Illinois Moms and Babies is a free Medicaid program that covers pregnant Illinois residents whose household income is at or below 213% of the Federal Poverty Level, and it does not require U.S. citizenship or lawful immigration status.1Illinois Department of Healthcare and Family Services. Moms and Babies The program pays for prenatal care, labor and delivery, and 12 months of postpartum care, and it covers the newborn through their first birthday. It is run by the Illinois Department of Healthcare and Family Services.
Who Qualifies
Three things have to be true: you live in Illinois, you are pregnant, and your household income is at or below 213% of the Federal Poverty Level.2Legal Information Institute. Illinois Administrative Code Title 89 – Eligibility for Pregnant Women and Children The 213% figure already includes the 5% income disregard required by federal Medicaid rules, so it is the effective ceiling your caseworker will apply.3Illinois Department of Human Services. WAG 25-03-02 (2) Medical FPLs
Immigration status is not a barrier. The eligibility rule for pregnant women does not require citizenship or a qualified immigration status, even though citizenship is required for children under the same regulation.2Legal Information Institute. Illinois Administrative Code Title 89 – Eligibility for Pregnant Women and Children Babies born to noncitizen mothers who themselves would not meet immigration requirements are still eligible for Moms and Babies coverage through age one.4Illinois Department of Human Services. MR 10.21 – Eligibility of Newborns Whose Mothers Are Noncitizens
Illinois uses Modified Adjusted Gross Income, the same method used on your federal tax return, to evaluate what you earn.5Illinois General Assembly. Illinois Administrative Code Title 89 Section 120.64 Once you are approved, any income changes during your pregnancy are disregarded through the 60-day period after delivery. A raise or a spouse’s new job mid-pregnancy will not push you off the program before you have recovered.
How Household Size Works
The income limit scales with household size, and Illinois counts each unborn child as its own household member. A single pregnant woman expecting one baby is a household of two. Expecting twins? Household of three.6Illinois Department of Human Services. WAG 06-10-05 – Income Guidelines
Using the 2026 Federal Poverty Level guidelines, the approximate gross monthly income ceilings at 213% FPL are:7U.S. Department of Health and Human Services. 2026 Poverty Guidelines – 48 Contiguous States
- Two-person household (pregnant woman plus one expected baby): about $3,841 per month
- Three-person household: about $4,849 per month
- Four-person household: about $5,858 per month
These are gross figures, before taxes and deductions. Your caseworker’s numbers may differ slightly because of rounding, but the ranges above are reliable for deciding whether to apply.
What the Program Covers
Moms and Babies pays for the full Illinois Medicaid benefit package rather than a limited pregnancy-only bundle. That covers outpatient and inpatient hospital care, labor and delivery, primary and specialty visits, and prescription drugs.1Illinois Department of Healthcare and Family Services. Moms and Babies Prenatal lab work, ultrasounds, and diagnostic testing are covered throughout the pregnancy, and the program pays for your delivery stay and any complications.
Postpartum coverage runs a full 12 months after birth, including checkups, mental health services, and follow-up care tied to the pregnancy or delivery.8Illinois Department of Human Services. MR 24.01 – Postpartum Update Illinois extended coverage to 12 months in April 2021.
Your newborn is covered from the moment of birth through their first birthday, with well-child visits, immunizations, specialist care, and prescriptions. At age one, the child can move to the All Kids program, which covers Illinois children across a range of income levels.9Illinois Department of Healthcare and Family Services. About All Kids
Getting Care Right Away: Presumptive Eligibility
A full Medicaid application can take weeks. Prenatal care should not wait that long, so Illinois lets certain qualified providers grant you temporary Medicaid coverage on the spot.10Illinois General Assembly. Illinois Administrative Code Title 89 Section 120.66 – Medicaid Presumptive Eligibility This is called Medicaid Presumptive Eligibility, and it is designed specifically for pregnant women.
Qualified providers include Medicaid-enrolled clinicians, federally qualified health centers, local health departments, WIC offices, and certain community organizations. The provider screens your income and household size on the spot, usually just by asking a few questions. Pay stubs are not required at that stage, and you do not need to give a Social Security number for the presumptive determination.11Medicaid.gov. MACPro Implementation Guide – Presumptive Eligibility for Pregnant Women
Coverage starts the day the provider approves you. To keep it going, you have to file a full Moms and Babies application by the last day of the month following the month you were screened. File on time and the presumptive coverage continues until the state issues a final decision. Miss that deadline and coverage ends at the close of that following month. You get only one presumptive eligibility period per pregnancy.10Illinois General Assembly. Illinois Administrative Code Title 89 Section 120.66 – Medicaid Presumptive Eligibility
Retroactive Coverage for Earlier Bills
Medical bills from before you applied may still be covered. Illinois can pay claims from up to three months before the month you submitted your application, provided you would have qualified during those months.12Illinois Department of Human Services. PM 06-25-03-a – Retroactive Coverage This matters if you had early prenatal visits or emergency care before you knew about the program. Ask providers to resubmit any qualifying bills once you are approved.
How to Apply
There are three ways to apply.
- Online through the Application for Benefits Eligibility portal at abe.illinois.gov. You can upload documents and track status through your account.
- By mail using Form HFS 2378H, downloadable from the Department of Healthcare and Family Services website. Include every page and sign where required.13Illinois Department of Healthcare and Family Services. Form HFS 2378H – Moms and Babies Application
- In person at a Family Community Resource Center. The Illinois Department of Human Services office locator lets you search by county.14Illinois Department of Human Services. Office Locator
Documents to Gather
Having these ready keeps the application moving:
- A written statement from your doctor or clinic confirming the pregnancy and your estimated due date
- Pay stubs from the last 30 days, or your most recent tax return if you are self-employed; note zero income directly on the application if that applies
- A state ID, driver’s license, or current utility bill showing your Illinois address
- Names, dates of birth, and Social Security numbers (where available) for everyone in your household, remembering that your expected baby counts
- Details of any private insurance you already have, so the state can coordinate benefits
List every household member accurately. Household size controls which income threshold applies to you, and getting it wrong in either direction causes trouble.
After You Apply
Illinois has 45 days to process your application.15Illinois Department of Human Services. Frequently Asked Questions – Medical Assistance Application Processing During that window a caseworker verifies your income, residency, and pregnancy. The decision arrives by mail. If the state asks for more documents, the clock effectively pauses until you respond, so send whatever they request quickly.
Managed Care and Your Baby’s Enrollment
Once you are approved, Illinois Client Enrollment Services assigns you to a managed care plan and a primary care provider. You will receive a packet in the mail with your assignment and a deadline for changing it if you prefer a different plan or doctor.16Illinois Department of Human Services. PM 20-24-01 – Enrolling in an MCO Picking your own plan usually works out better than accepting the auto-assignment.
When the baby is born, they are enrolled in your same plan. If the baby is added to your case within 45 days of birth, managed care coverage applies back to the birth date, which keeps hospital and newborn care from creating a coverage gap.16Illinois Department of Human Services. PM 20-24-01 – Enrolling in an MCO Report the birth as soon as you are able.
When Your Coverage Ends
Your postpartum coverage lasts 12 months from delivery. After that, you lose Medicaid unless you fit a different category, such as parent or caretaker Medicaid, which has a much lower income limit. Losing Medicaid opens a special enrollment period on the federal Marketplace: you have up to 60 days before your coverage ends or up to 90 days after to pick a plan through healthcare.gov.17Centers for Medicare and Medicaid Services. Pregnancy and Newborn Health Coverage Options Do not let that window close, since losing Medicaid is one of the few life events that lets you buy Marketplace insurance outside open enrollment.
Your baby’s path is different. Kids who were covered through Moms and Babies can move into All Kids, which covers Illinois children at higher income levels than adult Medicaid, so there is no gap in their coverage.9Illinois Department of Healthcare and Family Services. About All Kids
Appealing a Denial
If your application is denied or your benefits are cut or terminated, Illinois must send you a written notice explaining why and telling you how to appeal. The formal name for a Medicaid appeal is a State Fair Hearing, and you have 120 calendar days from the date on the notice to request one.18Illinois Department of Healthcare and Family Services. Illinois Medicaid MCO Grievance and Appeals Process To keep existing benefits running during the appeal, you must file within 10 calendar days of the notice.
Appeals can be sent by mail, fax, email, or phone. For medical service disputes, contact the Illinois Department of Healthcare and Family Services Bureau of Administrative Hearings at 69 W. Washington Street, 4th Floor, Chicago, IL 60602, email HFS.FairHearing@illinois.gov, or call 1-855-418-4421.18Illinois Department of Healthcare and Family Services. Illinois Medicaid MCO Grievance and Appeals Process If waiting could cause serious harm to your health, you can request an expedited hearing, and the denial notice will explain how.