Medicaid postpartum coverage now runs a full 12 months in every state except Arkansas, which still ends coverage at the federal minimum of roughly 60 days after pregnancy. Medicaid pays for about 41 percent of all births in the United States, so the length of that postpartum window matters to a lot of new parents.1Medicaid.gov. 2024 Medicaid and CHIP Beneficiaries at a Glance: Maternal Health Because states run their own Medicaid programs within federal rules, where you live decides how long you keep coverage and, in some cases, whether you qualify at all.
How Long Coverage Lasts After Birth
Federal law sets a floor. Every state must provide pregnancy-related Medicaid through the last day of the month that includes the 60th day after a pregnancy ends, whether that pregnancy ended in a live birth, miscarriage, stillbirth, or termination.2Office of the Assistant Secretary for Planning and Evaluation. Medicaid After Pregnancy: State-Level Implications of Extending Postpartum Coverage After that, coverage stops unless you qualify under another Medicaid category.
Since 2021, states have had the option to extend that window to 12 months, and Congress made the option permanent in the Consolidated Appropriations Act of 2023. Under the statute, coverage runs through the last day of the month in which the 12-month period following the end of the pregnancy ends, which works out to slightly more than a full calendar year for most people.3Office of the Law Revision Counsel. 42 USC 1396a – State Plans for Medical Assistance
As of March 2026, 49 states plus the District of Columbia have approved the 12-month extension.4KFF. Medicaid Postpartum Coverage Extension Tracker Most secured approval between 2022 and 2024. If you are on pregnancy Medicaid in any of these states, plan on a full year of postpartum coverage.
The Arkansas Exception
Arkansas is the only state that has not adopted the extension. A bipartisan bill passed the Arkansas House in early 2025 but was voted down by a Senate committee, leaving the state at the 60-day federal minimum. Reports indicate that 44 percent of Arkansas Medicaid postpartum enrollees lost coverage in the last quarter of 2025. If you gave birth in Arkansas, expect coverage to end about two months out unless you qualify under another eligibility pathway such as income-based adult Medicaid or disability.
Wisconsin was previously an outlier with a limited 90-day extension under a Section 1115 waiver.5Wisconsin Department of Health Services. Medicaid Section 1115 Postpartum Coverage Demonstration Waiver That is no longer the case. Wisconsin’s 12-month coverage took effect July 1, 2025.
Who Qualifies
Each state sets its own income limit for pregnancy Medicaid, expressed as a percentage of the Federal Poverty Level. Across the country, those thresholds range from about 133 percent of FPL to 375 percent.6KFF. Medicaid and CHIP Income Eligibility Limits for Pregnant Women as a Percent of the Federal Poverty Level These limits are considerably more generous than what standard adult Medicaid allows. As a rough benchmark, 200 percent of FPL for a family of two in 2026 is about $42,000 in annual household income, though the exact figure shifts each year with the poverty guidelines.
Immigration status adds another layer. Federal rules generally require “qualified” noncitizens to wait five years before Medicaid eligibility, but states may waive this waiting period for pregnant individuals and children who are lawfully residing in the state, and many have.7HealthCare.gov. Coverage for Lawfully Present Immigrants Twenty-five states also use the From-Conception-to-End-of-Pregnancy option under CHIP, which covers pregnant individuals regardless of immigration status by directing coverage to the unborn child.6KFF. Medicaid and CHIP Income Eligibility Limits for Pregnant Women as a Percent of the Federal Poverty Level Whether the 12-month postpartum extension applies through that CHIP pathway depends on the state; your state Medicaid agency can tell you.
Your Coverage Is Locked In
Once you qualify for pregnancy Medicaid, your coverage is protected for the entire postpartum period, whether that is 60 days or 12 months. If your income rises above the eligibility threshold during that window, your coverage does not end.8Centers for Medicare & Medicaid Services. Improving Maternal Health and Extending Postpartum Coverage in Medicaid and the Children’s Health Insurance Program Federal regulations make this explicit: states must continue coverage regardless of changes in circumstances during the postpartum period.9eCFR. 42 CFR 435.170 – Pregnant Women Eligible for Extended or Continuous Eligibility
You do not need to report income changes during this window, and you will not face a redetermination if you return to work, get a raise, or pick up other insurance. The state waits until the postpartum period ends to reassess your eligibility.
What the 12-Month Coverage Includes
States that extend to 12 months must provide the full Medicaid benefit package during that time, not a limited version. Federal law requires that services during the extension be no less in amount, duration, or scope than what standard Medicaid enrollees receive.3Office of the Law Revision Counsel. 42 USC 1396a – State Plans for Medical Assistance That includes:
- Postpartum checkups, follow-up visits, treatment for delivery complications, and management of chronic conditions like hypertension or diabetes.
- Prescription drugs and lab work for both new and ongoing health issues.
- Screening and treatment for postpartum depression, anxiety, and substance use disorders. Nearly all state Medicaid programs cover postpartum depression screening, and CMS guidance allows states to cover maternal depression screening as part of a well-child visit as well.10Medicaid and CHIP Payment and Access Commission. Access in Brief: Postpartum Mental Health in Medicaid
- Contraception and family planning services.
The mental health piece is the practical reason the extension matters. With a full year of benefits, you can start treatment for a perinatal mood disorder at week six and continue it through month ten without losing coverage in the middle.
What Happens When Coverage Ends
When your postpartum period expires, the state runs a redetermination to check whether you qualify under any other Medicaid category, such as income-based adult coverage in expansion states or a medically needy pathway.11Centers for Medicare & Medicaid Services. Streamlining the Medicaid, Children’s Health Insurance Program, and Basic Health Program Application, Eligibility Determination, Enrollment, and Renewal Processes Final Rule Fact Sheet If your income puts you above the standard adult limit, you will likely lose Medicaid.
Losing Medicaid opens a 60-day special enrollment period on the Health Insurance Marketplace. If you know your coverage is winding down, start comparing marketplace plans a month or two before it ends so you avoid a gap. Your baby’s coverage is separate: infants born to Medicaid-enrolled parents get their own Medicaid coverage for at least one year, regardless of what happens to yours.