12-Month Medicaid Postpartum Coverage

Delaware Medicaid and DHCP/CHIP provide 12-month extended postpartum coverage for eligible people who were covered at any time during pregnancy, including certain retroactive pregnancy periods. The extension was implemented July 1, 2022 and applies regardless of how the pregnancy ends. [DE-M2]

The postpartum year can cover doctor visits, hospital care, prescriptions, labs, mental-health and substance-use treatment, transportation to covered care and other Medicaid services. [DE-M1, DE-M6]

You must have received Delaware Medicaid or DHCP/CHIP at some point during pregnancy. The pregnancy Medicaid income standard is 212% of the Federal Poverty Level. The 2026 monthly table lists $2,820 for a family of 1; $3,822 for 2; $4,827 for 3; $5,830 for 4; $6,833 for 5; $7,838 for 6; $8,840 for 7; and $9,843 for 8. Pregnancy changes household counting, so apply rather than relying only on the table. [DE-M2, DE-M3, DE-M4]

You keep your Medicaid or DHCP health coverage rather than a maternity-only package. Most benefits are delivered through AmeriHealth Caritas Delaware, Delaware First Health or Highmark Health Options. [DE-M1, DE-M6]

Coverage begins the day the pregnancy ends and continues through the last day of the month in which the 12-month period ends. Continuous postpartum coverage is not ended because of a later change in income, household or family composition. [DE-M2]

Cost-sharing depends on your category and the service, so there is no one universal copay to publish. Confirm with your MCO or Delaware Medicaid. [DE-M1, DE-M6]

If you are pregnant and not enrolled, apply through Delaware ASSIST. If you are already on Medicaid, report the pregnancy and the date it ends and keep your address and phone current. Manage your case through ASSIST and the Medicaid Member Portal. [DE-M5, DE-M7]

Household, income, residency, pregnancy and citizenship/immigration information. The pregnant-person category counts the pregnancy in family size. Respond to any proof requests by the deadline.

You cannot qualify for the postpartum period alone if you were not eligible during pregnancy. Emergency-only labor and delivery services do not create 12-month postpartum eligibility. Immigration rules differ for pregnant people and children, so apply rather than self-disqualifying — but emergency-only coverage is not full pregnancy Medicaid. [DE-M2, DE-M4]

Medicaid is separate from Delaware Paid Leave, and you can qualify for both. Doula, behavioral-health, transportation and postpartum nutrition supports sit within or alongside Medicaid.

Start with your MCO. To choose or change your MCO, call the Health Benefits Manager at 1-800-996-9969, TTY 711. [DE-M6, DE-M7]

Medicaid and DSS provide language assistance, and provider search filters by language. Interpreter access is not the same as a culturally matched clinician.

Use ASSIST or HealthCare.gov and other state and federal options. WIC, Healthy Women Healthy Babies, home visiting and some community behavioral services have separate rules.