Nearly all states now offer 12 months of Medicaid coverage after pregnancy, a major expansion from the old 60-day cutoff. But once that year ends, your eligibility shifts, and keeping coverage depends on your income, your state’s rules, and whether you take a few key steps before your postpartum period runs out.
The 12-Month Postpartum Extension
Federal law originally required states to cover pregnant people through Medicaid for only 60 days after delivery. That changed when Congress gave states the option to extend postpartum coverage to a full 12 months, and nearly every state has taken it. As of 2025, 49 states plus Washington, D.C. have implemented the 12-month extension. Wisconsin is the only state with legislation still pending.
This means your pregnancy-related Medicaid coverage continues for 12 months after your baby is born, regardless of any changes in your income during that time. You don’t need to reapply or do anything special to keep it for that year. The coverage stays in place automatically.
What Happens When the 12 Months End
Here’s where things get more complicated. Pregnancy-related Medicaid uses higher income limits than standard adult Medicaid. Many states cover pregnant people earning up to 200% of the federal poverty level or more, while income limits for parents and other adults are often significantly lower. When your postpartum year ends, you’re no longer in the pregnancy category, and your state will reassess whether you qualify under a different eligibility group.
Your state Medicaid agency will conduct what’s called a redetermination. The timing depends on when your postpartum period falls relative to your regular renewal date. If your postpartum coverage ends before your scheduled annual renewal, the state treats it as a change in circumstances and checks whether you still qualify. If it ends after your renewal date would have been, the state conducts a full renewal at the end of the postpartum period. Either way, you’ll receive a notice, and you may need to provide updated income information or other documentation. Respond promptly to any mail or messages from your state’s Medicaid office, because missing a deadline can cause your coverage to lapse even if you still qualify.
Paths to Staying Covered
Once the postpartum period ends, there are several ways you might keep health coverage. Which one applies to you depends mostly on your household income and whether your state expanded Medicaid under the Affordable Care Act.
Medicaid Expansion for Adults
If you live in one of the 40 states (plus D.C.) that expanded Medicaid, adults earning up to 138% of the federal poverty level qualify for coverage. For a family of three in 2025, that’s roughly $33,000 a year. If your income falls below that threshold, you can transition from pregnancy Medicaid to standard adult Medicaid without a gap. Your state should check for this automatically during redetermination, but verify that your contact information and income details are up to date so nothing falls through the cracks.
Parent or Caretaker Relative Coverage
Every state offers a Medicaid category for parents and caretaker relatives, but income limits vary dramatically. Some states set the cutoff well below 100% of the federal poverty level. In states that haven’t expanded Medicaid, this may be your only Medicaid option after the postpartum period, and the income ceiling can be surprisingly low. Check your state’s specific limit through your local Medicaid office or the state’s benefits website.
Marketplace Insurance With Subsidies
If your income is too high for Medicaid but you don’t have employer coverage, the Health Insurance Marketplace is your next option. Losing Medicaid triggers a Special Enrollment Period, giving you 60 days to sign up for a plan outside of the usual open enrollment window. Premium tax credits can significantly reduce your monthly costs if your household income falls between 100% and 400% of the federal poverty level, and in some cases above that range as well.
Don’t wait until your Medicaid actually ends to explore Marketplace plans. You can browse options at HealthCare.gov (or your state’s marketplace website) ahead of time so you’re ready to enroll quickly and avoid any gap in coverage.
Keep Your Information Current
The single most common reason people lose Medicaid coverage they’re still eligible for is failing to respond to renewal paperwork. States are required to first try to verify your eligibility using data they already have, like tax records and wage databases. But if they can’t confirm your information automatically, they’ll send you a renewal form. You typically have a limited window to return it.
A few things you can do right now to protect yourself:
- Update your address and phone number with your state Medicaid agency. Renewal notices sent to an old address are the top cause of preventable coverage loss.
- Set up an online account with your state’s Medicaid portal if one exists. Many states let you complete renewals electronically, which is faster and easier to track.
- Report income changes proactively. If your income drops after pregnancy (for example, if you reduce work hours), reporting that change could help you qualify under a different Medicaid category.
- Open every piece of mail from your state’s health or human services department. It may look like junk mail, but a missed notice can result in automatic disenrollment.
Your Baby’s Coverage Is Separate
Your newborn’s Medicaid eligibility is handled independently from yours. Babies born to mothers covered by Medicaid or CHIP at the time of delivery are “deemed eligible,” meaning they’re automatically enrolled without a separate application. That coverage lasts until the child turns one year old. After that, children are reassessed, but Medicaid income limits for kids are substantially higher than for adults in every state, often covering families earning 200% of the federal poverty level or more. So even if you lose your own coverage, your child will very likely remain covered.
If You’re Denied, You Can Appeal
If your state determines you’re no longer eligible after the postpartum period and you believe that’s wrong, you have the right to appeal. States must provide written notice explaining why your coverage is ending, and that notice will include instructions for requesting a hearing. Filing an appeal before your coverage termination date can, in many states, keep your Medicaid active while the appeal is being reviewed. Contact your state’s Medicaid office or a local legal aid organization if you need help navigating the process.