How to get prenatal care when you have no insurance

Check Medicaid first

Prenatal care is the check-up care you get while you are pregnant. If you have no insurance, check Medicaid first. Medicaid is a health program for people with lower incomes. The federal government and each state run it together.

A group that advises Congress on Medicaid has numbers on this. It says Medicaid and the Children's Health Insurance Program, or CHIP, paid for slightly less than half of all U.S. births in 2018.

That group says federal rules cover pregnant women with incomes up to 138 percent of the federal poverty level. The poverty level is an income number that the government sets each year. As of 2023, all but four states covered pregnant women at higher incomes than that. Each state sets its own exact limit, so the quickest way to learn yours is to apply.

HealthCare.gov says you can apply for Medicaid or CHIP at any time of year. You do not have to wait for Open Enrollment, which is the yearly sign-up period. If you qualify during your pregnancy, Medicaid keeps covering you after you give birth. Almost every state now covers you for a full 12 months after the birth. Ask your state Medicaid office what its rule is. Whether you qualify depends on your household size, your income and your immigration status.

Coverage that can start right away

A full Medicaid application can take a while to be approved. Presumptive eligibility is a way to start your coverage sooner. It begins before your full application is finished. The federal Medicaid agency explains that a trained provider makes a quick decision based on your household income. That decision covers your prenatal visits, and the coverage starts the day it is made.

This early coverage has an end date that you need to know about. You must turn in a full application by the last day of the month after the decision, or the coverage ends that day. If you apply on time, the coverage continues until your application is approved or denied. You get one of these early periods for each pregnancy.

Not every state offers this option, so ask the clinic whether your state does. The federal Medicaid agency says health care providers, schools and community groups can be trained to make this decision. If the first place cannot help, call another one.

Free and low-cost clinics for pregnancy

If you do not qualify for Medicaid, call a community health center next. These clinics get federal money, and they adjust their fees by income and family size. A federal health agency says they serve everyone, even people who cannot pay. That agency's list of health center services names prenatal care. A center can give that care itself or arrange it with another provider. Our guide on community health centers shows how to find one.

When you call, these questions will help you get clear answers.

• Ask whether the center offers prenatal visits itself or sends patients to another office.
• Ask what a visit costs at your income and whether there is a payment plan.
• Ask which tests and ultrasounds are included in the fee and which ones cost extra.
• Ask where you will deliver the baby and who can answer questions about that hospital's bills.
• Ask whether someone at the center can help you apply for Medicaid while you are a patient.

The same questions work if you search for a free clinic for pregnancy near you. Our guide to free clinics explains what they usually offer and what to do when one is full. A direct primary care doctor can also help with health needs outside the pregnancy. That is a membership that usually costs $50 to $200 a month. This kind of membership is not insurance, so delivery and hospital care are separate costs. You can search for a cash-pay doctor near you on our site.

What prenatal care and delivery cost without insurance

We could not find a national price for a full pregnancy, so we do not give a total. A 2021 study in JAMA Network Open does give hospital cash prices for a few services. A cash price is what a person pays without insurance. The hospitals posted these prices as of July 2021.

• Routine pregnancy care with a vaginal delivery had a median cash price of $3,322 at 127 hospitals. The middle half charged between $2,400 and $4,514. This billing code covers the doctor's or midwife's care for the prenatal visits, the delivery and the check-up after birth. The hospital stay is billed separately, so ask the hospital for its own price too.
• A cesarean delivery, which is birth by surgery, had a median cash price of $3,650 at 108 hospitals. The middle half charged between $2,665 and $5,571. The hospital stay is billed separately here as well.
• A pregnancy ultrasound of one baby had a median cash price of $464 at 1,305 hospitals. The middle half charged between $286 and $686.
• A set of blood tests for pregnancy had a median cash price of $187 at 579 hospitals. The middle half charged between $121 and $295.

A median is the middle number, so half of the hospitals charged less than it and half charged more. These prices come from hospitals in 2021, so a clinic or birth center may charge differently. Ask what a quoted price includes, such as the doctor's fee, the hospital stay and care for the baby. Use these numbers only as a rough guide for your own questions.

Help with the bills, and what to do in an emergency

Before your due date, ask the hospital where you plan to deliver about its financial assistance policy. Our guide on hospital financial assistance explains how to apply. You should also ask for a written price. If you schedule care ahead of time, you may be entitled to a good faith estimate. That is a written price estimate for the care.

HealthCare.gov notes that being pregnant does not open a Special Enrollment Period for a Marketplace plan. The birth of a child does open one. A Special Enrollment Period is a window to buy a plan outside the yearly sign-up time. Medicaid and CHIP are open at any time, so they are the faster route during a pregnancy.

This page is general information and is not medical advice. Get care right away if you have bleeding or fluid leaking, severe belly pain or a bad headache that will not go away. The same is true for changes in your vision, chest pain, trouble breathing or your baby moving less. The CDC lists these as urgent warning signs in pregnancy. In an emergency, call 911 or go to the nearest ER. If you think you are in labor, go to the hospital, because federal law requires its emergency department to check you whether or not you can pay.