Cardinal Care Pregnancy and Postpartum Coverage

Virginia Medicaid and FAMIS provide no-cost, health coverage to pregnant members through Medicaid for Pregnant Women (MPW), FAMIS MOMS, and FAMIS Prenatal Coverage.

Covered Services

Medical visits (including care from a doctor or midwife, prenatal and postpartum visits, and general and specialty care for other health concerns)
Prescriptions
Comprehensive dental benefits through Cardinal Care Smiles
Labor and delivery, including the hospital stay
Doula services
Breast pumps and breastfeeding support
Behavioral health services, such as:
- Therapy and treatment for depression or anxiety
- Help to quit smoking or using alcohol or other drugs
- Treatment for substance use disorders
And more!

Most members get health care services through one of five Cardinal Care health plans. All health plans offer special benefits just for pregnant members, including special programs for those with high-risk pregnancies. Once enrolled, members can call their health plan’s Member Services phone number to learn more about these extra benefits. Visit the DMAS Cardinal Care page to learn more about the Cardinal Care health plans.

Eligibility

You may qualify if you:

Live in Virginia
Are pregnant or within 12 months postpartum*
Meet citizenship or immigration status requirements**
Meet family income guidelines (below)

For FAMIS MOMS or FAMIS Prenatal Coverage, individuals must also be uninsured at the time they apply to be eligible.

New applicants should report their pregnancy on the application. Providing the estimated due date or actual delivery date can also help make sure that they are enrolled correctly. Current Cardinal Care members who become pregnant should report their pregnancy by calling Cover Virginia, Monday through Friday, 8 a.m. to 7 p.m. and Saturday 9 a.m. to 12 p.m. at 1-855-242-8282 (TTY: 1-888-221-1590) and selecting the menu option for the Specialized Pregnancy Unit. The pregnancy can also be reported through the member’s account on Commonhelp.virginia.gov or to their local Department of Social Services.

* FAMIS Prenatal cannot be approved if the application is submitted after the month that that the pregnancy ends.

**FAMIS Prenatal is available regardless of immigration status and ability to provide a Social Security Number.

Income Guidelines

**Pregnancy and Postpartum Income Guidelines**
	Medicaid for Pregnant Women		FAMIS MOMS and FAMIS Prenatal
Family Size	Yearly Income	Monthly Income	Yearly Income	Monthly Income
1	$23,162	$1,931	$32,083	$2,674
2	$31,302	$2,609	$43,358	$3,614
3	$39,442	$3,287	$54,633	$4,553
4	$47,582	$3,966	$65,908	$5,493
5	$55,722	$4,644	$77,183	$6,432
6	$63,862	$5,322	$88,458	$7,372
7	$72,002	$6,001	$99,733	$8,312
8	$80,142	$6,679	$111,008	$9,251
Each Additional	$8,140	$679	$11,275	$940

2025 Income Guidelines as of January 15, 2025. Includes 5% Federal Poverty Level (FPL) disregard.

Once approved, coverage will start the month that the application was submitted and continue throughout the pregnancy. FAMIS MOMS and Medicaid for Pregnant Women coverage will continue for one year after the end of the pregnancy. FAMIS Prenatal Coverage will continue for 60 days after the end of the pregnancy. Medicaid for Pregnant Women may also cover medical bills for up to three months before the application month.

After the postpartum coverage ends, the member’s eligibility will be reviewed as a non-pregnant adult. They will be sent a letter telling them if they are still eligible or not. Members who are no longer eligible may be referred to Virginia’s Insurance Marketplace where they could be eligible to enroll in a private health insurance plan with financial assistance to help lower the cost of coverage and care.

Newborn Eligibility

Children born to Medicaid and FAMIS MOMS members are automatically eligible for and enrolled in Cardinal Care until they turn 1. Children born to FAMIS Prenatal members go through an expedited review and enrollment process. Members must tell us as soon as their baby is born so they can be enrolled. The birth can be reported to Cover Virginia at 1-855-242-8282 (TTY: 1-888-221-1590) or to the local Department of Social Services. Member can also ask the hospital or their Cardinal Care health plan about reporting the birth. To learn more, go to Enroll a newborn.

Apply

Ready to apply? Learn more and complete an application: Apply

For questions about Medicaid or FAMIS coverage for pregnant women or help completing an application, call Cover Virginia, Monday through Friday, 8 a.m. to 7 p.m. and Saturday 9 a.m. to 12 p.m. at 1-855-242-8282 (TTY: 1-888-221-1590) and select the menu option for the Specialized Pregnancy Unit.

Learn More

Members Postpartum Continuous Coverage Flyer

[PDF] English | Spanish

Stakeholders Postpartum Continuous Coverage Flyer

[PDF] English | Spanish

FAMIS MOMS Flyer