Short answer: CHIP Perinatal covers prenatal care and delivery for the unborn child when the mother is not eligible for Medicaid and household income is at or below 202% of the federal poverty level; it has no cost sharing.
Texas treats the unborn child as the CHIP member. The mother must not be eligible for Medicaid (often because of income or immigration status), and income must meet the CHIP Perinatal limit: $5,555 per month for a household of four on HHSC’s chart effective March 1, 2026.
Key rules:
- No enrollment fee or copays.
- A pregnant woman with any private health insurance is not eligible, even if that policy has no maternity coverage.
- After birth, the baby receives CHIP benefits through the end of the 12-month enrollment segment; the mother gets two postpartum visits, not full coverage.
It is not comprehensive coverage for the mother, so it is not a substitute for her own health plan.
Sources
1 Tex. Admin. Code 370.401law.cornell.edu/regulations/texas/1-Tex-Admin-Code-SS-370-401Texas Works Handbook D-1210 and D-1730 (CHIP Perinatal)fhb.hhs.texas.gov/handbooks/texas-works-handbook/d-1730-continuous-enrollment-periodTexas Works Handbook C-131.1, Income Limitsfhb.hhs.texas.gov/handbooks/texas-works-handbook/c-130-medical-programsTexas Works Handbook (Texas HHSC)fhb.hhs.texas.gov/handbooks/texas-works-handbook/d-1210-health-insurance