If you are approved, you will receive a Medicaid or CHIP card in the mail. You can use this card at any doctor, hospital, or pharmacy that accepts Medicaid or CHIP. If you are denied, the letter will explain why and tell you how to appeal the decision.
Frequently Asked Questions
Do I have to be a U.S. citizen to enroll in Medicaid or CHIP?
No. Most states cover pregnant people and children regardless of immigration status, though some states limit coverage to lawful permanent residents or people with certain visa types. Contact your state Medicaid office to find out what immigration statuses are covered in your state. Many states also have separate programs for uninsured immigrants.
What if my income changes after I enroll?
Tell your Medicaid office right away. If your income increases above the limit, your coverage may end, but you will receive notice before that happens. If your income decreases, you may become may be able to access for a higher level of benefits. Your coverage will not be canceled when ready — you will have time to report the change and update your enrollment.
Can I use Medicaid or CHIP to see any doctor?
Most doctors and hospitals accept Medicaid and CHIP, but not all. Before your first visit, call the doctor's office and ask if they accept your insurance. If you cannot find a doctor who accepts Medicaid or CHIP in your area, your state Medicaid office can help you find one or refer you to a community health center.
Does Medicaid cover mental health care during pregnancy?
Yes. Medicaid covers screening for depression and anxiety during pregnancy and after delivery, and it covers counseling and medication if you need treatment. Many states also offer separate postpartum mental health programs that provide free counseling or support groups.
What happens to my coverage after my baby is born?
Your coverage as a pregnant person ends 60 days after delivery. However, your baby is automatically enrolled in Medicaid or CHIP at birth and remains covered until age 19 (or older, depending on your state). You can enroll in Medicaid or CHIP for yourself if you meet the income limit for non-pregnant adults, which is usually lower than the pregnancy limit.