Prenatal care, labor, and postnatal care are covered by Medicare if you are a beneficiary, albeit this is uncommon. Medicare does not, however, cover the medical treatment that an infant might require.

For eligible individuals, Medicare offers government-administered health insurance. The following individuals are eligible for Medicare:

• adults age 65 years or older
• people who receive Social Security Disability Insurance (SSDI)
• people with certain health conditions, including end-stage renal disease (ESRD) and amyotrophic lateral sclerosis (ALS)

Original Medicare (parts A and B) will pay for your care if you are a Medicare beneficiary and get pregnant. Private insurance firms’ Medicare Advantage (Part C) plans are required to offer coverage comparable to Original Medicare.

To find out more about Medicare’s coverage of pregnancy and childbirth as well as alternative coverage options, continue reading.

Does Original Medicare cover the full cost of pregnancy and childbirth?

Your Medicare plan will pay for the medically required expenses of your care if you get pregnant or are already pregnant. This may consist of:

• doctor’s appointments and check-ups
• lab work, such as bloodwork and other tests you need
• hospital admission
• childbirth, whether a vaginal delivery or Cesarean delivery
• your postpartum care
• ER visits

You will still have to pay for it out of pocket, though.

It’s also crucial to remember that Medicare does not pay for postpartum medical care for the newborn. Health insurance through Medicaid or the insurance of the non-birthing parent may provide coverage for the infant.

Costs with Part A

Hospital insurance is provided by Medicare Part A.

The services you require will be covered by Part A if you are admitted to the hospital during pregnancy for a delivery or a complication. In 2025, there will be a $1,676 deductible for every hospital stay. If you stay in the hospital for longer than 60 days, you can incur additional expenses.

Costs with Part B

Medicare Part B offers health insurance that includes coverage for outpatient treatments, or medical care you receive without being admitted to the hospital. Before Medicare begins to pay, you will need to pay a $257 annual deductible in addition to the $185 monthly premium for 2025.

Additionally, there will be out-of-pocket expenses for medical procedures. You usually pay 20% of the outpatient service’s cost after your annual deductible has been satisfied.

Costs with Medicare Advantage (Part C)

Medicare Advantage plans are required to offer coverage that is comparable to that of Medicare Parts A and B.

Some plans, however, require you to visit a particular network of providers for your care to be covered. Your plan might not pay for you if you visit a medical practitioner or facility—like a hospital—that is not covered by its network.

The specifics and regulations differ depending on the insurance provider and the plan. To find out your exact coverage, it’s best to speak with a representative or go over your plan documentation.

Does Medicaid cover the full cost of pregnancy and childbirth?

Medicaid is a program that offers health insurance to eligible individuals with low incomes. Medicaid services are administered by states using federal funds.

You need to meet a Modified Adjusted Gross Income (MAGI) minimum income criteria to be eligible for Medicaid. The federal poverty level (FPL) for your household size is contrasted with this sum.

Pregnancy-related care is free of out-of-pocket expenses if you have Medicaid. Children under the age of eighteen are likewise excluded from paying out-of-pocket for medical care.

Medicare and Medicaid dual eligibility

Some individuals qualify for both Medicaid and Medicare. If so, the programs collaborate to address various facets of your care, such as pregnancy and delivery.

Medicare usually covers covered medical services first if you are dual-eligible. However, if Medicare does not cover those services, Medicaid might. It might cover the remaining amount if services are only partially covered.

The bottom line

If you are eligible, pregnancy-related services and deliveries are covered by both Medicare and Medicaid.

Medicare pays for medical care you receive both as an outpatient and during your hospital stay. You might still have to pay for it out of pocket, though.

Medicaid provides free out-of-pocket coverage for pregnancy-related services for eligible individuals.

Medicare and Medicaid will cooperate to pay for your care if you are eligible for both programs.

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