Medicaid for Pregnant Women – How It Works

Medicaid is a government sponsored medical aid program for those with lower incomes and other special groups to provide health insurance for children, seniors, people with disabilities and so on.

Medicaid for pregnant women may differ from state to state; for instance the nomenclature for Medicaid is “TennCare” in Tennessee, referred to a “MassHealth” in Massachusetts, “Medi-Cal” in California, “Oregon Health Plan” in Oregon, and so on and about 20% of Americans are part of a Medicaid program.

Medicaid for Pregnant WomenRegardless of nomenclature however in each case and each state the averred purpose of medical aid for pregnant women is to make sure that pregnant women receive requisite care during pregnancy and after childbirth.

Generally speaking there are three groups that are eligible to receive Medicaid – The Categorically Needy, The Medically Needy and Special Groups, though the criteria of eligibility for being part of one or the other group may differ from state to state.

There are many ways in which Medicaid for pregnant women can be of benefit

  • All the care that a pregnant woman needs as part of her pregnancy including testing (lab, x-ray services and so on), and other diagnostic and screening processes are provided for.
  • Midwife, nurse, and outpatient consultation and so on are provided for.
  • Hospitalization expenses and any complications that may arise in the pregnancy or the delivery are covered.
  • The care offered by Medicaid extends to 60 days after delivery (postpartum).
  • In some cases women may also be compensated for care received for their pregnancy before they applied for the aid, under the policy of Presumptive eligibility so that pregnant women can get all the care that they need during pregnancy.
  • Medicaid for women who are pregnant is usually given priority and women who are eligible for it, will qualify within a period of two to four weeks.

There are several factors or rather a combination of factors that determine qualification for Medicaid and the criteria for eligibility to receive it. Though low income is a factor, it is not the only factor and there are other criteria that determine eligibility for Medicaid for pregnant women , according to the website of the American Pregnancy Association–

  • Proof of income is one of the basic documents that have to be provided to prove qualification for Medicaid.
  • Proof of pregnancy is also required to be provided to receive benefit.
  • If a woman is a citizen of the country then proof of this is required to be provided; if she is not a citizen of the country then proof of non-citizenship is also required to be provided. Medicaid for non citizens is provided for – for instance the Emergency Medical Assistance program of Florida for Non-citizens covers emergency labor and delivery of a child; which is a form of Medicaid for women who are not American citizens.

Since Medicaid for pregnant women has several defining and eligibility criteria, it is best to contact one’s local Medicaid office to see if one qualifies.


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