Virginia

In Virginia, a variety of health insurance options are available to assist with the costs associated with pregnancy and childbirth. These include state-sponsored programs, employer-based coverage, marketplace plans, and additional resources aimed at ensuring expectant parents have access to necessary medical services. Below is an overview of key programs and services:

1. State Plans and Programs

a. Medicaid for Pregnant Women (Cardinal Care)
Virginia's Medicaid program, known as Cardinal Care, offers comprehensive health coverage for eligible pregnant individuals. Covered services include prenatal and postpartum care, delivery services, hospital stays, and infant care up to one year after birth. Dental benefits are also provided during pregnancy and postpartum through the Smiles for Children program. Eligibility is determined based on income and household size. For more information and to apply, visit Medicaid for Pregnant Women.

b. FAMIS MOMS
The FAMIS MOMS program provides health care coverage during pregnancy and for a full year after the birth. It encourages early and regular prenatal care and ensures continued coverage even if income changes during the postpartum period. Learn more

c. FAMIS Prenatal Coverage
FAMIS Prenatal Coverage offers full health care benefits for pregnant individuals who do not meet immigration status requirements for other programs. Coverage continues for 60 days after the birth. More information is available at Coverage for Pregnant Individuals.

1. Employer-Sponsored Plans

Many employers offer health insurance that includes maternity and newborn care. Coverage typically encompasses prenatal visits, ultrasounds, labor and delivery, and postpartum care. Individuals can enroll in coverage through their own employer or a spouse’s job.

1. Health Insurance Marketplace

Through Virginia's Health Insurance Marketplace, pregnant individuals can explore various health insurance plans that cover pregnancy and childbirth. Under the Affordable Care Act (ACA), all marketplace insurance plans are required to cover maternity and newborn care as essential health benefits. Enrollment is available at Virginia's Insurance Marketplace.

1. Private/Individual Insurance Plans

Private health insurance purchased outside the marketplace may also provide coverage for pregnancy and childbirth, though benefits can vary. Additionally, dependents under the age of 26 may be covered under a parent's health insurance plan, which can include maternity care, depending on the plan's provisions.

1. Other Assistance Programs

a. Indian Health Service (IHS)
American Indian and Alaska Native individuals are eligible for healthcare services through the Indian Health Service (IHS), which includes maternity and childbirth care. Services are typically free or low-cost. Learn More

b. Sliding Fee Scale Clinics
Federally qualified health centers (FQHCs) and community health clinics in Virginia offer maternity care at reduced costs based on income.

These clinics provide services such as prenatal care, family planning, and pediatric services on a sliding fee scale.

For assistance navigating insurance options, Virginians can contact local health navigators or Certified Application Counselors through Cover Virginia or Virginia's Insurance Marketplace.