Medicaid for pregnant women


What is Medicaid for pregnant women?

With Medicaid for pregnant women, you get full health care benefits during your pregnancy and for one year after your baby’s birth. Medicaid may also cover your medical bills for the three months before you enroll. You also get dental benefits during your pregnancy and postpartum. Dental services are through the Smiles for Children program. For help finding a dentist or to learn more, call Smiles For Children at 1-888-912-3456. Also read the [PDF] Guide to Dental Coverage.

What services are covered?

Medicaid covers breast pumps and breastfeeding support during your pregnancy and after your baby is born. 

You will get health care services through health plans. The health plans all have special programs for high-risk pregnancies. To learn more, go to Health Plan Information, or call your health plan.

Who qualifies?

Women who qualify have coverage during pregnancy and for one year after the birth. Your baby qualifies for coverage for the first year after birth. Tell us as soon as your baby is born to enroll the baby right away. You will need to give us the baby’s name, date of birth, race and gender. You can enroll your baby by phone with Cover Virginia at 833-5CALLVA (TDD: 1-888-221-1590). Or tell your eligibility worker at your local Department of Social Services (DSS) when your baby is born. You can also ask the hospital about submitting the enrollment information for your newborn.

After your 12-month postpartum coverage period ends, you may still qualify for health coverage. We will re-evaluate your benefits and send you a letter in the mail telling you our decision. If you no longer qualify, we will refer you to the Virginia Insurance Marketplace where you may be eligible to enroll in a private health insurance plan with financial assistance to help lower the cost of coverage and care.

Medicaid for children under age 19 and pregnant women

Medicaid for Children & Medicaid for Pregnant Women
Up to 148% FPL
Household size Yearly Monthly 
1 $22,289 $1,858
2 $30,252 $2,521
3 $38,214 $3,185
4 $46,176 $3,848
5 $54,139 $4,512
6 $62,101 $5,176
7 $70,064 $5,839
8 $78,026 $6,503
Each additional $7,963 $664

*Includes 5% FPL Disregard
2024 Income Guidelines as of January 17, 2024

How do you apply?

If you think you may qualify, go to Apply.

To find out if you may qualify for FAMIS MOMS or Medicaid for pregnant women, answer the questions on the screening tool at Am I eligible?

Eligibility for health coverage is based on income plus other factors. This tool screens for income only. You may qualify for coverage based on other things like age or disability. To get a full review, you need to apply.

Where to learn more

Member Postpartum Continuous Coverage Flyer image

Members Postpartum Continuous Coverage Flyer

[PDF] English | Spanish

Stakeholder Postpartum Continuous Coverage Flyer image

Stakeholders Postpartum Continuous Coverage Flyer

[PDF] English | Spanish

 

Medicaid Member Handbook

[PDF] English | Spanish