Texas Medicaid for pregnant women in 2025 provides full prenatal care, labor and delivery, and 12 months of postpartum coverage for low-income expecting mothers.
Eligibility is based on income up to 198% of the Federal Poverty Level and family size, counting the unborn baby. For full details, see our guide on pregnancy Medicaid income limits.
Applicants can get same-day temporary approval through presumptive eligibility at clinics while their full application processes.
Coverage includes prenatal visits, ultrasounds, lab tests, hospital delivery, mental health care, and newborn Medicaid for 12 months.
Pregnancy Medicaid Eligibility
Texas treats pregnancy as its own eligibility category, making it easier for moms to qualify.
Texas simplifies the process by treating pregnancy as an eligibility category, which helps more women qualify even if they previously didn’t meet standard Medicaid rules.
If you’re pregnant and a U.S. citizen or qualified immigrant, you can get full Medicaid; undocumented women get emergency coverage only, but babies born here qualify as citizens.
Learn more about emergency delivery services.
No asset test; it’s about income and family size, counting the unborn baby as +1.
In 2025, over 300,000 Texas women use this, higher than most states due to expansions. The shutdown slowed apps, but presumptive kicks in fast (more below).
For a broader overview of statewide requirements and options, see our Texas Medicaid complete guide.
Income Limits for Pregnant Women
Income for Texas Medicaid pregnancy tops at 198% of the federal poverty level (FPL), higher than regular Medicaid’s 138% to support moms.
For 2025 (through March 31), a pregnant woman alone qualifies up to $2,583 monthly ($31,000 yearly); with one child, $3,490 ($41,880).
Add $907 monthly per extra family member. This includes wages, child support, before taxes, with deductions for childcare.
| Family Size (Including Unborn) | Monthly Income Limit | Annual Income Limit |
|---|---|---|
| 1 (Pregnant Woman) | $2,583 | $31,000 |
| 2 | $3,490 | $41,880 |
| 3 | $4,397 | $52,764 |
| 4 | $5,304 | $63,648 |
| Each Extra | +$907 | +$10,884 |
These pregnancy Medicaid income limits Texas beat CHIP’s 201% for non-pregnant, prioritizing moms. Use HHS screener for exacts, and if you’re over the limit, you can try CHIP Perinatal.
For a full breakdown of updated Federal Poverty Level brackets and how Texas calculates family size, review the pregnancy Medicaid income limits page.
Presumptive Eligibility
Worried about waits? Presumptive eligibility in Texas lets qualified providers (clinics, hospitals) approve temporary coverage on the spot for pregnant women.
If you meet income (up to 198% FPL) and residency, get 60 days of prenatal care while your full app processes, no docs needed upfront.
In 2025, over 50,000 women used this key during shutdown delays. Find providers at HHS sites; it covers checkups, tests, but not delivery.
Apply full Medicaid right away to extend. It’s a fast start for prenatal care in Medicaid Texas.
Application Process for Pregnant Applicants
Applying is quick, online at YourTexasBenefits.com or call 2-1-1/877-541-7905 (Spanish too).
Upload ID, pay stubs, pregnancy proof (doctor note or test). Presumptive gets you immediate temp coverage; full approval in 15-45 days, often faster for moms.
Renew after birth, postpartum lasts 12 months. The shutdown caused backlogs, but priority for pregnant apps. Track via app; free navigators help.
Step-by-step instructions, required documents, and faster approval tips are available in our guide on how to apply for pregnancy Medicaid.
Covered Prenatal Services
Texas Medicaid pregnancy covers full prenatal care: Up to 20 visits, ultrasounds, lab tests, screenings for diabetes/anemia, nutrition counseling, and meds. Mental health support for depression, plus classes on birth and breastfeeding, all free if eligible.
In 2025, telehealth grew for rural moms, cutting travel. It’s comprehensive to cut risks; Texas ranks high in maternal issues.
Labor and Delivery Coverage
Medicaid pays for all labor and delivery, hospital, midwife, C-section, anesthesia, no matter the hospital. Includes pain relief, monitoring, and newborn care right after.
Choose birthing centers if in-network. 2025 updates added doula support in some plans for better outcomes. No out-of-pocket if eligible, covers complications too.
Postpartum Coverage Duration
Postpartum lasts 12 months from pregnancy end, covering checkups, family planning, mental health, and chronic care like diabetes. It’s auto after delivery, no reapply.
Texas extended from 60 days in 2023; 2025 keeps it amid high mom risks. Includes breastfeeding help and depression screens.
Emergency Delivery for Uninsured
Uninsured or undocumented? Emergency Medicaid covers labor/delivery if medically urgent. Hospitals can’t turn you away under EMTALA.
Applies if income under 198% FPL; covers birth but not prenatal/postpartum for mom.
The baby gets full Medicaid as a citizen.
Learn more about emergency delivery services.
Healthy Texas Women Program
After postpartum, Healthy Texas Women takes over for family planning, checkups, birth control, and cancer screens, up to 200% FPL, no pregnancy requirement.
Coordinates with Medicaid; auto-enroll post-delivery. 2025 added STI testing boosts.
WIC Coordination
WIC pairs with Medicaid for nutrition, free food, formula, counseling for pregnant/low-income moms up to baby’s first birthday (or 6 months postpartum if not breastfeeding).
Income up to 185% FPL; apply at clinics. Medicaid auto-refers; 2025 links apps for seamless food help.
Newborn Coverage
Newborns get automatic Medicaid for 12 months if the mom had coverage during pregnancy. Covers checkups, shots, and hospital care if needed. No separate app; starts at birth.
If mom had emergency only, baby still qualifies as a citizen.
Frequently Asked Questions (FAQ)
What is Texas Medicaid for pregnant women?
It’s a state program that provides full prenatal, delivery, and postpartum coverage for low-income pregnant women. Benefits include doctor visits, labs, ultrasounds, hospital delivery, and 12 months of postpartum care.
What are the income limits for pregnancy Medicaid in Texas for 2025?
Pregnancy Medicaid goes up to 198% of the Federal Poverty Level (FPL).
For example, a pregnant woman alone can qualify with income up to $2,583/month. Family size includes the unborn baby.
Does pregnancy count as an extra household member?
Yes. Texas counts the unborn baby as +1 in your family size, which raises the income limit and helps more moms qualify.
How fast can I get approved?
If you apply traditionally, approval takes 15–45 days, depending on backlogs.
But many women get presumptive eligibility, which grants temporary coverage the same day through clinics or hospitals.
What is presumptive eligibility?
Presumptive eligibility lets qualified providers give temporary Medicaid to pregnant women based on income and residency, no documents required upfront. It covers prenatal visits but not delivery, so you must submit a full application right away.
What services does Texas Medicaid cover during pregnancy?
Coverage includes up to 20 prenatal visits, ultrasounds, lab work, diabetes/anemia screening, prescriptions, nutrition counseling, mental health care, breastfeeding classes, and telehealth options.
Does Medicaid cover labor and delivery in Texas?
Yes. Texas Medicaid pays for all labor and delivery services, including hospital stays, C-sections, epidurals/anesthesia, midwife births, and newborn care.
How long does postpartum Medicaid last?
Postpartum coverage lasts 12 months after the pregnancy ends. This includes checkups, mental health care, chronic condition management, birth control, and breastfeeding support.
What if I’m undocumented or uninsured?
You may qualify for Emergency Medicaid, which covers only labor and delivery if it is a medical emergency. It does not cover prenatal or postpartum care.
Your baby will automatically qualify for full Medicaid as a U.S. citizen.
Where can I apply for Texas pregnancy Medicaid?
Apply online at YourTexasBenefits.com, through the YTB app, or by calling 2-1-1 / 877-541-7905. You will upload ID, proof of income, and proof of pregnancy.
Can I keep my doctor?
Yes, if your doctor is in your health plan’s network. If not, you may request to change your plan or ask for an out-of-network exception.
Does Texas Medicaid cover dental care during pregnancy?
No, adult dental services are limited. However, prenatal Medicaid covers oral health evaluations when medically necessary, and all newborn dental care is fully covered after birth.
How does WIC work with Medicaid?
If you qualify for pregnancy Medicaid, you’re very likely to qualify for WIC, which offers free food, formula, nutrition counseling, and breastfeeding support. Many moms are auto-referred.
Will my newborn automatically get Medicaid?
Yes. If the mother is on Medicaid (full or emergency) at delivery, the baby automatically receives 12 months of continuous Medicaid coverage. No new application needed.
What if my income is too high for pregnancy Medicaid?
You may qualify for CHIP Perinatal, which covers prenatal visits and delivery for babies. Texas HHS recommends applying for both; agents will place you in the correct program.
Conclusion
Texas Medicaid helps pregnant moms get the care they need. It pays for doctor visits, the baby’s birth, and care after the baby comes. If you live in Texas and are pregnant, you can apply and get help fast.
This program makes sure you and your baby stay healthy. Check the rules, see if you qualify, and sign up as soon as you can. Getting care early is the best way to have a safe and happy pregnancy.
