Does My Newborn Automatically Get Medicaid?
Yes — if the mother was enrolled in Medicaid when her baby was born, the newborn is automatically covered by Medicaid for the first full year of life, with no separate application required. This is called "deemed newborn" coverage, and it's a federal rule that applies in every state. If the mother wasn't on Medicaid at delivery, a separate application is required.
How Does Automatic Newborn Medicaid Enrollment Work?
Under federal law (Section 1902(e)(4) of the Social Security Act), a baby born to a mother enrolled in Medicaid on the date of delivery is automatically considered to have applied for and been found eligible for Medicaid from the moment of birth.
No income test applies during the first year — coverage continues regardless of any changes in the family's income or circumstances.
The mother's Medicaid ID number is used for the baby's medical claims until the state issues a separate Medicaid ID for the child.
The hospital typically notifies the state Medicaid agency, but parents should also report the birth directly to their state Medicaid office or managed care plan to avoid billing gaps.
Citizenship documentation is not required for deemed newborns.
In Louisiana: the hospital files a Newborn Request Form through LDH's provider portal, and LDH assigns the baby a Medicaid ID within three business days. Read more: ldh.la.gov/medicaid/lamoms.
What If My Baby Was Born Before I Had Medicaid?
The deemed newborn pathway only applies if the mother was enrolled in Medicaid at the time of delivery. If she wasn't, a separate application must be submitted for the baby.
Federal law requires all states to cover infants under one year old in families with income up to at least 138% of the Federal Poverty Level; most states, including Louisiana, set thresholds higher.
If the family's income exceeds Medicaid limits, the baby may still qualify for CHIP (called LaCHIP in Louisiana), which has a higher income threshold — up to approximately 217% of the Federal Poverty Level in Louisiana.
Apply as soon as possible after birth; coverage can often be backdated to the date of birth if the baby was eligible during that period.
It's worth applying even if the parents don't qualify for Medicaid themselves, since eligibility thresholds for infants are generally more generous than for adults.
Read more on how to apply: Nest Health Louisiana Medicaid Guide.
How Long Does Newborn Medicaid Coverage Last?
Deemed newborn coverage lasts for the baby's full first year of life, regardless of any changes in household income or family circumstances during that period. After the first birthday, the child's Medicaid eligibility is redetermined.
Most children continue to qualify after the first year, either through Medicaid or CHIP, since income thresholds for children are set higher than for adults. As of January 2024, states are required to provide 12 months of continuous eligibility for children once they're found eligible at any redetermination.
How Can Nest Health Support My Newborn's First Year of Care?
Nest Health provides whole-family pediatric and primary care for eligible Medicaid members in the New Orleans and Baton Rouge areas, including newborn well visits, developmental screenings, and postpartum support for mothers — all through in-home and virtual visits at no additional cost through participating health plans.
Nest services may be available to your family at no additional cost through your Medicaid health plan. Call 866-222-NEST (6378) to check your eligibility.
