While it’s not common, Medicare does cover prenatal care, childbirth, and postnatal care if you are a Medicare beneficiary. However, the medical care an infant may need is not covered under Medicare.
Medicare provides government-administered health insurance for those who qualify. People who qualify for Medicare include:
- 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)
If you have Medicare and become pregnant, Original Medicare (parts A and B) will cover your care. Medicare Advantage (Part C) plans, which are provided by private insurance companies, must provide similar coverage to Original Medicare.
Keep reading to learn more about pregnancy and childbirth coverage with Medicare and what other options are available for coverage.
If you are or become pregnant while on Medicare, your plan will cover the medically necessary costs of your care. This can include:
- 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
However, you will still have out-of-pocket costs.
It’s also important to note that Medicare does not cover healthcare services the infant requires after delivery. The infant may receive coverage under another plan, such as the non-birthing parent’s insurance or health insurance through Medicaid.
Costs with Part A
Medicare Part A provides hospital insurance.
If you are hospitalized during pregnancy due to a complication or for your delivery, Part A will cover the services you need. You will have to pay a deductible of $1,676 in 2025 for each hospital stay. You may have additional costs if your hospital stay lasts more than 60 days.
Costs with Part B
Medicare Part B provides medical insurance that covers healthcare services you receive while not admitted to the hospital, known as outpatient services. In addition to the 2025 monthly premium of $185, you will also have to pay a yearly deductible of $257 before Medicare starts to pay.
You will also have out-of-pocket costs associated with healthcare services. After you have met your yearly deductible, you are typically responsible for 20% of the cost of an outpatient service.
Costs with Medicare Advantage (Part C)
Medicare Advantage plans must at least provide coverage similar to Medicare Part A and Part B coverage.
However, some plans have a specific network of providers you must visit to have your care covered. If you visit a healthcare professional or facility, such as a hospital, that is not part of your plan’s network, the plan may not cover your costs.
The rules and details vary by plan and by the insurance company that administers it. It’s best to talk with a representative or review your plan documents to determine your specific coverage.
Learn about the benefits and drawbacks of Medicare Advantage plans.
Medicaid is a program that provides health insurance to people with a low income level who qualify. States administer Medicaid services with federal funding.
To qualify for Medicaid, you must have a minimum income threshold based on Modified Adjusted Gross Income (MAGI). This amount is compared to the federal poverty level (FPL) for your household size.
If you have Medicaid, pregnancy-related care is exempt from out-of-pocket costs. Health services for children under 18 years old are also exempt from out-of-pocket costs.
Medicare and Medicaid dual eligibility
Some people are eligible for both Medicare and Medicaid. If that is the case, the programs work together to cover different aspects of your care, including pregnancy and childbirth.
If you are dual eligible, Medicare typically pays first for covered medical services. But Medicaid may pay if those services are not covered under Medicare. If services are partially covered, it may pay the remainder.
Learn more about dual eligibility for Medicare and Medicaid.
Both Medicare and Medicaid cover pregnancy-related services and childbirth if you qualify for the programs.
Medicare covers health services you receive while admitted to the hospital and as an outpatient. However, you may still have out-of-pocket costs.
For those who qualify, Medicaid covers pregnancy-related services without any out-of-pocket costs.
If you qualify for both Medicare and Medicaid, both programs will work together to cover your care.